Bariatric surgery doesn't help obese live longer, study says
June 12th, 2011
11:00 AM ET

Bariatric surgery doesn't help obese live longer, study says

Getting bariatric surgery will not decrease mortality several years after the surgery, according to a study published in JAMA.

Although the weight-loss surgery has been shown to decrease weight and diminish diabetes, the older, severely obese male patients in the study were not living longer because of the procedure.

The study was to be presented Sunday at the Academy Health Annual Research Meeting.

For the severely obese, bariatric surgery is one of the most effective ways to reduce weight.  The most common bariatric surgery is gastric bypass, which creates a small stomach pouch that restricts food intake.

The study conducted at Veteran Affairs medical centers followed 850 veterans who had bariatric surgery from January 2000 to December 2006.

When study authors compared the raw rates, patients who had surgery had lower mortality rates with 6.8 percent versus 15.2 percent after six years.

But when researchers compared the 850 veterans to 1,694 similar patients who did not have bariatric surgery, they found that surgery was not significantly associated with reducing mortality.

Matthew Maciejewski, of Durham VA Medical Center and colleagues concluded that “bariatric surgery does not appear to be associated with survival during a mean of 6.7 years of follow-up.”

soundoff (186 Responses)
  1. Happy in Alabama

    I had the surgery 2 years ago and I have done very well . I am 6 feet 2 inches and I have went from 340 down to 200. I am in a size 34 waist and I am happy. I am 45 and was diabetic and taking 7 pills a day and now I just take vitamins. It is not for everyone as I was a happy fat person but when i developed diabetes at 41 it scared me. I am happy with my choice as in the long run it will probably save my insurance money with no prescription cost. It is your body so it is up to the individual what they think is best.

    June 13, 2011 at 09:22 | Report abuse | Reply
    • marie

      Up to the individual? Your insurance paid for it ... If this study is accepted, it will be up to the insurance company, and they will probably say no ... it costs all of us in increased premiums for surgery that is questionable – that does not extend life.

      June 13, 2011 at 09:46 | Report abuse |
    • AinT

      Marie, where did he say his insurance paid for it??? I had it done and my insurance did not....I PAID!! And I paid $20,000....I'd do it all again, even if it were twice the price. I'm over people judging fat people and saying it's a matter of willpower. Until you're the fat person who is on a diet constantly and can never lose the weight, shut your mouth. Judgemental people always speak the loudest and it's always about s**t they know nothing about but seem to think they are the authority.

      June 13, 2011 at 10:17 | Report abuse |
    • Brad

      AinT, I was a fat person who lost weight and it is a matter of will power. There is nothing forcing people to food down there throats and sit in front of a TV or computer all day. It's all about the ability to say no and take initiative to be active.

      Anyway, the reoccurance of addictive behaviors for people who have had bariatic surgery is over 50% so most people who need it to lose weight are going to become addicted to something else like alcohol or over the counter drugs or something with a quick gratification.

      June 13, 2011 at 11:18 | Report abuse |
    • mizsherle

      @Marie Your statement is not well thought out. The surgery is more than likely very much less of a financial drain on "your insurance premium" than managing the chronic care of diabetes and the number of other health problems that can occur with obesity. And no matter how healthy you think that you are, anything can happen at any time to anyone, and I doubt if you'd want someone who thinks like you sitting in judgement over your health care.

      June 13, 2011 at 11:28 | Report abuse |
    • Zeb

      Just because something doesn't extend life it does not mean it is not useful. It improves the quality of life. Capping your teeth, or getting an artificial limb if you loose one won't extend life either, but it will make it better.

      June 13, 2011 at 11:52 | Report abuse |
    • Cynthia

      Miz has it right, we pay lower premiums in the long-term. No more life long, multiple perscriptions. As for willpower, those of you making snide remarks about people taking care of their own weight problems, those people you see who are overweight may have a medical condition (my Munchkin mom was on prednison, she was barely eating but looked like she had gained 100 lbs.). Also, some people eat for reasons other than hunger or gluttony. You just prove 'perfect' people are soooooooo annoying.

      July 14, 2012 at 22:29 | Report abuse |
  2. Dandelion

    Every person is unique. Gastric Bypass is life changing. To be successful, the person receiving the procedure has to remain positive and focused on replacing bad habits with new, healthier ones. Exercise and good food choices are part of a persons success. I chose to have the surgery 10 months ago. I have lost 124 lbs and have regained a new life. I am grateful for the opportunity to live life healthier and happier.

