With the rate of obesity continuing to grow in many Western countries we are becoming ever more sensitive to the health risks associated with being very overweight and of the increased risk of death resulting from obesity. But just how far can these risks be lessened by undergoing gastric bypass surgery?
A study recently looked at the histories of a large number of patients who had gastric bypass surgery from 1995 to 2004 and discovered that in the region of one percent of patients died within a year of their surgery and that roughly 6 percent died within 5 years. When these numbers had been adjusted to take account of sex and age and matched against statistics for the population as a whole they were discovered to be reasonably high. So exactly what does this tell us about the ability of gastric bypass surgery to lessen the overall risk to our health?
If we are to find the answer this question we need to look behind the headline numbers and find out why these deaths happened and where the real variation lies between gastric bypass patients and the general population.
If we examine the detailed numbers two things in particular stand out.
The first is the number of deaths resulting from heart disease which is the main cause of death in the gastric bypass patients and is substantially above that found in the population at large.
The second is the number of deaths which resulted from suicide and drug overdoses which, though not officially recorded as suicide, must nevertheless raise the question of whether or not such overdoses were really accidents. Within the population at large you may expect to find about 2 suicides in a group of the same size as that used in the study and yet this group of patients showed a total of 30 deaths from suicide and drug overdoses.
If we examine these results and consider them alongside our general knowledge of patients undergoing gastric bypass surgery then we might perhaps understand this variation to some extent.
Despite the fact that bariatric surgery is usually very successful it is often not performed until patients are at risk from other medical problems and, while surgery will cure many of these problems and lessen the risk from others, a lot of patients are still at some risk following surgery. For instance, in a lot of cases patients continue to be troubled by things like hypertension and diabetes and it is possibly not surprising that this section of the population remains at higher risk from heart disease.
Further, while obesity surgery may result in a considerable weight loss a lot of patients remain heavily overweight for a considerable time following surgery and many individuals will remain so for years to come.
Lastly, the changes in lifestyle which follow surgery can be dramatic and a lot of patients experience depression in the weeks and months following their surgery. Certainly much attention is paid to the physical affects of weight loss surgery and the need for things like a strictly controlled diet and an exercise program but, all too frequently, very little more than lip service is paid to the very real psychological affects of surgery.
Time will tell whether or not this explanation stands up but there can be little doubt that improved follow-up care for gastric bypass patients could go a long way to finding a solution for this anomaly.
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