Does Bariatric Surgery Extend Life? Fat Chance! says JAMA Study

The risks of permanent harm from bariatric surgery are significant, and those who are at greatest risk from obesity are the ones with no likelihood of life extension.

by Heidi Stevenson

11 June 2011

A new study to be published by the Journal of the American Medical Association (JAMA) casts strong question on the purpose of bariatric surgery. The findings show that it provides no life extension in those who supposedly need it most, severely obese men.

Several different methods of bariatric surgery are in use, including removal of part of the stomach, removal or rerouting part of the intestine, and gastric band surgery, in which a band is placed around part of the stomach to limit the rate at which food can be processed.

The study was sponsored by the Office of Research and Development, Health Services Research and Developmental Service of the Department of Veterans Affairs. Matthew Maciejewski, PhD, and his fellow researchers believe that this is the first study of the long term survival of high risk male patients who have undergone bariatric surgery. Previous studies were done on primarily young, white, female patients whose risk of death related to obesity is relatively low.

The study examined the results of 850 bariatric surgeries in male veterans, comparing them with 41,244 nonsurgical controls, also veterans:

• Bariatric Surgeries
• 850 men
• Average age: 49.5 years
• Average body mass index (BMI): 47.4
• Control Group
• 41,244 men
• Average age: 54.7 years
• Average body mass index (BMI): 42.0

Surgeries were performed between the years 2000 and 2006. The average follow-up time was 6.7 years. The focus was on mortality from any cause. After adjusting for confounding factors, the authors found no significant decrease in men's mortality resulting from bariatric surgeries.

Adverse Effects of Bariatric Surgery

It is true that bariatric surgeries generally result in significant weight loss. However, adverse effects are highly significant, and their nature tends to result in serious loss in quality of life.

Nutrient Deficiencies

Different parts of the digestive tract process and absorb different nutrients. Therefore, whatever part of the alimentary canal is removed or disabled will likely result in some kind of nutritional deficiency. Dietary supplementation is required for anyone undergoing the treatment. The patient must accept life long follow-up, regular blood testing, and monitoring by medical practitioners, so the ongoing cost and interference will continue for the rest of the patient's life.

Nutrient deficiencies can have very serious consequences over the long term. I suspect that a significant number of people who have undergone bariatric treatment ultimately suffer from debilitating conditions that are not attributed to nutritional deficiencies caused by the surgery.

Gallstones

The rapid weight loss that usually results from bariatric surgery very frequently causes painful and potentially life-threatening gallstones. This then frequently results in surgical removal of the gall bladder, a far from minor treatment with its own negative effects on health.

Some doctors preemptively remove the gall bladder at the time of bariatric surgery. Others give drugs as a measure to prevent gallstones.

Peripheral Neuropathy

Generally not included among potential adverse effects of bariatric surgery, debilitating and painful peripheral neuropathy is a serious adverse effect that can have a devastating effect on quality of life. The American Diabetes Association reports that about 3% of all patients undergoing this surgery will end up with one of these problems:

• Carpal tunnel syndrome
• Sensory predominant polyneuropathy: This includes a range of symptoms, including prickly numbness in feet and hands; aching, stabbing, or burning pain; lightheadedness; urinary incontinence; impotence; reduced tendon reflexes; loss of strength, reflex, or sensation.
• Radiculoplexus neuropathy: This is sudden weakness and numbness of a large area, generally either the lower limbs or upper limbs.

Neural damage is generally permanent and often progressive. Its effects tend to result in serious deterioration in quality of life.

Bariatric Surgery Is a Fat Chance

In severe obesity in men, it appears that bariatric surgery does not extend life. The potential of suffering adverse effects that can be misery-making for the rest of one's life is significant. Submitting to these surgeries also results in turning a person into a life long patient.

The individual should be the final arbiter of whether to have bariatric surgery or to avoid it. However, before submitting to it, the importance of being aware of the very real risks in exchange for little or no extension of life must be made clear.

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