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Experts say there are many health advantages to having weight-loss surgery. Portra/Getty Images
  • Bariatric surgery is used by many people to help facilitate weight loss.
  • Researchers say the surgery can also lower the death rate from most causes, including diabetes, cardiovascular disease, and cancer.
  • They say their findings also include information that can help people decide whether to have the surgery and what they should do afterward.

People who have bariatric surgery appear to have a decreased likelihood of dying from most causes.

Among other conditions, the death rate from diabetes decreased by 72% with bariatric surgery, according to a retrospective study published today in the journal Obesity.

Researchers looked at health data for nearly 22,000 people who had undergone any of the four types of bariatric surgery between 1982 and 2018.

The death rate from all causes and specific cause conditions, such as cardiovascular disease, diabetes, and cancer, in people who underwent bariatric surgery, were compared to non-surgical participants matched for age, sex, and body mass index.

The findings included:

  • All-cause mortality was 16% lower in patients who had surgery compared to those who did not
  • Mortality from cardiovascular disease decreased by 29%
  • Mortality from cancer decreased by 43%
  • Mortality from diabetes decreased by 72%
  • Death rates from chronic liver disease were 83% higher in those who had had surgery

“This study is another reaffirmation of previous studies that show the long-term benefits of bariatric surgery,” said Dr. Mir Ali, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in California.

“The surgery has many long-term health benefits and increases life expectancy. The reduction in death rates from all causes shows that obesity can adversely affect every organ system in the body, and by getting to a healthy weight, a person can reverse those effects,” Ali told Healthline.

The researchers did note that higher rates of suicide in younger participants might indicate that a more detailed psychological screening before and after surgery is warranted.

“Bariatric surgery is life-changing,” said Dr. Megan Jenkins, a general surgeon specializing in advanced laparoscopy, bariatrics, and general surgery at N.Y.U. Langone Health in New York.

“Bariatric surgery is like hitting a reset button,” Jenkins told Healthline. “After surgery, you need to change your eating habits. Healthy eating after surgery means eating proteins and limiting carbs and sweets. You are starting a new lifestyle.”

Bariatric surgery, also called weight loss surgery, makes changes to the digestive system to help people lose weight.

There are four types of bariatric surgery, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

Gastric sleeve surgery removes most of a person’s stomach, leaving a smaller, banana-shaped section, which limits the amount of food that can fit, making you feel full sooner. Changes in hormones, bacteria, and the gastrointestinal system in response to the surgery could affect appetite and metabolism.

Gastric bypass has three steps. The first is decreasing stomach size by stapling off a section. The second involves removing the upper part of your small intestine, which allows food to bypass most of your stomach and the upper part of the small intestine. Your body absorbs fewer calories. Lastly, the upper part of the small intestine is reattached to the lower part of the intestine, allowing digestive juices in the stomach to bypass the upper section of the small intestine.

An adjustable gastric band surgeryinvolves placing a band filled with saline around the top of your stomach to make it smaller. The doctor can adjust the band to resize the opening by injecting or removing some fluid. This type of surgery is not done as often as other types of surgery because of complications and because the other types of gastric surgery allow for more significant weight loss.

Biliopancreatic diversion with duodenal switch surgery has two parts. The first is similar to the gastric sleeve and the second moves a section of the small intestine. This type of surgery allows for the most significant weight loss but also is associated with deficiencies in vitamins, minerals, and proteins because you absorb less than if you did not have the surgery. It may be the best option for people with severe obesity and certain health conditions.

The new study provides information doctors can share with their patients during decision-making.

“Most people struggling with excess weight have two goals in mind when trying to lose weight; one is to improve their health going forward, and the other is to improve the quality of life and ability to be active and involved, on a day-to-day basis,” said Dr. Brian Quebbemann, a bariatric surgeon, the founder of the N.E.W. program in Orange County, California, and author of “Dietary Rebuild.”

“Other studies show improvements in quality of life. this study confirms that the improvements in their health translate into a decreased risk of earlier death,” he told Healthline.

“I will also use the information on liver disease as a warning to my patients to be mindful of their alcohol drinking habit after surgery,” Quebbemann added.

Qualifications for bariatric surgery might vary from doctor to doctor.

According to the American Society for Metabolic and Bariatric Surgery, these include a person with a BMI of 35 or greater and individuals with a BMI between 30 and 35 who have a metabolic disease.

“It is important to have everyone undergo psychological screening, especially with the study finding that suicide rates increased after surgery,” said Jenkins. “One of the things I look for is the patient’s confidence level. Do they believe this will work? Do they believe the surgery will improve their life? Are they confident this is the right thing, and they can follow the diet after the surgery?”

Many bariatric programs and insurance carriers require a psychological screening before surgery.

“Perhaps looking deeper into the screening process and finding more effective ways to spot those at-risk individuals is needed,” Ali said. “Careful, long-term follow-up has always been an integral part of our program. I think it is and should be an essential part of every comprehensive weight loss program.”

In the days after surgery, people tend to feel typical post-operative symptoms, such as fatigue, pain around the incision, weakness, loss of appetite, gas, and emotional ups and downs, according to the University of California San Francisco.

The best way to a quick recovery is to get as active as possible as soon as possible under the guidance of a medical professional.

Exercise is essential after bariatric surgery. Experts say you should try to get up and move around the same day or the day after. Try walking at least three times per day, plus leg exercises. Your physical therapist can help you decide how much movement is best.

“The main factor in successfully maintaining weight loss after bariatric surgery is exercise,” Quebbemann said. “All patients say they want to lose weight to increase their physical activity. Medical professionals should reinforce this goal before and after surgery and tell patients that this increase in physical activity locks in their permanent success.”