Weight-loss surgery boosts survival rate
Updated: 2007-08-23 11:10
LOS ANGELES -- The first long-term studies of stomach stapling and other radical obesity treatments show that they not only lead to lasting weight loss but also dramatically improve survival. The results are expected to lead to more such operations, possibly for less severely obese people, too.
 Herb Olitsky, a 53-year-old business owner from New York City, walks across Manhattan's 47th Street, Wednesday, Aug. 22, 2007. Olitsky, who stands 5 feet 8 inches tall and underwent stomach-stapling surgery in 1999 and went from 520 pounds to his current weight of 160, credits his improved lifestyle to gastric bypass. [AP] |
Researchers in Sweden and the United States separately found that obese people who underwent drastic surgery had a 30 percent to 40 percent lower risk of dying seven to 10 years later compared with those who did not have such operations.
The research, published in Thursday's New England Journal of Medicine, should put to rest uncertainties about the benefits and risks of weight-loss surgery and may cause governments and insurers to rethink who should qualify for the procedure, some doctors said.
"It's going to dispel the notion that bariatric surgery is cosmetic surgery and support the notion that it saves lives," said Dr. Philip Schauer, director of bariatric surgery at the Cleveland Clinic in Ohio, who had no role in the research.
Obesity surgeries have surged in recent years along with global waistlines. In the United States alone, 177,600 operations were performed last year, according to the American Society for Metabolic & Bariatric Surgery. The most common method was gastric bypass, or stomach-stapling surgery, which reduces the stomach to a small walnut-sized pouch and bypasses part of the small intestine where digestion occurs.
The Swedish study is the longest look yet at how obesity surgery affects mortality.
Researchers led by Dr. Lars Sjostrom of Goteborg University compared 4,047 people with a body-mass index over 34 who had one of three types of surgery or received standard diet advice. BMI is a standard measure of height and weight and a BMI over 30 is considered obese.
After a decade, those in the surgery group lost 14 percent to 25 percent of their original weight compared to 2 percent in the other group. Of the 2,010 surgery patients, 101 died. There were 129 deaths in the comparison group of 2,037 people.
In the US study, Ted Adams of the University of Utah led a team that looked at 7,925 severely obese people in the state who had gastric bypass. They were matched with similar people who did not have the operation and who were selected through their driver's license records listing height and weight.
After an average of seven years' follow-up, 213 people who had surgery died compared to 321 who did not have the procedure. The study did not look at weight loss.
Deaths from diabetes in the surgery group were dramatically cut by 92 percent; from cancer by 60 percent and from heart disease by 56 percent. Surprisingly, the surgery group had a higher risk of death from accidents, suicides and other causes not related to disease. The researchers were puzzled by this.
Both studies were done before surgery advances that have led to smaller incisions and faster recovery time. Experts say future long-term survival rates from obesity surgery should be even better.
While neither study was the gold standard test, where patients are randomly given one treatment or another, surgery's dramatic benefits make it ethically hard to deny patients the operation, said Dr George Bray of the Pennington Biomedical Research Center at Louisiana State University.
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