Benefits of bariatric surgery may outweigh risks for severely obese

Mar 14, 2011

Bariatric surgery can result in long-term weight loss and significant reductions in cardiac and other risk factors for some severely obese adults, according to a scientific statement from the American Heart Association.

The statement, published in Circulation: Journal of the American Heart Association, is the first by the American Heart Association focused solely on bariatric surgery and cardiac risk factors, according to lead author Paul Poirier, M.D., Ph.D., director of the prevention/rehabilitation program at Quebec Heart and Lung Institute at Laval University Hospital in Canada.

"The statement is not an across-the-board endorsement of bariatric surgery for the severely obese," Poirier said. "It is a consensus document that provides expert perspective based on the results of recent scientific studies."

Bariatric surgery encompasses various procedures that decrease appetite while restricting food intake and/or causing food to pass through the gastro-intestinal tract without being fully absorbed or digested. The American Heart Association has long considered bariatric surgery an option to be evaluated carefully based on each patient's medical profile.

Severe obesity is defined as a (BMI) of more than 40kg/m2, according to the statement. For example, a sedentary woman who is 5-feet, 4-inches tall and weighs 235 pounds has a BMI of about 40.3kg/ m2. A 6-foot tall sedentary man who weighs 295 has a BMI of 40.

"Obesity has reached epidemic proportions in the United States, as well as in much of the industrialized world," Poirier said. "The most rapidly growing segment of the obese population is the severely obese. The of severe obesity are profound. In comparison with normal-weight individuals, a 25-year-old severely obese man has a 22 percent reduction in his expected lifespan."

Doctors and patients have been frustrated with the challenges of treating obesity, Poirier said. "Substantial long-term successes from lifestyle modifications and drug therapy have been disappointing, making it important to look at surgical options," he said.

When reviewing the scientific literature, the statement-writing committee found that, when indicated, bariatric surgery leads to significant weight loss and improvements in the health consequences of being overweight, such as diabetes, high cholesterol, liver disease, high blood pressure, obstructive sleep apnea and cardiovascular dysfunction. Recent studies have suggested that bariatric surgery prolongs life in the severely obese.

There are, however, surgical risks – including death – and long-term post-surgical lifestyle implications. Patients must make lifelong behavior changes, such as supplement use, and follow up with the surgical team.

"Bariatric procedures are generally safe; however, this is not a benign surgery," Poirier said. "At the moment, bariatric surgery should be reserved for patients who can undergo surgery safely, have severe obesity and have failed attempts at medical therapy."

More research on bariatric surgery in adults and youths is needed, Poirier said. The severely obese adolescent population continues to grow with no effective sustainable treatment available.

The value of psychological evaluations and profiles in cases is uncertain. The statement's authors suggest psychological evaluations should assess the behavioral and environmental factors that may have contributed to a patient's obesity, as well as the potential impact on a patient's ability to make the dietary and behavioral changes needed to achieve the best results from .

Explore further: Humiliation tops list of mistreatment toward med students

add to favorites email to friend print save as pdf

Related Stories

Are obese adolescents too young for bariatric surgery?

May 03, 2010

Severely obese adolescents may desire or potentially benefit from bariatric surgery. However, half of primary care physicians say they would not recommend the procedure to a patient under the age of 18, according to research ...

Recommended for you

Humiliation tops list of mistreatment toward med students

12 hours ago

Each year thousands of students enroll in medical schools across the country. But just how many feel they've been disrespected, publicly humiliated, ridiculed or even harassed by their superiors at some point during their ...

Surrogate offers clues into man with 16 babies

20 hours ago

When the young Thai woman saw an online ad seeking surrogate mothers, it seemed like a life-altering deal: $10,000 to help a foreign couple that wanted a child but couldn't conceive.

Nurses go on strike in Ebola-hit Liberia

20 hours ago

Nurses at Liberia's largest hospital went on strike on Monday, demanding better pay and equipment to protect them against a deadly Ebola epidemic which has killed hundreds in the west African nation.

ALS Ice Bucket Challenge arrives in North Korea

Aug 31, 2014

It's pretty hard to find a novel way to do the ALS Ice Bucket Challenge by now, but two-time Grammy-winning rapper Pras Michel, a founding member of the Fugees, has done it—getting his dousing in the center ...

Cold cash just keeps washing in from ALS challenge

Aug 28, 2014

In the couple of hours it took an official from the ALS Association to return a reporter's call for comment, the group's ubiquitous "ice bucket challenge" had brought in a few million more dollars.

User comments : 0