One weight-loss surgery shows lasting results

September 21, 2017 by Amy Norton, Healthday Reporter

(HealthDay)—Obesity surgery can have long-lasting effects on weight and the risk of developing type 2 diabetes and high blood pressure, a new study finds.

Doctors have known that a type of obesity , called gastric bypass, works in the short-term. Patients typically lose a lot of weight, and obesity-related health problems can be prevented or even cured.

But the new findings show that the benefits are still apparent 12 years later.

The study, of more than 1,100 severely obese adults, found that those who underwent gastric bypass lost an average of 100 pounds over two years. By year 12, they'd managed to keep 77 of those pounds off.

On top of the weight loss, had a much lower risk of developing type 2 diabetes—92 percent lower, versus obese patients who did not have surgery.

"This is very effective at diabetes prevention," said lead researcher Ted Adams, a professor at the University of Utah School of Medicine.

The surgery can also reverse existing diabetes. At year 12, half of patients who'd had type 2 diabetes before surgery were in remission, according to the study.

Still, Adams said, gastric bypass has risks, and it's considered a last resort after other weight-loss attempts have failed.

So candidates for the surgery should go in fully informed of the pros and cons, Adams said.

An obesity specialist who was not involved in the study agreed.

"It does take a lot of before and after surgery. And this is not a cure-all for diabetes," said Dr. Scott Isaacs, medical director of Atlanta Endocrine Associates.

The hard work includes a lifelong commitment to diet and exercise changes. So the surgery itself is no "magic bullet," said Isaacs, who is a spokesperson for the Obesity Society.

That said, he called the news findings "really clear-cut."

"It's one of the best studies we've had done to date," Isaacs said. "And it shows that this is a safe, effective surgery with durable results."

The study, funded by the U.S. National Institutes of Health (NIH), involved 1,156 severely obese adults.

In all, 418 underwent gastric bypass, while the rest either did not seek surgery or considered it but did not go through with it—mostly for insurance reasons.

During , a surgeon staples the stomach to create a "pouch" that can hold only a small amount of food at a time. Then a passage is created from the pouch to the middle of the small intestine—limiting the body's absorption of nutrients.

In general, Isaacs said, the surgery is reserved for people with a (BMI) of at least 40 —meaning they're around 100 pounds or more overweight. It may also be recommended for people who have a BMI of 35-plus and health conditions such as diabetes or heart disease.

There are risks from the surgery itself, including blood clots, infections and bleeding, according to the NIH.

"It's a major surgery," Adams said, "and you can't reverse it."

The risk of death, he added, is low—on par with hip replacement surgery—but it's a possibility.

After surgery, Isaacs said, there's a risk of nutrient deficiencies, so patients need to take prescribed supplements.

All of that has to be weighed against the potential benefits, Adams said.

Of surgery patients in his study, 3 percent developed diabetes over the next dozen years. That compared with 26 percent of nonsurgery patients.

Similarly, 16 percent developed , versus more than 40 percent of other patients.

Of patients who'd had before surgery, 75 percent went into remission by year two. That waned to 51 percent by year 12.

Still, Adams said, the long-term remission rate is "pretty remarkable."

There was one concerning finding—one that past studies have uncovered, too. Seven study patients died by suicide after having surgery.

It's not clear why, Adams said. But in the surgery group did tend to report a poorer quality of life before having the procedure, he said, versus people who did not opt for surgery.

It's possible, Adams speculated, that for certain people, the surgery did not improve their life to the degree they'd hoped.

Also, Isaacs noted that research suggests the surgery may change the way alcohol is metabolized—and potentially contribute to drinking problems in certain people.

The study findings were published in the Sept. 21 issue of the New England Journal of Medicine.

Explore further: Bariatric surgery found to reduce future health care costs

More information: Ted Adams, Ph.D., M.P.H., Intermountain Healthcare Live Well Center, and adjunct professor, internal medicine, University of Utah School of Medicine, Salt Lake City; Scott Isaacs, M.D., endocrinologist and medical director, Atlanta Endocrine Associates, Atlanta, and spokesperson, The Obesity Society, Silver Spring, Md.; Sept. 21, 2017, New England Journal of Medicine

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more on obesity surgery.

Related Stories

Bariatric surgery found to reduce future health care costs

November 5, 2015
(HealthDay)—Gastric bypass surgery may save health care dollars down the road, a new study suggests. The findings were scheduled to be presented at ObesityWeek 2015, a meeting hosted by the American Society for Metabolic ...

Delaying bariatric surgery until higher weight may result in poorer outcomes

July 26, 2017
Obese patients who underwent bariatric surgery were more like to achieve a body mass index (BMI) of less than 30 one year after surgery if they had a BMI of less than 40 before surgery, according to a study published by JAMA ...

Bariatric surgery tied to T2DM resolution in obese patients

February 16, 2017
(HealthDay)—Five years after bariatric surgery, patients with type 2 diabetes who have the procedure show better improvements in quality of life and overall health, compared with those who only take diabetes medications, ...

Weight loss surgery linked to gastrointestinal complaints

December 19, 2016
Laparoscopic gastric bypass is an effective treatment for obesity, but a new study finds that patients who undergo the surgery often complain of gastrointestinal problems.

Could drugs replace gastric bypass surgery?

February 8, 2017
Gastric bypass surgery is one of the most successful treatments for obesity and related disorders; however, some patients may not want to undergo surgery.

Weight-loss surgery has low complication rates, study finds

November 6, 2014
(HealthDay)—People with type 2 diabetes who undergo a weight-loss procedure called laparoscopic gastric bypass surgery have a low risk for complications or death, according to a new study.

Recommended for you

Surgeons have substantial impact on genetic testing in breast cancer patients who need it

July 3, 2018
For many women diagnosed with breast cancer, genetic testing can offer important information that might guide treatment choices. But studies have shown that only about half of women who could benefit receive genetic testing.

First major study comparing robotic to open surgery published in The Lancet

June 21, 2018
The first comprehensive study comparing the outcomes of robotic surgery to those of traditional open surgery in any organ has found that the surgeries are equally effective in treating bladder cancer. The seven-year study, ...

Antibodies may predict transplant rejection risk

June 19, 2018
The presence of certain antibodies in patients may suggest a higher risk of transplant rejection across multiple organ types, including the kidney, liver, heart and lungs, according to a new study published in PLOS Medicine.

First human test of robotic eye surgery a success

June 18, 2018
Researchers from the University of Oxford have completed the first successful trial of robot-assisted retinal surgery.

Surgical blood transfusions tied to clot risk

June 13, 2018
(HealthDay)—Blood transfusions around the time of surgery may raise your risk for dangerous blood clots, researchers say.

Tonsil and adenoid removal associated with respiratory, allergic and infectious disease

June 7, 2018
Tonsil and adenoid removal associated with long-term risks of respiratory, allergic and infectious diseases Removing tonsils and adenoids in childhood increases the long-term risk of respiratory, allergic and infectious diseases, ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.