A study to be published in this week’s issue of JAMA reports that men undergoing gastric bypass surgery for severe obesity had no improvement in survival over 7 years of follow up. The study is already making headlines on major news outlets. But several factors limit the validity of this study.
This was not a “randomized” trial in which participants are randomly assigned to receive surgery or non-surgical treatment. It is likely that the patients who got the surgery were sicker and had a poorer prognosis than those treated non-surgically. The rate of complications and death in the first 30 days after surgery was much higher than expected in this study. This not only may indicate these patients were sicker, it also reflects that the type of surgery that was done is more dangerous in obese men. Other types of surgical procedures for obesity may still show an improvement in survival because of the lower initial mortality. Prior studies have tended to show that surgical treatment of obesity does improve survival.
Weight loss surgery is associated with improvements in other conditions associated with obesity such as arthritis, diabetes and hypertension. Overall quality of life usually improves which is likely to be as important as overall length of life. In those patients who have been unable to control their weight with non-surgical means, surgery will continue to be a useful option.
So headlines simply stating that a study has shown weight loss surgery doesn’t help obese patients live longer should be taken with a large grain of salt. Further study is clearly warranted.
You can find the full text of the article in JAMA HERE.
David Fein, MD
Princeton Longevity Center