With the rate of obesity continuing to rise across the Western world we are becoming increasingly conscious of the health risks of being significantly overweight and of the increased risk of death as a result of obesity. But just how far can these risks be lowered by undergoing gastric bypass surgery?

A recent study examined the records of a large number of individuals who had obesity surgery from the start of 1995 to the end of 2004 and reported that roughly one percent of patients died within a year of their surgery and just over 6 percent died within 5 years. When these numbers had been adjusted to take account of age and sex and matched against figures for the population at large they were found to be fairly high. So what does this tell us about the ability of gastric bypass surgery to reduce the overall risk to our health?

If we want to find the answer this particular question we need to look behind the headline numbers and look at why these deaths happened and where the true variation lies between the general population and gastric bypass patients.

If we examine the breakdown of the numbers two particular things stand out.

The first is the number of deaths resulting from heart disease which is the main cause of death in the gastric bypass patients and is considerably above that seen in the population at large.

The second is the number of deaths resulting from suicide and drug overdoses which, though not formally categorized as suicide, must nevertheless raise the question of whether or not these overdoses were truly accidents. Within the population at large you could expect to find roughly 2 suicides in a group of the same size as that used in the study and yet this study group showed a total of 30 deaths from suicide and drug overdoses.

If we examine these findings and set them alongside our general knowledge about individuals having gastric bypass surgery then we might possibly be able to explain this variation at least in part.

Despite the fact that bariatric surgery is frequently very successful it is often not undertaken until individuals are at risk from other medical problems or comorbidities and, though surgery may cure many of these problems and reduce the risks from others, many individuals are still at some risk even after surgery. In many cases for example people continue to be troubled by things like diabetes and high blood pressure and it is therefore unsurprising that this section of the population remains at higher risk from heart disease.

Furthermore, while gastric bypass surgery can lead to a large weight loss many people are still very much overweight for a considerable time after surgery and some will remain so for months or years to come.

Lastly, the changes in lifestyle which follow surgery are dramatic and many individuals experience depression during the weeks following their surgery. Indeed much attention is given to the physical affects of gastric bypass surgery and the need for things like a strictly controlled diet and exercise but, all too often, very little more than lip service is paid to the very real psychological affects of surgery.

Only time will tell the extent to which this explanation stands up but there should be little doubt that improvements to post-operative care for gastric bypass surgery patients would go a long way to solving this variation.

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