Bariatric Surgery Halves Risk of Death, New JAMA Study Finds

Published in February Issue             

Middle-age men and women who had bariatric surgery had half the risk of death compared to those who treated their severe obesity with dieting and behavior modification alone over a 10-year period, according to a study published in the January obesity-themed issue of the Journal of the American Medical Association (JAMA).

"We showed that a long-term effect of bariatric surgery is a longer life for obese patients," said study co-author Philip Greenland, MD, professor of preventive medicine at Northwestern University Feinberg School of Medicine in a news release.

Researchers from Northwestern University and the Clalit Health Services’ Research Institute in Israel conducted a retrospective review of the electronic health records from an HMO in Israel of 33,540 patients for up to a decade.

They found, among patients who had bariatric surgery, there were 105 deaths (1.3%) compared to 583 deaths (2.3%) in the non-surgical group. The study, which ran from 2005 until 2014, compared 8,385 people who had either a gastric band, sleeve gastrectomy or gastric bypass to 25,155 patients who received traditional obesity management from a primary care physician, which may have included dietary counseling and behavior modification. On average, patients were 46-years-old and had a body mass index (BMI)
of 40. The median follow-up in the study was 4.3 years.

The most common comorbidities in the surgical and nonsurgical groups were diabetes, hyperlipidemia, and hypertension, which all significantly improved among the surgery patients. Diabetes remission was achieved by 23.6 percent of surgery patients versus 5.1 percent of all nonsurgical care patients.

The rate of hospital admission was 37.1 percent among nonsurgical patients and 43.2 percent in the surgery group, with the highest rate among gastric band patients (52%).

The JAMA “Reimagining Obesity in 2018” issue also highlighted four other studies on bariatric surgery including a second comparative study that showed patients with severe obesity not treated with bariatric surgery were significantly less likely to achieve remission of diabetes, hypertension, and dyslipidemia, and were at greater risk for new-onsite hypertension.

"Surgery sounds like a radical approach to managing obesity, and a lot of people reject it because it seems like a risky thing to do, but it's actually less risky to have the surgery," said Dr. Greenland in a news release about the study.

People with obesity are more likely to have life-threatening conditions and diseases including type 2 diabetes, hypertension, sleep apnea and many others. Previous research has shown significant decreases in mortality rates due to reductions in obesity-related diseases, which after surgery, drop by up to 80-90 percent.

Samer Mattar, MD

“The evidence continues to mount and our real-world experience continues to show bariatric surgery not only prevents, resolves, and improves obesity-related diseases, but also extends life,” said Samer Mattar, MD, President, American Society for Metabolic and Bariatric Surgery (ASMBS) and Medical Director, Swedish Weight Loss Services in Seattle, Washington. “It continues to amaze me that with all those proof, only between 1 and 2 percent of patients with severe obesity in the United States have bariatric surgery.
This needs to change.”