Study touts long-term benefits of gastric bypass surgery
By Wendy Leonard
September 18th, 2012 @ 8:05am
SALT LAKE CITY — Diet and exercise alone may not be enough to help people who are severely overweight.
A Utah-based study and one of the first of its kind in the U.S. has shown that, for severely obese individuals — those with a body mass index greater than 35 — gastric bypass surgery can lead to long-term health benefits that may be unobtainable with just making lifestyle changes.
"We know that with gastric bypass surgery, patients lose a substantial amount of weight," said Dr. Ted Adams, lead author of the study, and research and clinical director for the Intermountain Health and Fitness Institute at LDS Hospital.
Patients typically lose an average of 100 pounds and after two years, a previous study indicated that patients maintained a loss of about 35 percent of that initial weight.
"Now, six years out, there's still a significant amount of weight that has remained lost," Adams said. "But the benefits go beyond weight loss. We also found that patients who had the surgery were less likely to develop serious health problems like diabetes, high blood pressure and high cholesterol."
Researchers followed the medical records and practices of 1,156 individuals, ages 18 to 72, recruited from throughout Utah. Of those, 418 people had Roux-en-Y gastric bypass surgery, 417 were seeking to have it, but didn't mostly because their insurance wouldn't cover it, and a third group of 321 individuals were not seeking to have surgery.
The study found that gastric bypass surgery was effective in maintaining weight loss, as surgical patients maintained a loss of an average of 34.9 percent of their initial weight even two years after the procedure. They kept off an average of 27.7 percent six years later, Adams said.
Study participants in the groups that did not receive the surgery did not show an increase or decrease in weight, regardless of the various medical or non-medical approaches to losing weight that they participated in during the study.
Adams said that weight loss methods are typically considered successful if just a 7 percent weight loss is maintained.
In addition to helping patients maintain their weight loss, gastric bypass surgery was found to decrease the risks of cardiovascular and metabolic symptoms and diseases, such as high blood pressure, high cholesterol and type 2 diabetes.
"For most people who are severely obese, lifestyle approaches to weight loss alone generally are not enough," Adams said, adding that he believes obesity results from some genetic predisposition that is part of a person's physiology.
Gastric bypass surgery, Adams said, gives people who might have struggled to lose weight an "opportunity to have sustained weight loss."
The study also found that among patients who had diabetes prior to gastric bypass surgery, 62 percent were in remission six years afterward. Gastric bypass patients who did not have diabetes before the surgery were also five to nine times less likely to develop the disease than nonsurgical patients.
While the surgery has substantial benefits, Adams said risks, which can include infection and even death, should also be considered. Patients must also be committed to following a regimented balanced diet and be willing to participate in regular physical exercise for the best outcomes.
Obesity
- More than one-third of all adults in America are obese
- Obesity is a factor in some of the leading causes of preventable death, including heart disease, stroke, Type 2 diabetes and certain types of cancer
"After the surgery, you are limited in the volume of food you can eat … forever," he said.
The Swedish Obese Subjects study is the only other study available that follows patients longer, but it includes primarily gastric banding patients and only a small percentage of those who had gastric bypass surgery, Adams said. He has received funding from the National Institutes of Health to continue his research and will apply for funding yet again in four years.
"The longer, the better," Adams said. "It gives patients and physicians more information with which to make their decisions. And it is a big decision, one that needs to be weighed out. It's a major surgery. It's a major change in lifestyle. And it is expensive."
Further research on gastric bypass surgery, which is one of the most popular procedures conducted worldwide, may have an impact on insurance coverage, making the surgery available to a larger percentage of individuals.
Wendy Leonard
18 Sep, 2012
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