Most bariatric surgeries today are performed via laparoscopy, said Ted Adams, lead author of the study. (Portra, Getty Images)
Estimated duration: 7-8 minutes
SALT LAKE CITY — Weight loss surgery reduces the risk of premature death, especially from obesity-related conditions such as cancer, diabetes and heart disease, according to a new 40-year study of nearly 22,000 people in Utah who underwent bariatric surgery.
A study found that people who underwent one of four types of weight-loss surgery were 16 percent less likely to die from any cause than people of similar weight. The decline in deaths from obesity-related diseases, such as obesity, has been even more dramatic.
“Deaths from cardiovascular disease decreased by 29%, and deaths from various cancers decreased by 43%, which is very impressive,” said first author and adjunct associate in nutrition and integrative physiology at the University of Utah School of Medicine. Professor Ted Adams said.
“There was also a significant 72 percent reduction in diabetes-related mortality in those who had surgery compared to those who did not,” he said. One major drawback: The study also found that younger people who had surgery had a higher risk of suicide.
Supporting previous research
the study, Published Wednesday in the journal Obesity, reinforces similar findings from previous studies, including Study abroad in Sweden for 10 years Eduardo Grunwald, M.D., professor of medicine at the University of California, San Diego and medical director of the weight management program, said he found a significant reduction in premature death.
A Swedish study also found that a significant number of people had their diabetes in remission 2 and 10 years after surgery.
“This new study from Utah is more evidence that people undergoing these procedures have positive and beneficial long-term results.” new guidelines About obesity treatment.
The association strongly recommends that obese patients take recently approved weight-loss drugs or surgery in combination with lifestyle changes.
“And it’s important for patients to know that changing their diet becomes more natural and easier after bariatric surgery or taking new weight-loss drugs,” said the Utah study, which was not involved. Mr Grunvald said.
“While we still don’t fully understand why, these interventions actually change the chemicals in the brain, making it much easier to change your diet later on.”
Obesity is also a disease, but we blame obese people and torture them.
– Dr.Caroline Apobian, Professor of Medicine, Harvard Medical School
Caroline Apovian, M.D., professor of medicine at Harvard Medical School and co-director of the Center for Weight Management, says only 2% of patients eligible for bariatric surgery undergo surgery, often due to stigma about obesity. can not. Wellness at Brigham and Women’s Hospital in Boston. Apovian was the first author of the Endocrine Society. clinical guidelines For the pharmacological management of obesity.
Insurance companies usually cover the cost of surgery for people over the age of 18. body mass index More than 40, or a BMI of 35, if the patient has related conditions such as diabetes or high blood pressure, she said.
“I see patients with a BMI of 50 and I always say, ‘You are subject to all the medications, the diet, the exercise, the surgery.’ Don’t talk, I don’t want that.” They don’t want a surgical solution to what society has told them is a lack of willpower,” she said.
“We don’t torture people with heart disease. ‘Oh, it’s because you ate a lot of fast food.’ We don’t torture people with diabetes. , tell them they have a disease and treat it.
Both men and women can enjoy the benefits
According to Adams, most of the people opting for bariatric surgery (about 80%) are women. He said one of the strengths of the new study was that it included men who had surgery.
“For all causes of death, mortality decreased by 14% for women and 21% for men,” Adams said. In addition, deaths from related causes such as heart attack, cancer and diabetes were 24% lower in women and 22% lower in men compared to those who did not undergo surgery, he said.
This study investigated four types of surgery performed between 1982 and 2018: gastric bypass, gastric banding, gastric sleeve, and duodenal switch.
Developed in the late 1960s, gastric bypass creates a small pouch near the top of the stomach. A portion of the small intestine is brought out and attaches to that point, bypassing the first part of the small intestine, the stomach and most of the duodenum.
Gastric banding involves placing an elastic band around the top of the stomach that can be tightened and loosened to limit the amount of food that enters the stomach cavity. The procedure is “not very popular today,” says Adams.
“A gastric sleeve is basically a laparoscopic removal of about two-thirds of the stomach,” he said. “It takes less time to run and food passes through a much smaller stomach, making it a very popular option.”
A duodenal switch is usually reserved for patients with a high BMI, Adams added. Combining sleeve gastrectomy and intestinal bypass surgery, it is a complex procedure that is effective in type 2 diabetes. According to the Cleveland Clinic.
serious complications
One of the new research’s surprising findings was a 2.4% increase in suicide deaths among people who underwent bariatric surgery, mostly between the ages of 18 and 34.
“That’s because they’re told life will be great after surgery and medication. National Alliance for Eating Disorders, Non-profit advocacy group.
“All you have to do is lose weight, and people will want to hang out with you, people will want to be your friend, and your insecurities and The depression will go away,” she said. “But that’s not the reality.”
Additionally, given the postoperative risks and side effects associated with bariatric surgery, such as nausea, vomiting, alcoholism, potential weight loss failure, and even weight gain, project heal, Help people suffering from eating disorders.
“How do you define health in these scenarios? And are there other interventions? Weight-neutral interventions?” asked Vibert.
Grunvald said previous research has also shown a link between suicide risk and bariatric surgery, but research on this topic is not always able to identify a patient’s mental health history.
First, we as a society must think of obesity not as a moral failure, but as a disease, a biological problem.
– Dr. Eduardo Grunvald, Professor of Medicine
“Did the person choose surgery because they had unrealistic expectations or underlying psychological disorders that were not resolved after surgery? Or was this somehow a direct effect of bariatric surgery?” We can’t answer for sure,’ he said.
Intensive preoperative counseling is usually necessary for everyone undergoing surgery, but it may not be enough, Apovian said. She lost her first bariatric surgery patient to suicide.
“She was older in her 40s. She had surgery and lost 150 pounds. Then she died in front of a bus due to bipolar disorder she was self-medicating with her diet. I did,” Apovian said. “As a society, we use a lot of food to mask our trauma. What this country needs is more psychological counseling for everyone, not just those undergoing bariatric surgery.”
Experts say weight management is a unique process that combines genetics, culture, environment, social prejudices and personal health. There is no one-size-fits-all solution.
“First, we as a society must view obesity not as a moral failure, but as a disease, a biological problem.” That’s my first piece of advice.
“And if you believe your life will benefit from treatment, consider evidence-based treatment that research shows if lifestyle changes alone haven’t worked.
