More Evidence That Weight-Loss Surgery Prevents Early Death
For those who are obese, weight-loss surgery can boost quality of life and quickly improve some chronic health conditions, like type 2 diabetes. Now, a new study confirms that weight-loss procedures probably also add years to your life.
Canadian researchers found that people who had bariatric surgery reduced their risk of dying from any cause by about one-third over five years. Folks 55 and over seemed to fare even better -- cutting their risk nearly in half.
The study also found that the risk of dying from heart disease and stroke (cardiovascular disease) or from cancer was also reduced by about 50%.
"People sometimes shy away from having surgery because they think the damage has been done, but our findings show there's no reason not to do bariatric surgery in older age groups," said study lead author Dr. Aristithes Doumouras. He's an associate professor and bariatric surgeon at McMaster University and St. Joseph's Healthcare's Centre for Minimal Access Surgery in Toronto.
More than 26,000 people from Ontario participated in the study. Based on their height and weight measurements, their average body mass index (BMI) was 47 -- extremely obese. A BMI of 30 or more is considered obese.
Half underwent weight-loss surgery; half did not. Nearly 9 in 10 of those who had surgery underwent gastric bypass -- a procedure that allows food to bypass most of the stomach and part of the small intestine. The rest had the newer gastric sleeve procedure -- a surgery that removes most of the stomach. The researchers then followed their health for an average of nearly five years.
Doumouras said it's not clear yet whether there are specific benefits from the surgery itself, or if it's just the weight loss that provides benefits. He said this is a hard question to answer because people who have the surgery lose substantial amounts of weight, and it's difficult to lose large amounts of weight and keep it off on your own without an operation.
"My personal opinion is that I think surgery does have specific benefits for type 2 diabetes and heart disease. With surgery, people often can come off their diabetes medications, sometimes within hours of surgery. I think surgery offers metabolic effects beyond weight loss," Doumouras said.
The study was published Aug. 17 in the Annals of Internal Medicine.
Another study in the same issue of the journal -- conducted by researchers led by Dr. Carlos Schiavon from the HCor Research Institute in Sao Paolo, Brazil -- found a benefit from weight-loss surgery in 100 people with mild obesity (BMI of 30 to 40) and high blood pressure.
After three years, people who had surgery took one blood pressure medication versus three medications for the nonsurgery group. Plus, about 1 in 3 people who underwent surgery were able to come off their high blood pressure medications entirely. These study authors suggest that weight-loss surgery may be a good option for people who aren't very obese, but have hard-to-control high blood pressure.
While weight-loss surgery clearly has significant benefits, it's not a panacea. Some people regain weight. Others have to contend with side effects such as vitamin deficiencies and nausea or diarrhea after eating (dumping syndrome), usually when they don't follow a recommended diet, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.
Dr. Marc Bessler is chief of minimal access/bariatric surgery at New York-Presbyterian Hospital and Columbia University Medical Center. "We tell patients that bariatric surgery is a tool," he said. "Obesity isn't just one disease, so there isn't just one answer. For some patients, everything falls into place after surgery, but for some, they'll regain weight."
Bessler said the idea that weight-loss surgery can decrease mortality rates isn't new. He said what was interesting about the Canadian study was that even older patients can see a benefit. He said people sometimes don't have the surgery because they think they won't have time to accrue benefits from the procedure.
But Bessler advised, "Don't wait till you have diabetes or cancer to get surgery. Damage to your joints, your cells and metabolic stress aren't always reversible, so don't put it off. For obese patients with type 2 diabetes, bariatric surgery is two times as effective at achieving remission."
Doumouras added, "People up to age 70 can probably have benefits."
Learn more about weight-loss surgery from the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.
SOURCES: Aristithes Doumouras, M.D., M.P.H., associate professor and bariatric surgeon, McMaster University and St. Joseph's Healthcare's Centre for Minimal Access Surgery, Toronto, Canada; Marc Bessler, M.D., chief, division of minimal access/bariatric surgery, New York-Presbyterian Hospital and Columbia University Medical Center; Annals of Internal Medicine, Aug. 17, 2020