    June 13, 2011 at 09:24 | Report abuse | Reply
  3. Mary

    If a person is overweight enough to require bariatric surgery there are psychological issues going on in addition to the weight. If the person doesn't get a handle on what is going on psychologically their life will be shortened anyway, surgery or no, so why not get the surgery and not worry about this stupid report.

    June 13, 2011 at 09:33 | Report abuse | Reply
    • marie

      Because it's a waste of health care dollars.

      June 13, 2011 at 09:46 | Report abuse |
    • AinT

      Again, Marie???? Really, do your research before you spout off with your ignorant mouth

      June 13, 2011 at 10:18 | Report abuse |
    • Smexy

      "If a person is overweight enough to require bariatric surgery there are psychological issues ..." not always. We here in the US live in a "super-size me" culture which contributes to bad eating habits as well

      June 13, 2011 at 10:38 | Report abuse |
    • MT

      What's to say that it's a waste of healthcare dollars. Aren't the tons of medications and extra doctor visits that being morbidly obese and having a myriad of illnesses that are associated with it going to cost some insurance company $? Most people find that these illnesses either go away completely or are reduced to the point of not needing prescription medications. I'm not sure why the study was focused on mortality, as that is not usually the main reason people have such surgery, rather the quality of life.

      June 13, 2011 at 10:49 | Report abuse |
    • aubrie

      Marie..... You spend your health care dollars as you see fit, and leave the ignorant comments at the door. My life has vastly improved as a result, and I don't need "you" to tell me that is not so...... Sorry it didn't work out for you if that's what you're so bitter about....

      June 13, 2011 at 14:02 | Report abuse |
  4. traveler04

    I am a few months away from having bariatric surgery. I am 36 yrs old and have been overweight since I was approx 4 yrs old. My sister is a normal weight, I have always been overweight. Same parents. Same upbringing. Same meals. I got the short end of the genetics stick. I belong to a gym and take spinning classes there 2-3 times a week. I also take yoga, pilates, strength training, etc. I am diabetic, have high blood pressure, PCOS (polycystic ovarian syndrome) and have tried and tried for years to loose weight. The PCOS comes with hormone imbalances. I can walk normally, climb stairs, ride amusement park rides and can walk all day long. I have tried starvation, phentermine, Weight Watchers, liquid diets. I do not drink soda, I do not smoke, I do not drink alcohol and I do not eat fast food and try to eat organic food as much as possible. Sometimes, life just isn't fair and I determined it was time for me to look for help in fighting my obesity. On the outside I seem normal but look bigger. On the inside, I am ill and there is a war waging with my diabetes. So, I am preparing to have gastric bypass to use as my tool to healthier living. I've tried everything I can think of on my own. Sometimes the forces of nature are greater than yourself and that is when help is needed. I'm willing to do my part but I have come to the realization that I can't keep doing it the way I've been doing it. Not all overweight people are lazy overeaters looking for an easy way out (however yes, some are). I know I do not fall into that category and I am grateful I have a way to live a healthier life and will finally be able to see the fruits of all of my workouts by finally looking and being healthier inside and out!

    June 13, 2011 at 09:48 | Report abuse | Reply
    • Bunson44

      @traveler04. Good luck with the surgery. I had it done about 9 years ago and, although it is an excellent tool for losing weight (i dropped about 125 lbs), a good diet and exercise program will definitely be needed to maintain the weith loss as this surgery is not a cure for obesity. Your exercise regimen and eating habits will hold you in good stead. I was frightened before my surgery, being over 55 at the time and was second guessing myself, but I am so happy that I went through with it. Although I am not a skinny mini, my diabetes scare has gone away along with other issues. I wish you the best.

      June 13, 2011 at 10:05 | Report abuse |
    • Jonathan

      Traveler04... have you ever changed the way you eat through out the day? Take in the same calories but spread them out... eat approx 2000 calories but instead of eating them in 3 meals eat them in 6. You will feel like you are eating more and your glycemic index will balance out and allow your metabolism to shift. I have seen this happen in someone with your exact history so I know it can work. Don't get discouraged, I understand for many people like yourself it is not as simple as it is for others but you CAN live at a healthy weight. Please try this technique as I promise you will not be disappointed. If you are truly doing all the other things you listed I KNOW this will get you results.

