Study Examines Safety, Effectiveness of Weight-Loss Bariatric Surgery

Bariatric surgery helps patients lose weight and get rid of obesity-related diseases, although the risk of complications, reoperation and death remain, according to updated analyses of the effects of weight-loss surgery by Su-Hsin Chang, of the Washington University School of Medicine, St. Louis, and colleagues.

The prevalence of obesity is well-established and so are the outcomes of bariatric surgery, such as the remission of diabetes and hypertension.

Researchers reviewed available medical literature and analyzed 164 studies (37 randomized clinical trials and 127 observational studies between 2003 and 2012) that included 161,756 patients with an average age almost 45 years and body mass index (BMI) of nearly 46.

Study findings indicate that:

  • Within 30 days of surgery, the death rate was 0.08 percent, and 30 days after surgery, the rate was 0.31 percent.
  • BMI loss five years after surgery ranged from 12 to 17.
  • Complication rates ranged from 10 to 17 percent
  • The reoperation rate was about 7 percent
  • Obesity-related diseases, including diabetes, hypertension and sleep apnea, improved after surgery.
  • Among different surgical procedures, gastric bypass was more effective for weight loss but was associated with more complications.
  • Adjustable gastric banding had lower death and complication rates but reoperation rates were higher and weight loss was less than gastric bypass.
  • Sleeve gastrectomy appeared to be more effective for weight loss than adjustable gastric banding and comparable with gastric bypass.

“In conclusion, our study suggests that bariatric surgery has substantial and sustained effects on weight and significantly ameliorates obesity-attributable comorbidities in the majority of bariatric patients,” the study concludes.

(JAMA Surgery. Published online December 18, 2013. doi:10.1001/jamasurg.2013.3654.