These are bariatric operations, among which is the partitioning of the stomach or the reduction of that organ. All procedures were performed in Utah. Compared with people of a similar weight, people who underwent one of four types of weight loss surgery had a 16 percent lower mortality rate, the study found.
The decline in mortality from diseases caused by obesity, such as heart disease, cancer and diabetes, has been even more dramatic.
“Death from cardiovascular disease was reduced by 29 percent, while death from cancer of any type was reduced by 43 percent, which is pretty impressive,” said lead study author Ted Adams, associate professor of nutrition and integrative physiology at the University’s School of Medicine. Utah.
“Also, there was a huge drop in diabetes-related mortality, which was 72 percent in people who had the surgery compared to those who didn’t,” Adams said.
However, the study also found that younger people who had the surgery were at a higher risk of suicide.
The study, published in the journal Obesity, supports similar findings from earlier research, including a 10-year study in Sweden that found a significant reduction in premature deaths, said Dr. Eduardo Grunwald, professor of medicine and director of the Division of Weight Management Programs at the University of California, San Diego.
“This new study from Utah provides more evidence that people who undergo these procedures have positive, beneficial long-term outcomes,” said Grunwald, who co-authored the American Gastroenterological Association’s new obesity treatment guidelines.
Many are afraid of surgery
The association recommends that morbidly obese patients use recently approved weight-loss drugs or surgery in combination with lifestyle changes.
“Although we still don’t fully understand why, these interventions actually change the chemistry in your brain, making it easier to change your diet afterwards,” says Grunwald.
“Despite the benefits, only two percent of patients eligible for bariatric surgery undergo it, often because of the stigma associated with obesity,” said Dr. Caroline Apovian, professor of medicine at Harvard Medical School and co-director of the Center for Weight Management and Wellness in Boston. .
Apovianova was also the lead author of the Endocrinology Society’s clinical practice guidelines for the pharmacological management of obesity.
“When I see patients who have a high body mass index and who, in my opinion, are candidates for everything – drugs, diet, exercise and surgery, many tell me not to talk about it and that they don’t want to think about surgery.” “I don’t think they want a surgical solution to what society has told them is a failure of willpower,” said the doctor.
Most people who choose bariatric surgery, about 80 percent of them, are women, Adams said. One of the strengths of the new study, he emphasized, was the inclusion of men who had undergone the procedure.
“Mortality was reduced by 14 percent in women and 21 percent in men,” Adams said.
In addition, mortality from related causes, such as heart attack, cancer and diabetes, was 24 percent lower for women and 22 percent lower for men who underwent the surgery compared to those who did not, he added.
A serious complication whose cause is not yet known
However, one alarming finding of the new study was a 2.4 percent increase in suicide deaths, primarily among people who had bariatric surgery and were between the ages of 18 and 34.
“That’s because they’re told life will be great after surgery or medication.” They were probably also told that all they had to do was lose weight and then people would want to hang out with them, they would want to be their friends, and their anxiety and depression would go away. But that’s not reality,” explained Joan Handelman, clinical director of the National Eating Disorders Alliance.
In addition, there are postoperative risks and side effects associated with bariatric surgery, such as nausea, vomiting, alcoholism, and potential failure to lose or even gain weight, said Susan Vibert, an advocate for Project HEAL, which provides assistance to people struggling with eating disorders.
Past research has also shown an association between suicide risk and bariatric surgery, Grunwald said, but studies on the topic aren’t always able to determine each patient’s mental history.
“Whether the person decided to have the surgery because they had some unrealistic expectations or underlying psychological disorders that didn’t resolve after the surgery, or if it was a direct effect of the bariatric surgery – we can’t answer that for sure,” Grunwald said.
Intensive pre-surgery counseling is usually required for everyone who undergoes the procedure, but that may not be enough, said Apovianova, who lost one patient after bariatric surgery. It is about a middle-aged woman who suffered from bipolar disorder and committed suicide.
“We as a society use a lot of food to compensate for trauma. What we need is more psychological counseling for everyone, not just people undergoing bariatric surgery.
Weight management is a unique process for each person, a mix of genetics, culture, environment, social stigma and personal health, experts say. There is no one-size-fits-all solution.
“First, we as a society must consider obesity a disease, a biological problem, not a moral deficiency. That’s my first advice,” said Grunwald.
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