      June 13, 2011 at 10:05 | Report abuse |
    • Pennswoodsman

      If you are serious, then thank you for at least TRYING to lose weight the right way. the so called "stomach staple" is the crappy, lazy way out of obesity, and the few people I have known who got it, all got fat again after a few years, cause they didn't change their diet and still got no excersise. gastric bypass is not a magic cure all. It still requires a change in lifestyle...the only difference is it allows you to start from square one with a new body. I'm not suprised to hear that it doesn't allow you to live longer though. Obseity does terrible damage to your body and even after you get surgery, the damage is already done. Our country is so damn fat...just walk into any walmart and see how many tubs of crap you see driving around in those little carts cause they are to lazy to waddle around. It disguists me.

      June 13, 2011 at 10:28 | Report abuse |
    • motherof3

      Traveler, I just had my gastric bypass 6 weeks ago and couldn't be happier. I did exactly what you did and despite my best efforts, I still would not lose the weight necessary. Women who have PCOS from the onset of puberty tend to have difficulty losing weight normally. Given that the moment I hit puberty I had to struggle to keep my weight at the high end of normal with hours of exercise daily, a healthy diet, no sodas, juice or other sugary drinks I finally had enough! I have dropped in 6 weeks what it took me almost a year to drop with 1100 calories a day and 2 hours daily in the gym. It is a great tool and though I have had a couple of complications, they haven't been horrible and certainly something I am glad I did. Do keep in mind though that this really is nothing more than a tool to help us achieve a healthier body. Good luck on your journey!

      June 13, 2011 at 10:46 | Report abuse |
    • Eric79

      As much as we like to think we have no choice it really is calories in and calories out. If I took you and threw you in a locked room and fed you bread and water for a month, you'd definitely lose weight. A lot of it.

      June 13, 2011 at 10:53 | Report abuse |
    • Brad

      travler04, you cannot change the laws of physics no matter how many times you want to say it is genetic. you are overweight because you eat more than you burn. PCOS does come with a lot of issues, but the bottom line is that you are not controlling something. Probably food intake. Think about it. If you were controlling your food intake you wouldnt need the surgery. All bariatric surgery does is limit the amount of food you can ingest at one time. I'm sorry for your condition, but you have other issues. Good luck with the surgery.

      June 13, 2011 at 11:23 | Report abuse |
    • traveler04

      Brad –
      I currently take in approximately 1000 calories a day and am under the supervision of an MD for the diet I am on. I supplement meals with protein shakes. I have coffee, skim milk and artificial sweetner and a protein shake (180 cals) for breakfast. I have another protein shake for lunch or a salad that I make myself. I drink water all day. I also have a protein bar as a snack and a normal dinner meaning protein, veggie and limited starch. About an hour before bedtime I drink another protein shake. I lost approx 47 pounds doing this however, my diabetes has progressed. The proetin shakes have started to raise my blood sugar which they had not done previously. Also, post workouts, my blood sugars would be in the 70-90 range. Now, due to advancing insulin resistance, my blood sugars post-workout are approaching 200. This caused me to be prescribed yet another diabetes medicine. Yes, I had overeaten in my past to get me here (i am around 250 lbs) and have for the past several years changed many things with my diet and exercise. When insulin does not work properly in your body, you are working with a broken system which complicates things.

      June 13, 2011 at 11:41 | Report abuse |
    • motherof3

      Brad, bariatric surgery does more than limit food intake. Depending on the surgery performed, food intake is severely limited and in a Roux N Y procedure a portion of the intestines is bypassed to create mal absorption so you do not absorb a portion of the calories you do consume. When you have a base line metabolism of 1100, you have to create a 500 calorie deficit to see any results, which can be done with a combination of diet and exercise, but you are talking about consuming approximately 700 calories a day and an hour on the treadmill at a moderate pace to see any weight loss. I don't know of anyone who could eat so few calories on a daily basis with a normal anatomy and not be starving and feeling hunger pains. I am now able to consume about 450 calories a day and be completely satisfied. I exercise anywhere from 30 mins to an hour and I am incredibly happy to have been able to have this surgery, because I am finally getting results that I have been desperate to achieve.

