Short-term complications and death rates were low following bariatric surgery in extremely obese patients, according to the Longitudinal Assessment of Bariatric Surgery or LABS-1.
These study findings are reported in the July 30 issue of New England Journal of Medicine (NEJM).
LABS-1 followed 4,776 patients who had bariatric surgery for the first time. Their surgeries were performed over a two year period at 10 medical centers that specialize in these procedures. Researchers evaluated complications and death rates within first 30 days following surgery. Four bariatric surgical procedures were used but almost two thirds (2,975 patients) had laparoscopic gastric bypass and a quarter (1,198 patients) had lap-band surgery.
Study participants had an average body mass index (BMI) of 44 which is considered extremely obese. Participants were at least 18 years old, primarily white and female. The average age was 44.5 years.
Only 4.1% of patients had an adverse outcome within 30 days following surgery. Less than one percent (0.3%) of study participants died within 30 days. Complications included development of blood clots, repeat surgeries or a hospital stay longer than 30 days.
The differences in complication rate were not significant by gastric bypass procedure. However, patients with a higher BMI, sleep apnea or previous health issues, had a higher risk of complications following surgery.
LABS-1 and LABS-2
The Longitudinal Assessment of Bariatric Surgery or LABS is a National Institutes of Health funded consortium of six clinical centers and a data coordinating center. LABS is designed to assess the benefits and risks of bariatric surgery in extremely obese adults.
LABS-1 was designed to study the short-term safety and risks of bariatric surgery. LABS-2 is ongoing and will follow-up with patients after 6 months, 1 year and annually. The goal is to recruit 2,400 patients to form a detailed description of health problems before surgery and complications after surgery.
The Bottom Line
Based on these latest study findings, the risks associated with gastric bypass surgery in extremely obese patients is lower than previously thought. In fact, according to this study, the risk of death is 35% lower for someone who has the surgery compared to someone who remains severely obese.
Gastric bypass surgery is not for everyone. The procedure is intended for those who are severely obese (BMI over 40) or whose BMI is 35 to 39.9 but have a serious weight related problem, like diabetes or high blood pressure.
Clearly this is a procedure that must be discussed between your doctor and family. You need to be psychologically and medically prepared for the surgery. And, you need to have tried using conventional weight loss methods without success before having the surgery.
If all else has failed and you are a good candidate for bariatric surgery, then the benefits seem to outweigh the risks. But, the hard part comes after the surgery. That’s when the dietary, lifestyle and psychological factors that contributed to your obesity must be addressed. Adopting a healthy diet is especially important as bariatric surgery limits food intake, nutrient absorption, or both.
David H. Rahm, M.D. is the founder and medical director of The Wellness Center, a medical clinic located in Long Beach, CA. Dr. Rahm is also president and medical director of VitaMedica. Dr. Rahm is one of a select group of conventional medical doctors who have education and expertise in functional medicine and nutritional science. Over the past 20 years, Dr. Rahm has published articles in the plastic surgery literature and educated physicians about the importance of good peri-operative nutrition.