(Ivanhoe Newswire) -- A computerized model suggests that most morbidly
obese individuals would likely live longer if they had gastric bypass surgery.
However, the best decision for individual patients varies based on age,
increasing body mass index and the effectiveness of surgery.
An estimated 5.1 percent of the U.S. population is morbidly obese, with a body
mass index (BMI) of 40 or higher. Available evidence suggests that dietary,
behavioral and pharmacologic treatments frequently fail to result in meaningful
weight loss for individuals in this group. Bariatric surgery appears to be the
only effective therapy for promoting clinically significant weight loss and
improving obesity-related health conditions for the morbidly obese.
The procedure is not without risk, however, including in-hospital death.
Daniel P. Schauer, M.D., M.Sc., of the University of Cincinnati Academic Health
Center, and colleagues used two nationally representative surveys and a recent
large observational trial to construct a model estimating the benefits and risks
of gastric bypass surgery. The model included data from almost 400,000
individuals nationwide to estimate the risk of death from obesity and its
complications, data from 23,281 patients undergoing bariatric surgery to
calculate in-hospital death rates, and outcomes from participants in a
seven-year study to determine the effects of surgery on survival.
According to the resulting model, an average 42-year-old woman with a BMI of 45
would gain an estimated additional three years of life expectancy as a result of
undergoing bariatric surgery. A 44-year-old man with the same BMI would gain an
estimated 2.6 additional years.
Younger women with higher BMIs are projected to gain the most life expectancy
from surgery. Younger men with higher BMIs might also gain more life expectancy
after surgery, but the gain would be less for men than for women in each
subgroup. "Younger patients have lower surgical risk and more time over which to
realize the benefits of surgery," the authors were quoted as saying. "For older
patients, the gain is smaller, and for some, gastric bypass surgery will
decrease life expectancy."
"In conclusion,” they wrote, “. . . we believe results of this analysis can be
used to better inform both patients' and physicians' decisions regarding gastric
bypass surgery."
SOURCE: Archives of Surgery, January 2010
