There are more than 30 million Americans that are classified as obese or extremely obese. A new study shows that they might benefit from surgery that reconstructs the stomach to accommodate less food. Gastric bypass surgery leads to weight loss and improvement of health related problems, and may yield long-term health benefits. The scientists published their findings in the Journal of the American Medical Association. Previous studies had shown improvement, but tracked patients for shorter intervals. The new study tracked hundreds of extremely obese patients for six years with a BMI above 35. The findings indicate that those who received the surgery had better health outcomes than those who didn’t and preexisting cases of type-2 diabetes went into remission in more than half of the cases (62%).
Initially, researchers were unsure if gastric bypass surgery would lead to long term health benefits without other interventions. Half of the 835 patients in the study ended up getting a form of gastric bypass known as Roux-en-Y. The researchers enrolled another 321 extremely obese people from the community who weren’t going to get the surgery. Two years later, those who had undergone the procedure had reduced their weight by 35%, which accounted as much as 100 pounds or more under their baseline weight. The control group remained extremely obese. After six years, the patients who had the surgery were still 28% lighter than before and improved their quality of life compared to the control groups. The procedure also led to an 80% reduction in the risk of developing type-2 diabetes and a 20-times larger chance that existing diabetes would go into remission. It lowered risks for cardiovascular disease and hypertension as well. Those who hadn’t received the surgery had increased their risk to all of these conditions after six years. Other lifestyle changes recommended by health professionals in the course of receiving the bypass procedure might have helped patients make healthier lifestyle choices than those in the control groups, but the researchers noted that other lifestyle interventions usually shave off less than 10% of a patient’s total weight and keep off only around 2% four years later. The surgery carries the risk of complications, as all major surgical procedures do and the patients may experience a large loss of muscle mass. Patients need to incorporate strength training into their post-procedure regimes, and researchers are currently investigating how to best do this. Also many chemicals, from alcohols to medication, are metabolized differently once the gut has been remodeled. Those changes could affect mental states as well as reactions to drugs. The team plans on continuing with another follow-up, 10 years after the procedure, to see if health benefits continue. Reference: “Health Benefits of Gastric Bypass Surgery After 6 Years” by Ted D. Adams, PhD, MPH; Lance E. Davidson, PhD; Sheldon E. Litwin, MD; Ronette L. Kolotkin, PhD; Michael J. LaMonte, PhD; Robert C. Pendleton, MD; Michael B. Strong, MD; Russell Vinik, MD; Nathan A. Wanner, MD; Paul N. Hopkins, MD, MSPH; Richard E. Gress, MA; James M. Walker, MD; Tom V. Cloward, MD; R. Tom Nuttall, RRT; Ahmad Hammoud, MD; Jessica L. J. Greenwood, MD, MSPH; Ross D. Crosby, PhD; Rodrick McKinlay, MD; Steven C. Simper, MD; Sherman C. Smith, MD and Steven C. Hunt, PhD, 19 September 2012, Journal of the American Medical Association.DOI: 10.1001/2012.jama.11164
