WEIGHT-LOSS SURGERY: MOST EFFECTIVE TOOL FOR SEVERELY OBESE
April 11, 2005
Expensive weight-loss surgeries such as gastric bypass are by far the most effective options for severely obese people who want to lose a lot of weight, according to a new analysis.
Scientists from several medical institutions reviewed 225 studies on diet drugs and bariatric procedures, including gastric bypass and adjustable gastric banding. Among the findings reported in Annals of Internal Medicine:
- Severely obese people who have procedures such as gastric bypass surgery lose and keep off an average of 44 to 66 pounds for up to 10 years; the average cost for gastric bypass, which creates a much smaller stomach and rearranges the small intestine, is $26,000.
- Overweight people who take prescription diet drugs while dieting and exercising lose an average of 8 to 10 percent of their starting weight, about 15 to 20 pounds, in the first year.
This research did not cover as many years as did the bariatric-surgery studies.
- Weight-loss surgery helps improve or eliminate diabetes, high blood pressure, sleep apnea and high cholesterol for most patients.
- The mortality rates from all the bariatric procedures is under 1 percent; overall, about 20 percent of people had some complications such as intestinal leaks and nutritional abnormalities.
- Deaths and complications were significantly higher when performed by surgeons who had done fewer than 50 such surgeries.
While these findings might not seem surprising, this analysis is important because it was financed by the government -- the U.S. Agency for Healthcare Research and Quality --and may be a factor as insurance companies and government agencies debate whether to pay for weight loss or bariatric surgeries. Currently, Medicare covers bariatric surgery only if the obese patient has other life-threatening conditions, such as diabetes and heart disease. Benefits for Medicaid patients vary by state.
Source: Nanci Hellmich, "For obese, surgery more effective than drugs," USA Today, April 4, 2005; based upon: Melinda A. Maggard et al., "Meta-Analysis: Surgical Treatment of Obesity," Annals of Internal Medicine, Vol. 142, April 5, 2005.
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