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Star Tribune, August 23, 2007

Studies confirm death rates drop dramatically after Bariatric surgery.

The latest: Surgically induced weight loss produces as much as a 40 percent reduction in deaths in the 10 years after the operation, two large studies reported today.

'Absolutely clear': Researchers already knew bariatric surgery sharply reduces diabetes, hypertension and high cholesterol, in addition to improving quality of life. But the new studies, reported in the New England Journal of Medicine, are the first to document a long-suspected link between weight loss and survival.

"It is now absolutely clear that losing weight and keeping the weight off adds years to your life," said Dr. Edward H. Phillips, a bariatric surgeon at Cedar-Sanai Medical Center in Los Angeles, who was not involved in the studies.

More could have surgery: Last year, an estimated 177,600 Americans had bariatric surgery, according to the American Society for Metabolic and Bariatric Surgery. But that is less than 1 percent of those who would be eligible for the surgery under the current criteria, the society said.

Guidelines call for a prospective patient to have a body mass index, or BMI, of 40, or a BMI of 35.0 - 39.9 with one or more other conditions, such as diabetes, osteoarthritis, sleep apnea or hypertension. For a 5-foot-10-inch person, a weight of 245 pounds would translate into a BMI of 35, and a weight of 275 pounds would translate into a BMI of 40.

NIH to discuss issue: The National Institute of Health will convene a panel this fall to consider whether the qualification guidelines should be relaxed.

Two procedures: There are two main types of bariatric surgery. The simplest is banding, in which an inflatable silicone band is placed around the stomach to reduce its capacity, allowing the patient to feel full after consuming much less food.

In a gastric bypass, the stomach is tailored to reduce its capacity to three or four ounces, and the intestines are connected directly to the newly created pouch, bypassing part of the area where food absorption occurs. This is generally more invasive but produces faster weight loss.

Two studies: In the first study, Dr. Lars Sjostrom of Gothenburg University in Swedend studied 2,010 obese patients who underwent bariatric surgery and 2,037 patients who received conventional medical treatment for their obesity. There were 129 deaths in the control group over the 10-year period and 101 in the surgery group. Taking into account age, sex and risk factors. that amounted to a 29 percent reduction in the number of deaths, they said.

In the second study, Dr. Ted D. Adams of the University of Utah School of Medicine and his colleagues compared 7,925 obese patients who underwent gastric bypass surgery with an equal number of patients who did not. Over the average seven years of follow-up, there was a 56 percent decrease in deaths from cardiovascular disease, and a 92 percent drop in deaths from diabetes.

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