An investigation of the risks facing individuals following gastric bypass surgery and just how these compare to the risks found in the general population.


With obesity continuing to increase across much of the Western world we are becoming more and more informed about the health risks from being significantly overweight and of the increased risk of death as a result of morbid obesity. But to what extent are these risks lessened by undergoing gastric bypass surgery?


A study recently examined the histories of a large number of patients who had bariatric surgery in the 10 years from the start of 1995 to the end of 2004 and found that in the region of one percent of patients died within twelve months of surgery and that approximately 6 percent died inside 5 years. When the statistics had been adjusted to take account of age and sex and matched against figures for the population as a whole these figures were found to be quite high. So exactly what does this say about the ability of obesity surgery to lessen the general risk to our health?


To answer this question we must look behind the headline numbers and look at just why these deaths occurred and where the real difference lies between obesity patients and the population at large.


If you look at the detailed numbers two particular things stand out.


The first is the figure for patients who died from heart disease which was the major cause of death in obesity patients and is substantially above that seen in the population as a whole.


The second is the figure for deaths that resulted from suicide and drug overdoses that, while not formally recorded as suicide, must nevertheless raise the question of whether or not such overdoses were really accidental. Within the population as a whole you may expect to see about 2 deaths from suicide in a group of the same size as the study group and yet this group of patients showed no fewer than 30 suicides and drug overdoses.


If we examine these findings and set them alongside our general knowledge about patients undergoing obesity surgery then we can possibly understand this variation at least in part.


Although bariatric surgery is generally very successful it is often not undertaken until patients are at risk from other medical problems or comorbidities and, though surgery will cure a number of these conditions and lessen the risk from others, many patients still remain at some risk following surgery. For instance, in many cases patients remain troubled by such things as diabetes and hypertension and it is thus unsurprising that this section of the population remains at higher risk from heart disease.


Further, while bariatric surgery may lead to a considerable weight loss many patients remain heavily overweight for a considerable time following surgery and some will remain so for months or years to come.


As a final point, the changes in lifestyle that follow surgery are dramatic and many patients find that depression sets in during the weeks and months following their operation. It is a fact that a lot of attention is paid to the physical affects of obesity surgery and the need for such things as a strictly controlled diet and the need for exercise but, more often than not, little more than lip service is paid to the psychological affects of surgery.


Only time will reveal the extent to which this explanation holds water but there should be little doubt that improved post-operative care for obesity surgery patients could go a long way to finding a solution for this variance.


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