Weight Loss Surgery Extends the Longevity of Lives: Study Finds

 

The Surgery for Weight loss Extends the Longevity of lives : Study

'To change your body you must first change your mind'

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Weight loss surgery decreases the risk of premature death, especially from such obesity-related conditions as  diabetes, cardiac disease and cancer  according to a new 40-year study of near about  22,000 people who had bariatric surgery in Utah.

The study found, Comparing  with the similar weight, those people who became  one of four types of weight loss surgery were 16% less likely to die from any cause,. The drop in deaths from diseases triggered by obesity, such as cardiovascular  disease, diabetes and  cancer, was even more dramatic.

Ted Adams,  lead author of the study, an adjunct associate professor in nutrition and integrative physiology, the University of Utah's School of Medicine said,  "Deaths from cardiovascular disease decreased by 29%, while deaths from various cancers decreased by 43%, which is pretty impressive,"

 "There was also a huge percentage drop — a 72% decline — in deaths related to diabetes in people who had surgery compared to those who did not," he added. It was a significant downside that the study also found those people who were younger and had the surgery were at higher risk for suicide. 

 

The study supports previous research

 A renowned professor of medicine and medical director of the weight management program at the University of California San Diego Health, Dr. Eduardo Grunvald said, the study, published  in the journal Obesity, reinforces similar findings from earlier research, including a 10-year study in Sweden that found significant reductions in premature deaths.

The Swedish research also found a significant number of patients were cured from diabetes at both two years and 10 years after surgery.

Dr. Eduardo Grunvald who co-authored the American Gastroenterological Association's new guidelines on obesity treatment, also said,  "This new research from Utah is more evidence that people who undergo these procedures have positive, beneficial long-term outcomes," 

 

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The association of USA strongly recommends the patients with obesity use recently approved weight loss medications or surgery paired with lifestyle changes.

Dr. Grunvald, who was not involved in the Utah study, also added,  "And the key for patients is to know that changing your diet becomes more natural, more easy to do after you have bariatric surgery or take the new weight loss medications,"

"While we don't yet fully understand why, these interventions actually change the thinkings in your brain, making it much easier to change your diet habit afterwards.

 

 

Obesity is also a disease

 

Dr. Caroline Apovian, Endocrinologist, a professor of medicine at Harvard Medical School and codirector of the Center for Weight Management and Wellness at Brigham said, 'Despite the benefits though, only 2% of patients who are eligible for bariatric surgery ever get it, often due to the stigma about obesity'.

She said,  "Naturally, Insurance companies cover the cost of surgery for people over 18 with a   BMI (body mass index) of 40 or higher, or a BMI of 35 if the patient also has a related condition such as diabetes or high blood pressure".

 

 

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" I will say the patients with a BMI of 50 and invariably, 'You're a candidate for everything — medication, diet, exercise and surgery.' And many tell me, 'Don't talk to me about surgery. I don't want it.' They don't want a surgical solution to what society has told them is a failure of willpower," she added.

She said more, "We don't torture the people who have cardiac disease or with diabetes: ' We tell them they have a disease, and we treat it. Obesity is also a disease, but we torture people with obesity by telling them it's their fault."

 

 

Both of men and women get benefit

Most of the patients who choose bariatric surgery — around 80% — are women, Adams said. One of the leaders of the new study, he said, was the inclusion of men who had undergone the procedure.

Adams said, "For all-causes of death, the mortality was reduced by 14% for females and by 21% for males,"  He added,  deaths from related causes, such as cardiac attack, cancer and diabetes, was 24% lower for females and 22% lower for males who underwent surgery compared with those who did not.

Between 1982 and 2018,  four types of surgery were examined in the study: gastric bypass, gastric banding, gastric sleeve and duodenal switch.

Gastric bypass, creates a small pouch near the top of the stomach,  developed in the late 1960s . In this Method, a part of the small intestine is brought up and attached to that point, bypassing most of the stomach and the duodenum, the first part of the small intestine.

 

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In gastric banding, is not a popular procedure today, an elastic band that can be tightened or loosened is placed around the top portion of the stomach, thus restricting the volume of food entering the stomach cavity. Because gastric banding is not as successful in creating long-term weight loss," Adams added.

"The gastric sleeve is that procedure where essentially about two-thirds of the stomach is removed laparoscopically,  takes less time to perform, and food  passes through the much-smaller stomach,  become a very popular option."- he said.

according to the Cleveland Clinic- the duodenal switch is typically reserved for patients who have a high BMI, Adams added.

 

A severe complication

 

One alarming finding of the new study was a 2.4% increase in deaths by suicide, primarily among people who had bariatric surgery between the ages of 18 and 34.

"The reason is that they are told that life is going to be great after  medication or surgery," said Joann Hendelman, clinical director of the National Alliance for Eating Disorders, a nonprofit advocacy group.

"After all you have to do is to lose weight, and people are going to want to hang out with you, people  want to be your friend, and your anxiety and depression are going to be gone," she said. "But the reality is not that."

On the other hand, there are postoperative risks and side effects associated with bariatric surgery, such as nausea, vomiting, vertigo, alcoholism, a potential failure to lose weight or even weight gain, said Susan Vibbert, an leared advocate at Project HEAL, which provides help for people struggling with eating disorders.

 

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"How are we defining health in these scenarios? And is there another intervention — a weight neutral intervention?" Vibbert asked.

Previous research has also shown an association between suicide risk and bariatric surgery, Grunvald said, but studies on the topic are not always able to determine a patient's mental history.

 

 First, we as a society must consider obesity as a disease, as a biological problem, not as a moral failing.

– Dr. Eduardo Grunvald, a professor of medicine

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"Did the person opt for surgery because they had some unrealistic expectations or underlying psychological disorders that were not resolved after the surgery? Or is this a direct effect somehow of bariatric surgery? We can't answer that for sure," he said.

Intensive presurgery counseling is typically required for all who undergo the procedure, but it may not be enough, Apovian said. She lost her first bariatric surgery patient to suicide.

 

"She was older, in her 40s. She had surgery and lost 150 pounds. And then she put herself in front of a bus and died because she had underlying bipolar disorder she had been self-medicating with food," Apovian said. "We as a society use a lot of food to hide trauma. What we need in this country is more psychological counseling for everybody, not just for people who undergo bariatric surgery."

Managing weight is a unique process for each person, a mixture of genetics, culture, environment, social stigma and personal health, experts say. There is no one solution for all.

"First, we as a society must consider obesity as a disease, as a biological problem, not as a moral failing," Grunvald said. "That's my first piece of advice.

"And if you believe your life is going to benefit from treatment, then consider evidence-based treatment, which studies show are surgery or medications, if you haven't been able to successfully do it with lifestyle changes alone."

 

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 Source :  CNN | Posted - Jan. 28, 2023 at 8:42 p.m.