Learn Why Lap Band Surgery Has A High Success Ratio
Weight-loss surgery is the most effective way for very obese people to lose weight
, but it's a major operation with serious risks. A new study shows that 3 in 1,000 people die shortly after this type of surgery. This risk has to be balanced against the health problems someone might face because of their weight.
What do we know already?
About half the adults in England and Wales are overweight, and about a quarter are obese. Someone who becomes obese at a young age could lose 20 years of their life because of health problems caused by their weight.
Individuals with lots of will power may be able to lose weight through diet and exercise, but the majority of people end up putting at least some of the weight back on. Weight-loss drugs can increase the benefits of diet and exercise, but the effects are small and the drugs have side effects.
The only treatment proven to lead to substantial, sustained weight loss is a drastic one: surgery on the stomach and digestive system, called bariatric surgery. In the past, the high risks of surgery, including the possibility of death, meant it was used only as a last resort. Now however, bariatric surgery is much safer, and the obesity epidemic means that more and more people suffer serious health problems because of their weight. So, surgery is becoming more common.
Researchers have looked at the records of nearly 5,000 people having bariatric surgery, to get a better idea of whether the operation is worth the risks.
What does the new study say?
The death rate in the first month after surgery was 3 in 1,000. Around 1 in 25 people got some kind of serious problem after surgery, such as a dangerous blood clot in a vein, the need for more surgery, or the need for a long stay in hospital.
The risks were higher for gastric bypass surgery, where a small pouch is made in the stomach and connected directly to the intestines. All of the deaths happened to people having this type of surgery. No one died after a smaller operation called gastric banding, where a removable band is used to close off part of the stomach. However, gastric banding doesn't help people lose as much weight as a gastric bypass, so although the risks are lower, the benefits may not be as great.
The risks of surgery were higher for people who were very obese, who had a history of blood clots, or had a problem where they stopped breathing for short periods at night (sleep apnoea).
How reliable are the findings?
One problem with the study is that all the operations were done by expert surgeons. We don't know whether the risks of surgery would be higher in a typical hospital.
The majority of patients were in their 30s and 40s, most were women, and 90 percent were white. So, we don't know if the risks of surgery would be different for older people, men, or ethnic minorities.
Where does the study come from?
The researchers were based in the United States. Their study was published in The New England Journal of Medicine, which is owned by the Massachusetts Medical Society.
Funding came from several sources, including the US National Institute of Diabetes and Digestive and Kidney Diseases.
What does this mean for me?
If you're considering weight-loss surgery, this study gives some important information about the risks you face. However, it's important to talk to your surgeon, as your own risk will depend on how good your overall health is, and on the exact type of surgery you've been offered.
This particular study only followed patients for 30 days after surgery, so it doesn't tell us whether the benefits of weight loss outweigh the short-term risks of surgery. However, other research shows that bariatric surgery can help with health problems such as diabetes and heart disease, as well as extending people's lives in the long run.
What should I do now?
Bariatric surgery isn't usually the first option doctors recommend, but NHS guidelines say it can be offered to adults with a body mass index (BMI) of 40 or more. Someone with a height of 175 centimetres (5 feet 9 inches) would have a BMI of 40 if they weighed around 122 kilograms (19 stone). People with a lower weight can be considered for surgery if they have other health problems, such as high blood pressure.
If you're concerned about your weight, talk to your doctor about the best approach for you.
by: Adam Matheson
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