Bariatric Surgery

BARIATRIC SURGERY
Via ASMBS

OVERVIEW
• Bariatric surgery, or weight loss surgery, limits the amount of food the stomach can hold by surgically reducing the stomach’s capacity to a few ounces. In addition to reducing food intake, some weight loss surgeries alter the digestion process, which curbs the amount of calories and nutrients absorbed
• Primary types of bariatric surgery include: laparoscopic and open gastric bypass surgery, laparoscopic adjustable gastric banding and duodenal switch
• Appropriate candidates have a body mass index (BMI) of 40 or more, or a BMI of 35 or more with an obesity-related disease, such as type 2 diabetes, heart disease or sleep apnea
• In 2007, an estimated 205,000 people with morbid obesity in the U.S. will have bariatric surgery
• About 15 million people in the U.S. have morbid obesity; only 1% of the clinically eligible population is being treated for morbid obesity through bariatric surgery

IMPACT ON OBESITY-RELATED DISEASES
• A study published in the Journal of the American Medical association (JAMA) in October 2004 of 22,000 bariatric surgery patients showed improvements in the following obesity-related conditions:
o Type 2 diabetes eliminated in 76.8% of patients; 86% eliminated or improved
o Hypertension eliminated in 61.7% patients and resolved or improved 78.5%
o Obstructive sleep apnea or sleep-disordered breathing eliminated in 85.7% of patients
o High cholesterol levels or hyperlipidemia decreased in more than 70% of patients
o Average weight loss was 61.2 % for all patients

RISKS
• A study published in JAMA in October 2004, showed 0.1% mortality for laparoscopic adjustable gastric band (LAGB) patients, 0.5% mortality for gastric bypass patients and 1% mortality for biliopancreatic diversion (BPD) and duodenal switch (DS) patients
• The national in-patient death rate associated with bariatric surgery declined from 0.89% to 0.19% between 1998 and 2004, according to the Agency for Healthcare Research and Quality (AHRQ)

EFFECTIVENESS
• Clinical studies show most bariatric surgery patients lose weight quickly and continue to lose weight 18 to 24 months after the procedure
• Patients may lose 30 to 50% of their excess weight in the first six months and 77% of excess weight as early as 12 months after surgery. Another study showed that patients can maintain a 50-60% loss of excess weight 10-14 years after weight loss surgery