August 22, 2007 (Insidermedicine) Bariatric surgery for severe obesity results in long-term weight loss and decreased overall mortality, according to a recent study published in the New England Journal of Medicine.

The rate of adult obesity has doubled in the past 20 years and tripled in children, affecting an estimated 30% of the US population. The health risks associated with obesity are significant, and include heart disease, diabetes, and cancer. As well, the life expectancy of someone who is severely obese is estimated to be about five to 20 years lower than a person who isn’t obese.

Here are some important facts to remember about obesity management:
•    Basic treatment consists of a gradual and permanent change in lifestye. The cornerstone of a lifestyle program includes weight loss through caloric reduction and increased excercise. 
•    Drug therapy may be beneficial in some cases.
- Surgical options may be considered  for selected patients with morbid obesity.  NIH guidelines support consideration of bariatric surgery in those  whose BMI is above 40 kg/m2, and in those whose BMI is greater than 35 and who have coexisting illness such as cardiovascular disease, type 2 diabetes and sleep apnea.

In the present study, researchers compared the overall death rate of more than 4,000 obese people, half of whom underwent bariatric surgery and half who received conventional treatment.

Depending on the type of surgery performed, the patients lost between 14% and 25% of their body weight at 10 years compared to less than 2% in those receiving conventional treatment. As well, after adjusting for covariates, weight loss surgery lowered the death rate by 29%.

Bariatric surgery may be an option for morbidly obese patients who have been unsuccessful losing weight through conventional approaches, including lifestyle modification with counseling, and drug therapy. This is the first prospective controlled study to show a benefit in overall mortality in those who received bariatric surgery.

For Insidermedicine in Depth, I'm Maria Radina.