CHICAGO – Obesity surgery, which is fast becoming a popular way to battle the nation’s weight crisis, may be a lot riskier than most patients realize.
New research found a higher-than-expected risk of death in the year after surgery, even among young patients.
“It’s a reality check for those patients who are considering these operations,” said University of Washington surgeon Dr. David Flum, lead author of a Medicare study that analyzed the risks.
The findings appear in today’s Journal of the American Medical Association.
Some previous studies of people in their 30s to their 50s – the most common ages for obesity surgery – found death rates well under 1 percent.
But in a study of 16,155 Medicare patients who underwent obesity surgery, more than 5 percent of men and nearly 3 percent of women aged 35 to 44 were dead within a year. And slightly higher rates were found in patients 45 to 54.
Among patients 65 to 74, nearly 13 percent of men and about 6 percent of women died. In patients 75 and older, half of the men and 40 percent of the women died.
There are several types of operations to lose weight, most generally involving surgically shrinking the stomach and usually restricted to “morbidly” obese people more than 100 pounds overweight.
Those patients often have medical problems brought on by their girth, including heart trouble, diabetes and breathing difficulties – problems which obesity surgery can sometimes resolve but which can also contribute to making the surgery risky.
Patients studied underwent surgery between 1997 and 2002.
“This is a major operation in a high-risk population. “When you do a complicated operation in a complicated population, we should expect to see adverse outcomes” occasionally, Flume said.
A JAMA editorial said even if Medicare patients do face higher risks, they should not be denied obesity surgery.
“These patients may also represent the potential greatest benefit associated with major lasting weight loss given their associated disease burden,” the editorial said.
The surgery may be lifesaving when done on the right patients, by experienced surgeons, the editorial said.
The American Society for Bariatric Surgery predicts obesity surgery will be performed more than 150,000 times this year in the United States. That is more than 10 times the number in 1998.