The surgery itself appeared to carry little short-term risk. The death rate in the year after surgery (0.53 percent) was nearly identical to that of people who did not get gastric bypass, the researchers said.
here is the link to the actual article... for whatever it's worth.
I read a similar article earlier today. I think there's some good info there to encourage WLS, but there needs to be some caution and the headline is misleading. The headline reads "Weight-loss surgeries extend lives" which implies that the surgery is the CAUSE of longer life among the groups studied (people who have and don't have surgery).
But the article I read this morning did point out that the research is not experimental. It is just correlational. This means that they did not take people and assign 1/2 to receive surgery and 1/2 to not receive surgery, etc -- the only way to make a causal claim like that is with experimental research.
There could be other reasons why the people who had the surgery lived longer. Perhaps they were more ready to make changes in their lives and that is what caused the longer lives... or some other reason.
I think it's still a positive story for WLS, and I was happy to see it. But the claim about surgery itself causing longer lives is not supported by the kind of research that was conducted.
agreed, wyellen. but it seems to me that doing the truly matched, randomized, controlled trial would be unethical in this field. so this kind of data might be the best that we'll ever get.
agreed, wyellen. but it seems to me that doing the truly matched, randomized, controlled trial would be unethical in this field. so this kind of data might be the best that we'll ever get.
I agree!
It is heartening news -- I just wish the media would be more responsible. Heck, I wish the RESEARCHERS would be more responsible with their claims! (I thinking I'm singing to the choir here, Jiffy!! )
by the way - and i'm not sure that this is the place to discuss this next issue i'm about to bring up - it would be interesting to see if they did any correction for WLS patients who were compliant vs those who were not. and for those who hit their goals vs those who lost less than 25% of their excess body weight.
hmmmm. seems like i'll have to go get the paper. gotta scoot!!!
not sure whether to laugh or cry! i just went to the New England Journal of Medicine and read the TWO studies. one's from the US, the other is from Sweden. and, although they came to similar conclusions, they're very different.
the US study used matched WLS patients with age and weight matched controls. the Swedish study took a group of people from a given area at a given time and sorted them according to whether they received surgery or underwent conventional weight loss treatment. overall, the Swedish subjects had lower BMIs than the US subjects.
The US study then looked at deaths over time -without regard to anyone's weight loss or weight maintenance or followup or compliance or anything. the Swedish study followed everyone, and reported that those undergoing WLS maintained a weight loss of approx 25% [they gained a bit of weight, but held steady after 10 years or so]. and the conventional treatment group kept within 2% of their original weight.
both studies found reduced mortality rates, and differences by cause. but what was most interesting was the increased risk of accidents and suicides among the US WLS group. there was no mention of accidents or suicides in the Swedish study.
sooo, i'm still not sure what to think. it appears that having surgery ALONE can help reduce the risk of death. the amount of weight lost in the Swedish study is NOT spectacular, although the fact that they kept it off is, of course, one of the main reasons most of us have surgery.
Thanks for the additional info!!! I still think it's possible that it's not the surgery itself that's the cause, but maybe something about the people who are choosing surgery vs those who are not. [Talking to self: "Of course, they still all UNDERWENT the surgery, so it may be that having the surgery is still a big part of the effect here. I mean, it's not like we have people who CHOOSE the surgery and then don't have it as a comparison... definitely not ethical!" ]
That bit about accidents/suicides is intriguing, but I suppose the cause could be anything!
There may actually be a true surgery effect, at least in the US study, which looked only at gastric bypass patients. And remember, we have no other information whatsoever on the US patients, other than they'd had the surgery. So, a large section of intestine is bypassed and therefore doesn't participate in food or nutrient absorption. Therefore, regardless of whether someone loses, regains, doesn't lose, isn't compliant, whatever, there's a documented decrease in calorie absorption, fat absorption, and nutrient absorption. But what does that mean for mortality risk??? I have no idea, unless we start discussing antioxidant theories!
On the other hand, the Swedish study included lapbanders and people who'd had vertical gastroplasty as well as gastric bypass patients. so, decreased absorption DOES NOT explain the decreased risk among lapbanders. and there's no subgroup analysis. HOWEVER, there IS documentation of significant weight loss, and maintenance of weight loss over time in this study.
But what does that mean in the context of mortality risk????
Clueless here!!! but it IS interesting!
and one more aside - gastric bypass had the lowest rate of reoperations or conversion surgeries over 10 years - 17%. banding was 31%, and vertical banded gastroplasty was 21%. implications? not at all sure, but it is an interesting tidbit!
yes, it is really interesting, especially the differences between the different surgery groups. It's heartening to see 2 studies report the same general outcome using the different methodologies -- gives you more faith in the conclusion.
I keep coming back to people who choose WLS vs people of similar weights who don't choose the option. Is there any research that discusses what might be different about people who decide to go the WLS route? I never considered it for a number of reasons... among them, I think, was that I was quite healthy and relatively mobile even at nearly 300 pounds. I also knew that I really had never exhausted other options with regard to trying to lose weight. I opted out of trying. I also didn't know much about WLS at all (I've learned so much here on 3fc!), so was uninformed about options, etc.
What I find really interesting to contemplate is that, with no other info, I would have guessed that, compared to people who did not choose WLS, people who choose WLS may do so for impending health reasons. Fear of getting ill and dying. And that perhaps these fears are not just generalized, but that people are starting to see that they are really headed in that direction (blood work, diagnoses).
If that were the case, you'd expect that this group of people would have a HIGHER mortality risk. And yet, those who get the surgery have a LOWER risk, which, if all the above is correct, really does point to a surgery effect.
Of course, all that is sheer speculation on my part. I really don't know!!
interesting questions, Heather, and i have no answers! have you ever checked out the polls at the top of our forum? we ask why people are considering the surgery, and a few other questions. the responses are interesting, but overall, people who have the surgery view this as a last, almost desperate, effort to become healthy. some clinicians say that we have to 'hit the wall' before we decide to have the surgery.
just from my own personal observation [and it's nothing more than that, so i hope no one reads anything into this!!!] the people who have the surgery tend to be those who have tried multiple diets and strategies, have done it multiple times, and have regained everything and more over and over and over again.
people who decide against the surgery tend to say that they have faith that if they give it just one more try, they can do it. some succeed, others don't.
having said that, the biggest single reason i had the surgery was to reduce my risk of REGAINING!!!! losing is relatively easy - keeping it off is the hardest thing ever!!!
Latest NEJM studies on mortality and WLS
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