Heart Deaths, Suicides Up After Weight Loss Surgery

Content provided by Reuters

Thursday, November 8, 2007

NEW YORK (Reuters Health) - Among people who have undergone so-called bariatric surgery for obesity, death rates are higher than seen among other people of the same age, new research shows. In particular, deaths due to suicide and coronary heart disease are higher than might be expected normally. The study looked at data for all Pennsylvania residents who underwent a bariatric operation such as stomach stapling or gastric bypass between 1995 and 2004. Deaths in these patients were compared with those seen in the general population.

A total of 440 deaths were noted after 16,683 weightloss procedures during the study period, Dr. Lewis H. Kuller, from the University of Pittsburgh, and colleagues report.

Male gender and advancing age were both associated with increased death rates, according to the team's report in the Archives of Surgery.

For all age groups, the death rate was much higher in bariatric surgery patients than in the general population.

The difference was particularly pronounced for patients between 25 and 34 years of age. In this group, the death rates for male and female patients were 13.8 and 5.0 per 1000 persons per year, respectively, compared with rates of 1.3 and 0.6 per 1000 persons per year in the general population.

The most common cause of death was coronary heart disease, the report indicates. In addition, there were 16 suicides, 10 of them women. Based on data from the general population, the authors estimate that only three suicide deaths would have been expected in this number of people.

Kuller's group says the excess deaths after bariatric surgery could be reduced by better control of high blood pressure, diabetes, high cholesterol, and smoking, "as well as efforts to prevent weight regain by diet and exercise, and psychological support to treat depression and prevent suicide."

SOURCE: Archives of Surgery, October 2007.

Copyright 2007 Reuters Li

I'll comment on the suicide rate, which I would think is bound to happen. If you're not psychologically sound, and if you can find a surgeon to do this proceedure, then guess what? They just took away your coping mechanism. So what are you gonna do? The obvious is you're gonna be in serious mental trouble. I can relate to this because I had the staple back in 1981, lost 105 pounds and regained 150. So from my point of view, I blew it out, regained the weight plus, and was in very serious mental trouble. In my case it wasn't the removal of the coping mechanism, but seeing myself regaining all of that weight. Had I not had this monstrous fear of dying, I could've easily been one of the number in this study. People, make sure you're mentally and emotionally sound before doing this surgery. If you're not, it isn't a question of IF the surgery will fail, it's simply a matter of when.

Heck, I couldn't even get past the first line... what does it mean "so-called bariatric surgery for obesity"  I very seriously tried to read this artical, but I do NOT understand why they called it "so called"...that makes no sense. anyway...like the poster above said - if you are using food as a crutch for many things in life, and suddenly you don't have a crutch - seems logical that you're gonna fall...

Another look:

Weight Loss Surgery Saves Lives

Research Shows Fewer Deaths From Diabetes, Heart Disease, and Cancer

By Salynn Boyles WebMD Medical News

Reviewed By Louise Chang, MD

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Aug. 22, 2007 -- Weight loss surgery is known to help severely obese people shed pounds and lower their risk of diabetes, heart disease, and other obesity-related diseases. Now two landmark studies show that the surgery also saves lives.

In one study, deaths decreased by more than 90% from diabetes and 50% from heart disease in severely obese people who had weight loss surgery compared with those who did not.

In separate research, weight loss surgery was associated with a 29% reduction in deaths over an average follow-up of 10 years, compared to those who did not have weight loss surgery.

Both studies are published in the Aug. 23 issue of The New England Journal of Medicine.

Longtime obesity researcher George Bray, MD, of Louisiana State University, tells WebMD that the new research provides the important "missing link" showing that weight loss surgery reduces mortality.

Weight loss surgery, says Bray, "is associated with a dramatic reduction in diabetes and other diseases associated with obesity, so it stands to reason that it would positively impact survival. But there has been some question about this, and a few studies have even suggested the opposite."

Weight Loss Surgery vs. No Surgery

In the larger of the two studies, roughly 8,000 gastric bypass patients and 8,000 people who did not have weight loss surgery matched for sex, age, and weight were followed for an average of seven years.

University of Utah School of Medicine researchers reported a 40% overall reduction in deaths among the surgery patients compared to the patients who did not have weight loss surgery.

Surgery patients' deaths decreased by 92% from diabetes, 56% from cardiovascular disease, and 60% from cancer.

Researcher Ted D. Adams, PhD, MPH, tells WebMD that the difference in cancer mortality was very surprising.

"We did not anticipate such a large reduction in cancer deaths in such a short time, and we aren't really sure what to make of it," he says, adding that his research team is currently exploring the issue.

Death Rates From Causes Other Than Disease

There was yet another surprise in the findings. While surgery patients had a lower death rate from diabetes, cancer, and other diseases than nonsurgery patients, death rates from causes other than disease, such as accidents and suicide, were greater.

Patients who had weight loss surgery had death rates from nondisease causes that were 58% greater than people who did not have surgery.

The study offered few clues about the reason for this. But several previous studies have suggested a link between weight loss surgery and an increase in drug and alcohol abuse and other risk-taking behaviors.

Adams says the findings highlight the need for better ways to identify psychological "red flags" in patients who are considering weight loss surgery and for assessing mental status after surgery.

Weight Loss Surgery vs. Dieting

The second study involved just over 4,000 severely obese patients, half of whom were treated with weight loss surgery and the other half with either no treatment or nonsurgical weight loss interventions like dieting.

Ten years later, weight loss among the surgery patients averaged 14% to 25%, compared with less than 2% among the nonsurgery patients.

During the follow-up, 129 deaths occurred among nonsurgery patients, compared with 101 deaths among the surgery group.  The number of heart attack deaths were lower in the surgery group (13 vs. 25), as were cancer deaths (29 vs. 47).

Researcher Claude Bouchard, PhD, of Louisiana State University's Pennington Biomedical Research Center, tells WebMD that the two studies prove that weight loss surgery is a lifesaving option for severely obese patients.

Consensus Conference Needed

Bray agrees that weight loss surgery may prove to be a more important weapon in the battle against obesity and obesity-related disease than any previous intervention.

But he says the benefits and risks of modern approaches to weight loss surgery must be examined before the indications for the surgery are expanded.

He is calling for a national conference to address the matter. The last such conference was held in 1991.

"A lot has happened since then, he says.  "Laparoscopic surgery has all but replaced the open surgery -- and surgical mortality rates have declined as a result. But there are unanswered questions about which patients will benefit most from this surgery."

SOURCES: Snowstorm, L. and Adams, T.D. New England Journal of Medicine, Aug. 23, 2007; vol 357: pp 741-761. Ted D. Adams, PhD, MPH, research professor, cardiovascular genetics division, University of Utah School of Medicine, Salt Lake City. George Bray, professor of medicine, Pennington Biomedical Research Center of Louisiana State University, Baton Rouge. Claude Bouchard, PhD, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge. Kelvin Higa, MD, president, American Society for Metabolic and Bariatric Surgery; clinical professor of surgery, University of California at San Francisco.

I wonder why more heart disease? Suicide I understand, any major life change could trigger that, but how could heart disease get worse after WLS?

Damned if we do--Damned if we don't! 

I once had a dr, tell me to either stay fit or stay fat because the yo y o thing is very hard on your body and im sure its hard on your heart.losing 100 gaing 150 loosing it gaing back 170.loosing weight fast can be hard on your body.