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Obesity Surgery Riskier Than Thought

Severely obese individuals hoping to take a short cut – literally – to losing pounds may be biting off more than they can chew by opting for gastric bypass surgery. Three new studies appearing in last month’s Journal of the American Medical Association (JAMA) called the safety – and supposed cost savings – of obesity surgery into question.

The most disturbing of these contradicted previous statistics which reported death rates well under 1% for middle-aged patients. The new data suggests that 5% of men and 3% of women aged 35-44 died within a year of the surgery. Among patients 65-74 years old, 13% of men and 6% of women died and among those over 74 years old, half of the men and 40% of the women died. “The risk of death is much higher than has been reported,” said lead author Dr.David Flum of the University of Washington.”It’s a reality check for those considering these operations.”

Whether the sobering news will deter those 150,000 patients predicted to undergo obesity surgery in the U.S.this year is hard to say. The popularity of such surgeries has grown ten times in the past seven years according to a second JAMA study. This explosion reflects the ballooning proportion of Americans who are more than 100 pounds overweight, from 1 in 200 a decade ago to 1 in 50 today.

Gastric bypass is the most common type of obesity surgery and involves attaching a section of the upper stomach to the lower intestine, effectively preventing patients from eating their usual amount of food.Post-surgery complications can include infection, malnutrition, bowel and gallbladder problems. Of course, the list of obesity-related ailments is even longer with heart disease, diabetes, and sleep apnea among the best documented.

It was such widely recognized health concerns that led the federal government to extend Medicare coverage to obesity surgery but the third JAMA study cast doubt on whether the procedure actually reduces health care costs.

Following patients for three years, researchers found that while an average of 8% were hospitalized before surgery, a full 20% had been hospitalized a year afterward, primarily for complications relating to their surgery.

Bottom line: The risks of obesity surgery are higher than previously believed. A healthier path to lasting weight-loss begins with a healthy diet filled with high-fiber, low-calorie fruit and vegetables, and daily exercise.

Published November 7, 2005

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