Study: Obesity Surgery Risky

Chances Of Dying After Surgery Higher Than Previously Thought

(AP) 
Obesity surgery is usually reserved for "morbidly" obese people more than 100 pounds overweight. These patients often have life-threatening medical problems brought on by their girth, including heart trouble, diabetes and breathing difficulties — problems that surgery can sometimes resolve but which can also make the operation riskier.

Flum said the new study suggests that in many cases, obesity surgery may not be right for an older person "who already has the burden of 60 years of obesity on their heart" and other organs.

Medicare covers obesity surgery if it is recommended to treat related conditions such as diabetes and heart problems. The government is considering whether to cover surgery to treat obesity alone.

Medicare is for younger Americans with disabilities and for patients 65 and older. Flum said most of the patients he studied were under 65 and probably qualified for Medicare because of obesity-related ills, including heart and joint problems.

There are several types of obesity surgery, but the most common one in the United States, gastric bypass, involves creating an egg-size pouch in the upper stomach and attaching it to a section of intestine. That reduces the amount of food patients can eat and results in less food being absorbed. Flum's study lumped together data on the different operations.

Researchers said one reason men may have higher post-surgery death rates is that they tend to wait longer than women to seek medical help and may be sicker when the operation is performed.

A third JAMA study cast doubt on whether obesity surgery reduces health-care costs. It found that among patients followed for about three years, an average of 8 percent were hospitalized before surgery, mostly for obesity-related complications, compared with 20 percent a year afterward, mostly for surgery-related complications.

That study's lead author, Dr. David Zingmond of the University of California at Los Angeles, said some people mistakenly view obesity surgery as a cosmetic procedure and "may greatly discount the chances that they're going to have problems after surgery."

Hutcher said patients should seek experienced surgeons who meet his group's guidelines. Those include thoroughly evaluating patients before and after surgery and giving them long-term follow-up care.

Most patients "will receive a good outcome. A good outcome does not mean there's no risk for complications or mortality," Hutcher said. But he said the surgery is riskier than, say, a tonsil removal. And "these patients are very sick," he said.