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Weight Loss Surgery May Add Years to Life

Risk of Obesity Greater Than Risk of Surgery

By Laird Harrison
WebMD Medical News Archive  Reviewed By Michael  Smith, MD
on Friday, October 11, 2002  


October 10, 2002 - There's no doubt that stomach-stapling surgery
leads to dramatic weight loss. But new research shows that the
procedure might also add years to life.

As the number of obese people in the U.S. has soared, so has the
popularity of the surgery. In fact, East Carolina University
researchers estimated that the number of people undergoing weight-loss
surgery increased from 40,000 in 2001 to 86,000 this year and will
reach 140,000 next year.

Past research has shown that gastric bypass improves diabetes, high
blood pressure, and other diseases related to excess fat. But the
effect on a person's lifespan has been unknown, until now

To answer that question, researchers at New Hampshire's
Dartmouth-Hitchcock Medical Center first looked at data from previous
research that showed how much a weight an average person loses after
having the surgery. Then they looked at the average life expectancies
of people at various heights and weights. In this way, they could
estimate how much the change in weight caused by surgery would affect
patients' life span.

The results suggest that most people eligible for the surgery would
benefit, says lead researcher G. Darby Pope, MD, surgery resident at
Dartmouth-Hitchcock. "By undergoing the surgery, they will gain life
years," he said. Pope presented the study this week at a meeting of
the American College of Surgeons in San Francisco.

People with a BMI -- a measure of obesity that takes both height and
weight into account -- over 25 are considered overweight. But
according to U.S. government guidelines, patients should have a BMI of
at least 40, or a BMI of 35 with a related serious disease, to be
eligible for gastric bypass surgery. Most such patients are more than
100 pounds overweight.

The results varied according to the patients' age, gender, and body
mass index (BMI). According to the researchers, a woman with a BMI of
45 at age 40 would gain three years of life. A man of similar age and
size could expect to gain 3.9 years.

These results are better than those obtained by heart disease surgery,
Pope said. But he cautioned that no one should interpret these
findings literally. The actual effects of the gastric bypass surgery
will vary a lot from one individual to another.

Questions about the benefits of gastric bypass surgery will be
answered with more certainty by studies now under way on large groups
of patients, Pope says.

The surgery is getting more popular not only because more people are
obese, but also because surgeons have improved their techniques. In
earlier weight-loss surgery, doctors routed the digestive track past
much of the intestines, resulting in malnutrition.

In the kind of surgery in the Dartmouth-Hitchcock study, most of the
stomach is stapled shut so that food can only enter a small pouch at
the top. A branch of the intestines is connected to this pouch. (The
unused part of the stomach is connected to this branch downstream in
order to drain its fluids.)

Patients vomit if they overeat, but feel full with much less food.
Typically, they lose about three-quarters of their excess weight in
the first year, then gradually gain some back. After ten years or
more, most carry about half the excess weight they had before the
surgery, says Pope.

Patients must take nutritional supplements for the rest of their
lives, and there is a chance of dying from complications of the
surgery. But Pope and his colleagues took this risk of complications
into account in their study and the results suggest that the risk of
death from the procedure are much less than the risk of death from
obesity.