Bariatric Surgery Reduces Mortality Risk of Specific Conditions

In a new study with 40-year follow-up, all-cause and cause-specific conditions were significantly reduced in people who underwent bariatric surgery compared with those that did not undergo surgery.

Despite the decline in most all-cause and cause-specific conditions, the researchers found an increase in suicide rates in individuals who had bariatric surgery and were in the younger age group of patients.

The researchers conducted a retrospective study that included 21,837 surgery and non-surgery patients who were matched for age, sex, BMI, and surgery date. The follow-up was conducted up to 40 years where researchers examined the long-term mortality results after surgery. Compared with patients who did not undergo surgery, all-cause mortality was 16% lower in the group that had surgery (hazard ratio = 0.84; [95% CI, 0.79 to 0.90]; p < 0.001). The lower rates of all-cause mortality were observed in both female and male patients.

Mortality from conditions and disease like cardiovascular disease, cancer, and diabetes saw a decrease in the groups who received surgery by 29%, 43%, and 72%, respectively.

Additionally, in the group of patients who had bariatric surgery, suicide rates were 2.4 times higher than those in the non-surgery group (95% CI, 1.57 to 3.68; p < 0.001). The trend was observed in surgery patients aged between 18 and 34 years. From their findings, the researchers believe there should be a “more aggressive presurgical psychological screening and postsurgery follow-up, especially among patients representing this age group,” they wrote.

The researchers reported one limitation of the study, which included a lack of clinical data at the time of bariatric surgery or date of application. Additionally, the researchers note an absence of clinical surveillance throughout the study.

“Results of this study attest to the decades-long durability of bariatric surgery in reducing death from all causes and reducing deaths related to cardiovascular disease, cancer, and diabetes when compared with matched participants with severe obesity. In addition, favorable mortality outcomes were evident for major bariatric surgery procedures” the researchers concluded. “Serious concern, however, continues to be exhibited regarding increased mortality following bariatric surgery in relation to suicide, accidents, and cirrhosis of the liver.”

Reference:

Adams TD, Meeks H, Fraser A, et al. Long-term all-cause and cause-specific mortality for four bariatric surgery procedures. Obes Res. Published online January 25, 2023. doi:10.1002/oby.23646