GASTRIC BYPASS SURGERY PROS AND CONS VERSUS DIETING:IN WEIGHT LOSS SURGERY EXPERIENCE COUNTS

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Often a topic for comedians, weight is not so funny when you are fighting a long battle, dieting with little to show to control excess weight that colors every part of your existence from your health to your social life. Many people have chosen gastric bypass surgery.












A New England Journal of Medicine research article found that gastric bypass surgery is beneficial. "In fact, the benefit is quite dramatic. The authors studied 9,949 patients who had undergone weight loss surgery, and compared them to a control group of 9,628 severely obese individuals who did not have the surgery".




They wrote an article about weight loss, diets and gastric bypass surgery. One is an economist and the other a writer but as they discussed the pros and cons of weight loss surgery and dieting in their New York Times column "The Stomach Surgery Conundrum", the authors of Freakonomics totally neglected to mention this article,one of the most important New England Journal research paper about weight loss surgery and it's consequences.




As the Freakonomics boys do point out when it comes to doing surgery experience counts. You want a doctor who does many bariatric weight loss procedures. "Technological innovations, especially the use of laparoscopic procedures (using a tube that is inserted through an incision in the abdominal wall so it's less invasive) have made for considerable gains in safety and efficacy. While the operation is still dangerous in some circumstances — one study found that for a surgeon’s first 19 bariatric operations, patients were nearly five times as likely to die than patients that the surgeon later operated on — the overall mortality rate is now in the neighborhood of 1 percent.

The editorial in the New England Journal also points out that the lowest surgical mortality is seen among surgeons who have performed more than 50 operations and preferably more than 100 operations.



After gastric bypass surgery there was a significant reduction particularly from diabetes, heart disease, and cancer. However, the rate from causes other than disease was higher in the surgery group than in the control group".

Study Shows Dramatic Health Benefit From Obesity Surgery






Dubner and Levitt also say that "a significant fraction of postbariatric patients acquire new addictions like gambling, smoking, compulsive shopping or alcoholism once they are no longer addicted to eating". In fact, the New England article does say that "Despite reductions in disease-related deaths after gastric bypass surgery, the risk of non–disease-related death, such as accidents and suicides, increased by a factor of 1.58, as compared with that in the control group. Reports reveal that a substantial number of severely obese persons have unrecognized presurgical mood disorders or post-traumatic stress disorder or have been victims of childhood sexual abuse".

World's Fattest Man Loses Hundreds of Pounds with Love, Diet and Surgery

After Weight-Loss Surgery, Some Find New Addictions



"Not only do most patients keep off a significant amount of weight but the other medical problems that accompany obesity are also often assuaged. One recent analysis found that 77 percent of bariatric-surgery patients with Type 2 diabetes experienced “complete resolution” of their diabetes after the procedure; the surgery also helps eliminate hypertension and sleep apnea. From an economic standpoint, research suggests that the operation can pay for itself within a few years because a postbariatric patient now requires less medical care and fewer prescriptions. That’s why some insurance companies cover bariatric surgery — as more do, it will likely lead to a further spike in the volume of operations".

Long-Term Mortality after Gastric Bypass Surgery (this is a pdf)

Freakonomics in the Times Magazine: The Stomach-Surgery Conundrum

Freakonomics The Stomach-Surgery Conundrum

Laparoscopic Adjustable Gastric Bandings