Researchers from the Geisinger Health System followed nearly 2,700 patients who had gastric bypass at the system’s nationally accredited bariatric surgery center between 2004 and 2014. Mortality benefits began to emerge within two years after surgery and were significant within four years. The biggest reduction in risk occurred in patients 60 years or older at the time of surgery and in patients who had diabetes before surgery.
“The long-term survival benefits these older patients and those with diabetes experience likely relate to improvements in long-term metabolic and cardiovascular health, among other risk factors,” said Michelle R. Lent, Ph.D., a Geisinger Obesity Institute researcher, who presented her team’s findings. “While this study did not evaluate specific-cause mortality, as expected, we did find significant improvements or remission in diabetes and high blood pressure.”
In the study, more than 60 percent of patients with diabetes before surgery experienced diabetes remission about five years after surgery. Previous studies have shown death from heart disease and even certain cancers are lower in gastric bypass patients than patients with severe obesity who do not have the operation.
“While bariatric surgery provides significant health benefits to most patients, it is important to note that in our study some of the strongest mortality risk reductions following gastric bypass were found in older adults,” said Dr. Lent. “Until recently, older age was viewed as a relative contraindication to bariatric surgery, as the benefits were less clear. Our findings help to challenge that myth and instead support offering the surgery to older patients.”
People with obesity and severe obesity have higher rates of heart disease, diabetes, some cancers, arthritis, sleep apnea, high blood pressure and dozens of other diseases and conditions. Studies have shown individuals with a BMI greater than 30 have a 50 to 100 percent greater risk of premature death compared to healthy weight individuals.[1][2]
“Obesity and related diseases kill and the data continues to confirm this fact,” said Raul J. Rosenthal, MD, ASMBS President and Chairman, Department of General Surgery, Cleveland Clinic Florida, who was not involved in the study. “The good news is the Geisinger study shows we can do something about it. The long-term data on bariatric surgery provides the proof.”
Metabolic/bariatric surgery has been shown to be the most effective and long lasting treatment for severe obesity and many related conditions and results in significant weight loss. The Agency for Healthcare Research and Quality (AHRQ) reported significant improvements in the safety of metabolic/bariatric surgery due in large part to improved laparoscopic techniques.[3] The risk of death is about 0.1 percent[4] and the overall likelihood of major complications is about 4 percent.[5]
According to the Centers for Disease Control and Prevention (CDC), in 2011–2014, the prevalence of obesity was just over 36 percent in adults, with a higher prevalence among women than men (38.3% vs. 34.3%) and older than younger adults (37% vs. 32.3%). Obese is medically defined as having a body mass index (BMI), a measure of height to weight, that's more than 30. The ASMBS estimates about 24 million Americans have severe obesity, which would mean a BMI of 35 or more with an obesity-related condition like diabetes or a BMI of 40.
About the ASMBSThe ASMBS is the largest organization for bariatric surgeons in the nation. It is a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of morbid obesity, as well as the associated risks and benefits. It encourages its members to investigate and discover new advances in bariatric surgery, while maintaining a steady exchange of experiences and ideas that may lead to improved surgical outcomes for morbidly obese patients. For more information, visit http://www.asmbs.org. ###
*Long-Term Mortality Risk Following Roux-en-Y Gastric Bypass (RYGB): A Case-Control StudyWood G. Craig Danville PA1, Peter Benotti Danville PA1, Tooraj Mirshahi Danville Pennsylvania2, Glenn Gerhard Philadelphia PA3, William Strodel Danville PA4, Anthony Petrick Danville PA4, Jon Gabrielsen Danville PA4, David Rolston Danville PA4, Christopher Still Danville PA1, Michelle Lent Danville PA1 Geisinger Obesity Institute1 Weis Center, Geisinger Clinic2 Temple University3 Geisinger Clinic4
[1] Office of the Surgeon General – U.S. Department of Health and Human Services. (2004). Overweight and obesity: health consequences. Accessed October 2013 from http://www.surgeongeneral.gov/topics/obesity/calltoaction/fact_consequences.html [2] Kaplan, L. M. (2003). Body weight regulation and obesity. Journal of Gastrointestinal Surgery. 7(4) pp. 443-51. Doi:10.1016/S1091-255X(03)00047-7. [3] Encinosa, W. E., et al. (2009). Recent improvements in bariatric surgery outcomes. Medical Care. 47(5) pp. 531-535. Accessed October 2013 from http://www.ncbi.nlm.nih.gov/pubmed/19318997 [4] Agency for Healthcare Research and Quality (AHRQ). (2007). Statistical Brief #23. Bariatric Surgery Utilization and Outcomes in 1998 and 2004. Accessed October 2013 from http://www.hcup-us.ahrq.gov/reports/statbriefs/sb23.jsp [5] Flum, D. R., et al. (2009). Perioperative safety in the longitudinal assessment of bariatric surgery. New England Journal of Medicine. 361 pp.445-454. Accessed October 2013 from http://www.content.nejm.org/cgi/content/full/361/5/445
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