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Weight-Loss Surgery Safe And Effective In Obese Patients

A study found that complications associated with bariatric surgery may be much lower than expected.

The study found the risk of death associated with both gastric bypass surgery and laparoscopic adjustable gastric banding (Lap-Band surgery) was 0.3 percent and the risk of a major adverse outcome was 4.3 percent.

Bariatric surgery is safe, said study co-author Bruce Wolfe, MD, a professor of surgery at Oregon Health & Science University in Portland. Certain factors [such as a history of blood clots, obstructive sleep apnea or impaired functional status] increase the risk of complications, but you can discuss these risks as well as the potential benefits with your surgeon.

However, the surgery is not effective for everyone. If you’re five or 10 pounds overweight, bariatric surgery isn’t for you, said Malcolm K. Robinson, MD, an assistant professor of surgery at Harvard Medical School, and the author of an accompanying editorial.

Basically, when I or my colleagues advise surgery, it’s because the benefits of surgery outweigh the risks. In general, that’s the case for someone with a BMI (body-mass index) of 35 and weight-related health problems like diabetes or high blood pressure, or someone with a BMI of 40 or more, said Robinson, who added that as the risks of the surgery keep dropping, those BMI numbers may get even lower in the future.

The present study involved 4,776 people who underwent different types of bariatric surgeries such as 1198 patients underwent Lap-Band surgery, 2975 with laparoscopic gastric bypass, 437 with open gastric bypass or 166 with another procedure. All of the surgeries were performed between March 2005 and December 2007.

The participant had an average age of 44.5 years, 22 percent of the study volunteers were male and 11 percent were nonwhite. The average BMI reported was 46.5. The authors reported that more than half of the study group had at least two coexisting medical conditions.

In his editorial, Robinson points out that these procedures may represent best-case scenarios because they were done by experienced surgeons in high-volume bariatric centers. However, he said that because the field of bariatric surgery has advanced so much in the past few years, he believes these results are a generally achievable phenomenon.

Both Robinson and Wolfe recommend that any person considering bariatric surgery should choose a facility that’s been designated as a Center of Excellence because that means that the surgeon and the whole health-care team are qualified and experienced.