Bottom Line: Obese patients who underwent weight-loss surgery had a lower rate of death from any cause compared with obese adults who received nonsurgical care to manage their obesity.
Why The Research Is Interesting: Much is known about the short-term outcomes of bariatric surgery for weight loss but relatively little is known about its long-term effects. Some previous research has been limited by a number of factors, including the lack of a comparison group of obese patients who did not undergo bariatric surgery.
Who and When: 8,385 obese patients in Israel who underwent bariatric surgery (laparoscopic banding, Roux-en-Y gastric bypass, or laparoscopic sleeve gastrectomy) from 2005-2014; 25,155 obese patients who received nonsurgical care for obesity management from primary care physicians that may have included dietary counseling and behavior modification.
What (Study Measures): Bariatric surgery (exposure); death from any cause (outcome)
How (Study Design): This is a retrospective cohort study that used data from the past to compare obese patients who had bariatric surgery with those who didn't and death from any cause. The study is observational. Because researchers are not intervening for purposes of the study they cannot control for all the natural differences that could explain study findings.
Authors: Orna Reges, Ph.D., Clalit Health Services, Tel Aviv, Israel and coauthors
Results: The rate of death from any cause over about 4.5 years was lower among obese patients who underwent bariatric surgery compared with patients who managed their obesity with nonsurgical care.
Study Limitations: Imbalances caused by matching groups of obese patients for comparison based on age, sex, body mass index and diagnoses of diabetes.
Study Conclusions: The association between bariatric surgery and a lower rate of death from any cause adds to the limited literature describing the beneficial outcomes of these surgical procedures for obese patients.
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Related material:
The following related elements from this issue of JAMA are also available on the For The Media website:
-- Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss at 5 Years Among Patients With Morbid Obesity
-- Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss in Patients With Morbid Obesity
-- Lifestyle Intervention and Medical Management With vs Without Roux-en-Y Gastric Bypass and Control of Hemoglobin A1c, LDL Cholesterol, and Systolic Blood Pressure at 5 Years in the Diabetes Surgery Study
-- Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities
-- Editorial: Comparing the Outcomes of Sleeve Gastrectomy and Roux-en-Y Gastric Bypass for Severe Obesity
-- Editorial: Reimagining Obesity in 2018 - A JAMA Theme Issue on Obesity
For more details and to read the full study, please visit the For The Media website.
(doi:10.1001/jama.2017.20513)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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