WEIGHT LOSS SURGERY
IS IT WORTH IT?
An annual $190 billion is spent on obesity-related medical costs, according to a Reuters report, citing data from the Mayo Clinic. There are even obesity-associated costs to the overall economy. The report says job absenteeism among the obese is higher, airlines need an extra $5 billion in jet fuel to fly heavy passengers compared to 1960 weight data, and we spend an additional $4 billion annually on extra gas for heavy passengers and drivers. Bruce Kennedy from MSN’s MONEY “Is weight-loss surgery worth the cost?” (Feb 25, 2013).
A popular online encyclopedia defines it thusly, “A variety of procedures performed on people who are obese. Weight loss is achieved by reducing the size of the stomach with a gastric band or through removal of a portion of the stomach or by resecting and re-routing the small intestines to a small stomach pouch.” Although it varies for different procedures, the cost for Bariatric Surgery runs between $15,000 and $45,000.
What do the studies say about surgical weight loss? Although several recent studies of Bariatric Surgery (a couple from just last week) show health benefits that could only be described as “astounding”, we might not be getting the whole story. And as is all too often the case, the story we are getting might be bought and paid for.
Research suggests that over several years, many bariatric patients regain some of the weight they lose in the first two years — a fact that has raised doubts about the cost-effectiveness of the surgery, which can cost $20,000 to $25,000 for the initial procedure, plus a wide range of costs to treat complications after surgery. Melissa Healy from a November 13, 2013 article in the “Science Now” portion of the LA Times.
“In contrast, the surgical group lost almost one-third of their lean body mass [muscle mass]. This is kind of a dirty secret that’s not very well advertised for bariatric surgery, that you can lose a lot of lean mass and I don’t think we fully understand the long-term consequences of that.” Dr. David Cummings being quoted by Nancy Walsh in Tuesday’s issue of MedPage Today concerning whether a “Diabetes Cure” via surgery is more effective than by medication.
Complications from weight loss surgery are frequent. A study of insurance claims of 2522 who had undergone bariatric surgery showed 22% complications during the initial hospital stay and a total of 40% risk of complications in the subsequent six months. This was more common in those over 40 and led to an increased health care expenditure….. Nutritional derangements due to deficiencies of micronutrients like iron, vitamin B12, fat soluble vitamins (A, E, D, & K), thiamine, and folate are especially common after malabsorptive bariatric procedures…… A study in Veterans Affairs (VA) patients has found no survival benefit associated with bariatric surgery among older, severely obese people when compared with usual care, at least out to seven years. Wikipedia
The point is, although everyone seems to be singing the praises of of Bariatric Surgery these days, it’s not all peaches and cream. Just visit some of the weight loss surgery message boards. Although most people will still say, “I’ve tried everything and nothing works — it’s time for the surgery“, this is rarely the case. As a last resort, see a doctor who specializes in “FUNCTIONAL MEDICINE“. Lastly; can we really trust the research? As you should have noticed from my post THE OTHER DAY, I have serious doubts.
One of the latest studies (presented recently at Atlanta during the “Obesity Week” meetings) touting the benefits of Bariatric Surgery was headed by Dr. Cummings, who just happens to be on the payroll (he “received the financial support“) of Johnson & Johnson —- the maker of the “Realize” gastric band. The meetings themselves were sponsored by the American Society for Metabolic and Bariatric Surgery — an organization whose mission statement reads, “The purpose of the society is to advance the art and science of metabolic and bariatric surgery by continually improving the quality and safety of care and treatment of people with obesity and related diseases“.