For years people have wondered whether gastric bypass surgery on severely obese people would reduce the likelihood of early mortality or create further complications. A study completed by U researchers reveals that the benefits of weight loss achieved by the surgery outweigh potential risks.
The study looked at 10,000 severely obese patients who received the surgery over the past 18 years and 10,000 severely obese patients who didn't undergo surgery. Of the 20,000 patients reviewed, those who had surgery were much less likely to die from diabetes, coronary artery disease and, oddly enough, cancer. Obese patients who did not recieve the surgery were about twice as likely to die from cancer or coronary artery disease and about nine times more likely to die due to diabetes.
There have been concerns about the risks involved with gastric bypass surgery, an operation that literally bypasses the stomach and creates a small pouch connected to the small intestine. The small pouch makes it difficult to eat quantities of food larger than a person's fist.
"We thought we'd find that the surgery group would have decreased mortality rates because generally studies have shown that they improve in health with lower blood cholesterol, diabetes going away and more," said Ted Adams, program director of the Intermountain Health and Fitness Institute at LDS Hospital and professor in the Division of Cardiovascular Genetics.
However, some of the study's findings came as a surprise.
Although the surgery group was less likely to die from severe obesity, they were more likely to die from car accidents, suicide and other non-disease related causes.
"No one was sure that the risks involved in gastric bypass surgery and the subsequent change in lifestyle would outweigh the benefits in health," said Steve Hunt, co-author of the study and a research professor in cardiovascular genetics. There is no definite answer as to why patients who had the surgery were more likely to die from alternate causes.
"It might be because the surgery group were able to get out of the home and drive more, or a chemical dependency may be the cause, too," Hunt said. "We just don't know enough yet."
Two additional studies are being planned to look into what lifestyle changes occurred with the surgery group to alter mortality rates and what increased the likelihood of cancer in those who did not undergo the surgery.
Nonetheless, the researchers believe the study was successful and will be very useful in the future for patients and doctors determining the various risks and benefits of having gastric bypass surgery.
Doctors and patients should spend considerable time making the decision that is best for that patient, Adams said.
Michael English, a third-year medical student, said the study would aid patients in deciding whether to commit to a life-altering surgery such as gastric bypass.
"(The study) should help patients understand the risks and developments of this surgery, and it shows the importance of diet and exercise," English said.
l.groves@chronicle.utah.edu
