As obesity continues to rise in the West people are becoming more and more conscious of the health risks from being significantly overweight and of the increased risk of death resulting from obesity. But to what extent are these risks lessened by undergoing gastric bypass surgery?
A recent study examined the histories of a substantial number of individuals who had bariatric surgery in the 10 years from the start of 1995 to the end of 2004 and discovered that roughly one percent of patients died within a year of their surgery while roughly 6 percent died inside 5 years. When the figures were adjusted to take account of sex and age and matched against figures for the population as a whole they were discovered to be reasonably high. So what does this say about the ability of gastric bypass surgery to lessen the general risk to our health?
To answer this question we must look beyond the headline figures and look at just why these deaths happened and where the real variation lies between the general population and obesity patients.
When you examine the detailed figures two particular things stand out.
The first is the number of patients whose deaths resulted from heart disease which is the leading cause of death in the weight loss patients and is substantially above that seen in the general population.
The second is the number of deaths which resulted from suicide and from drug overdoses which, while not officially recorded as suicide, must nevertheless raise the question of whether these overdoses were truly accidental. In the general population you might expect to see roughly 2 deaths from suicide in a group of the same size as the study group and yet this group of patients showed no fewer than 30 suicides and drug overdoses.
When we examine these results and consider them alongside our general knowledge about individuals undergoing gastric bypass surgery then we can possibly understand this variation at least in part.
Although bariatric surgery is normally extremely successful it is often not performed until individuals are suffering from other medical problems and, while surgery can cure several of these problems and lessen the risks from others, a lot of individuals still remain at some risk even following surgery. For example, in a lot of cases people continue to be troubled by things like diabetes and hypertension and it is possibly unsurprising that this section of the population at large remains at higher risk from heart disease.
Also, while gastric bypass surgery may lead to a considerable loss in weight a lot of people remain heavily overweight for a considerable time following surgery and some people will stay that way for years to come.
As a final point, the changes in lifestyle which follow surgery are dramatic and a lot of individuals experience depression during the weeks and months following their surgery. Without doubt a great deal of attention is paid to the physical affects of obesity surgery and the requirement for things like a strictly controlled diet and an exercise program but, more often than not, very little more than lip service is paid to the psychological affects of surgery.
Only time will show the extent to which this explanation holds water but there can be little doubt that improved post-operative care for obesity patients would go a long way to solving this anomaly.