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How Many Years Can Bariatric Surgery Add To Your LIfe?



Yesterday, I discussed the impact of bariatric surgery on life expectancy in Ontario, Canada, which showed a clear positive impact on reducing overall mortality, particularly from cardiovascular disease and cancer. 

But this study is by far not the only data we have on this issue. In fact, a recent meta-analysis by Nicholas Syn and colleagues, published in The Lancet, should dispel any remaining doubts as to the overall impact of having bariatric surgery.

The authors looked at data from over 170,000 participants across 16 matched cohort studies and one prospective controlled trial (the one from Ontario not included!), representing over 1,2 Million patient years. 

Overall bariatric surgery was associated with a reduction in hazard rate of death of 49·2% with median life expectancy being 6·1 years longer than with usual care. In fact, for patients with diabetes, life expectancy was 9.3 years longer (compared to 5.1 years longer in participants without diabetes).

Based on these observations, the numbers needed to treat to prevent one additional death over a 10-year time frame was  slightly greater than 8 for those with diabetes vs. 30 for those without diabetes. This, by any measure, puts bariatric surgery squarely in place as one of the most effective treatments for any serious condition in all of medicine!

In an interesting extrapolation of these results to the global pool of potential surgery candidates, the authors project that even just a 1% increase in rates of bariatric surgery, could translate into 5.1 to 6.6 millions potential life-years saved. 

To anyone who would still prefer to pooh-pooh this vast body of evidence, because they only “believe” in randomised controlled trials, the authors point out that,

Randomised clinical trials with sufficient power to assess a rare outcome such as mortality are unlikely to ever be done because such studies require large sample numbers, long-term follow-up spanning decades, and are prohibitively expensive.

So, this may well be the best evidence we may ever have on this issue – take it or leave it.

Either way, finding a justification to deny or discourage patients with severe obesity from seriously considering surgery as a treatment for their chronic disease is becoming increasingly untenable. 

@DrSharma
Berlin, D

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