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 The findings, reported in JAMA Surgery, show that the so-called
gastric bypass operation is associated with a mortality benefit
along with its better-known "metabolic" benefits, said lead author
Lance Davidson, of Brigham Young University in Provo, Utah.
He told Reuters Health the benefit is "pretty significant and pretty
convincing."
In a gastric bypass procedure - formally known as Roux-en-Y gastric
bypass - surgeons reduce the size of the stomach and also
reconstruct the gastrointestinal tract so that food will bypass part
of the intestines as it's being digested.
Past research has found weight loss surgeries are tied to reduced
deaths from any cause, cancer and heart disease. Those studies left
several unanswered questions, however.
Specifically, why are deaths from so-called external causes - like
accidents and poisoning - more common among people who have weight
loss surgery? Also, does the reduced risk of death apply to older
people undergoing weight loss surgeries?
For the new study, the researchers studied 7,925 patients who had
gastric bypass between 1984 and 2002, and 7,925 similarly obese
patients who didn't have surgery.
Over the next seven years, surgery patients ages 35 through 44 were
46 percent less likely to die from any cause than people who didn't
undergo surgery.
Similarly, people ages 45 through 54 had a 57 percent reduced risk
of death and people age 55 through 74 years had about a 50 percent
reduced risk of death.
There was no difference in death rates among people under age 35,
however. The researchers found the lack of difference is primarily
due to the increased risk of death from external causes being
concentrated among women in that age group.
For women under age 35, the risk of dying from an external cause was
over three times greater for those who had gastric bypass than those
who didn't have surgery.
Davidson said the new study can't say why young women who have
gastric bypass surgery are at an increased risk of death from
external causes.
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It could be, he added, that we would see a reduced risk of death in
these younger patients, too, if researchers followed them for
another decade or so.
As for older obese people considering gastric bypass, Davidson said
the benefits are likely larger as people get older because deadly
conditions related to obesity are more likely to occur as people
age.
"I’d say if they qualify for it and are safe to undergo that
surgery, the mortality and metabolic benefits are pretty strong," he
said.
But the new results should be interpreted with caution, said Dr.
Malcolm Robinson, of Harvard Medical School and Brigham and Women’s
Hospital in Boston, wrote in an accompanying editorial.
"Bariatric surgeons exclude high-risk patients from surgery, which
represents the major flaw in this study," wrote Robinson. In other
words, the obese people who had the surgery were a relatively
healthy group to start with.
Davidson said bariatric surgery patients tend to be the most obese,
however.
SOURCE: http://bit.ly/1PG1Zkh and http://bit.ly/1PG1ZRr JAMA
Surgery, online February 11, 2016.
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