Long term effects from Bariatric Surgery

Research looked at the long term effects of RNY gastric bypass surgery at 12 years post-op. They concluded surgery appears to be successful for at least 12 years in terms of diabetes prevention or remission, as well as for improvement of lipid profiles and weight loss. But they noted an increase in suicide risk among patients.

The investigators, led by Dr. Ted D. Adams from Intermountain Healthcare in Salt Lake City, Utah, followed 418 patients who had RYGB gastric bypass surgery, and compared them to 417 patients who didn't have surgery (although they wanted to) because their insurance didn't cover it (non-surgery group 1 (NS1) and to a group of 321 equally obese people who didn't have surgery and hadn't tried to obtain it (NS2).

As expected, the surgery group lost more weight than either non-surgery group by 12 years post-procedure — - 35, three and zero percent respectively. In addition, the surgery group maintained an improved metabolic profile compared to either their baseline status or to the other groups. For example, their blood glucose levels dropped post-surgery, while those of NS1 and NS2 increased. Similarly, the level of LDL cholesterol decreased post-surgery while that of the NS groups had increased, and the opposite was true for HDL (good) cholesterol. Furthermore, the level of glycated hemoglobin (a measurement of glucose levels over time) didn't change in the surgical group, while it increased in both non-surgery groups. Also, of the 88 patients in the surgery group who had type 2 diabetes initially, 43 of those were no longer diabetic 12 years post surgery. By contrast, the risk of developing diabetes was less than one percent of that for either non-surgery group — a highly significant difference.

However, there was an association between bariatric surgery and death by suicide, an association that has been described in the past. The authors noted that it's unclear whether the increased suicide rate is related to the surgery itself, or might follow any large and sustained weight loss.

https://www.acsh.org/news/2017/09/21/bariatric-surgery-effects-are-good-long-term-11856