Bariatric surgery: do the benefits outweigh the risks?
Obesity prevalence is the highest it has ever been. And with the increase in obesity comes an increase in the number of weight loss surgery procedures. But how safe are the procedures, and do the benefits outweigh the risks?
There is no doubt that obesity is a major cause of a number of serious and potentially life-threatening diseases.
The condition can lead to type 2 diabetes, heart disease, stroke, and it has also been linked to some cancers, including breast cancer and colon cancer. Furthermore, the condition can severely damage a person’s quality of life, leaving them immobile and often triggering depression.
Based on these factors, it is not difficult to understand why excessively overweight individuals look to various weight loss interventions in order to combat their obesity. And weight loss surgery, also known as bariatric surgery, is now one of the most common interventions to which obese individuals turn.
What is bariatric surgery?
Bariatric surgery refers to a series of weight loss procedures that an obese individual can have in order to reduce their food intake, therefore causing them to lose weight.
A person is classed as obese if their body mass index (BMI) is over 30. If their BMI is over 40, they are deemed severely obese.
There are three main bariatric surgery procedures that are widely used. These are gastric bypass, gastric banding and sleeve gastrectomy.
Recovery time from these procedures varies from patient to patient. But it could take months for a patient to resume their normal daily activities following surgery, and many will have to follow a liquid diet and introduce normal foods slowly.
This prompts the question – why does bariatric surgery appear to be the preferred option over other weight loss interventions?
‘Most effective option’ for obese patients
According to Dr. Jaime Ponce de Leon, medical director for Mexico Bariatrics, standard diet and exercise strategies only lead to significant weight loss in 5% of the population.
Surgery for weight loss and control of associated diseases, has been shown to be the most effective option available for patients suffering from obesity and related diseases.
Furthermore, studies have shown that weight loss surgery is associated with fewer cardiovascular events, such as heart attack and stroke, and it has even been suggested that the procedure is linked to improved sex drive in patients.
But are patients overlooking the potential negative effects associated with the surgery?
Positives ‘outweigh’ the negatives
Bariatric procedures themselves present an array of possible complications.
For example, the ASMBS notes that a side effect of gastric banding may involve dilation of the esophagus (food pipe) if the patient overeats. This means patients need to stick to a strict diet for the rest of their lives and have regular postoperative follow-up visits.
Gastric bypass procedures also have their disadvantages. The ASMBS states that the surgery can lead to long-term vitamin and mineral deficiencies, and patients must have lifelong supplementation as a result.
But Dr. Ponce de Leon says that all surgeries present their risks, and these vary with each patient. He adds:
However, in the appropriate patients, the health risks from obesity far outweigh the risks associated with bariatric surgery. Metabolic and bariatric surgery is associated with major reductions in risk of premature death over a 5-year period versus not having surgery, and the risk of bariatric surgery is now no greater than laparoscopic gall bladder surgery.
Patients ‘need better advice to make decisions’
Dr. Ponce de Leon says he believes better communication is needed between doctors and obese patients, in order to ensure patients are better informed about the risks associated with bariatric surgery and whether the procedure is right for them.
“Bariatric and metabolic surgery is a major decision, and patients need time to consider it and explore their options. However, if a patient waits too long in their disease progression, the benefits from surgery may be impacted,” says Dr. Ponce de Leon.
Although there are many surgical options available to assist with weight loss, there is no denying the importance of following a healthy diet in order to maintain a healthy weight.