      June 13, 2011 at 11:46 | Report abuse |
    • Slkelly00

      Good for you! I had mine in Nov 2010. Dropped 120 pounds already. I always worked hard but never could lose it. Now it is amazing how great I feel. You dont realize how much of a burden that extra weight is, until you're no longer carrying it. I realize now it was like wearing a lead wetsuit. Imagine living everyday with that. It does wreak havoc on your body. Good luck with your surgery. I'm sure you will be amazed at just how much it affects your life. And congrats on taking charge of your own outcome.

      June 13, 2011 at 11:48 | Report abuse |
    • brad

      Motherof3, what you said does not make sense. yes, there are some procedures that remove a small portion of the small intestines and yes this is the part of the digestive system that is responsible for the majority of nutrient absorption, however; your math does not add up. Any adult human being has to burn a certain number of calories to maintain a basal metobolic rate. This includes maintaining an appropriate body temperature. Any human between the ages of say 18 and 55, between 5 foot and say 6 foot 3 (body surface area) and with a minimum lean mass of around 100 pounds is going to burn about 1000 calories a day at the absolute minimum without doing anything except laying there. If it comes from fat you lose weight, if it comes from food you won't. If you are intaking 450 calories a day you will reach a point, and it will come well before you hit your ideal weight, where you begin to have sever metobolic issues. Most people need around 1400 calories a day to function properly and this is a minimum amount. Larger people or people with a high lean muscle mass (even if they are excessively overweight) need more. you need to know your lean muscle mass before going on a calorie resrictive diet.

      There are roughly 3500 kcal in a pound of fat, so a 500 cal deficit will result in a loss of about a pound a week. This is an ideal situation. People who are severly overweight can drop extreme amounts of weight much quicker because even though fat is not usful tissue other than storage of energy the lean body mass a excessively overweight person has will have to work harder to supply blood, heat, nutrients to the extra tissue. Counting calories is probably not the best way to lose weight for the severally overweight. Understanding portion size and limiting the number of portions is a much better tactic and I believe shows better results. If a person understands what a serving of potato chips looks like (about 12 chips) its more effective than saying, "Im only going to eat 160 calories in potato chips". Most people think a serving of potato chips is half the bag.

      June 13, 2011 at 13:20 | Report abuse |
    • brad

      Travler04, one other thing. you should never ever listen to an MD regarding dietary intake. They are not qualified. Speak with a registered dietician (unless the doctor is a registered dietician as well). Unfortunitely, most insurances will only pay for a single session with a RD, where they will pay for you to visit a doctor for an unlimited number of times. I work in NC and the hospital I consult for requires that all individuals who undergo gastric bypass have at least two sessions with a registered dietician and three with a mental health specialist before they undergo the procedure. It's actually funny because most insurances (blue cross, aetna) will pay for the three visits to the therapist and the doctor's visits, but will only pay for one visit to the registered dietician. That is probably the most important part of the pre and post surgery support.

      June 13, 2011 at 13:32 | Report abuse |
    • mandee

      Good luck with your surgery! I'll be 3 years post surg in August, and I've never felt better. The length of my life may not be longer, but the quality of my life has sure improved. Also, this study is looking at older adult males with severe obesity. This is one study, and would not be enough for insurance companies to decide right away they're unwilling to pay for.

      I'm glad I had the surgery, and I wish success to anyone who makes the attempt! It is NOT the easy way out, there are life changes one must make and must stick to. I've had to change my entire way of living, eating, drinking, etc. I was lucky and my insurance company paid for the surgery. I think in the long run they DO save money. If I hadn't had the surgery I would likely end up with diabetes, heart disease, and other illnessess associated with obesity. As it was I had severe GERD, PCOS, and other issues. In the long run it would cost a lot more to treat those conditions year after year, as opposed to the surgery. Yes, it is expensive up front, but in the long run I really do believe it is best for all involved.

      I'm getting off on a tangent, but I wish you lots of luck! I would recommend Unjury as your protein supplement! Drinking protein shakes 1-2x/day has been a major help to me!

      June 14, 2011 at 17:44 | Report abuse |
    • Pat


      Unless you have a medical condition or are on meds that cause you to gain weight. If you are any sort of psychiatric meds, chances are you will gain weight (sometimes a *lot *of weight), and quite frankly if the choice is between weight and returning psychosis, I'll take the weight, thank you very much.

      July 28, 2011 at 19:32 | Report abuse |
    • ldyluvslighthouses

      Hi Traveler04, I just read your post and I'm curious did you have the gastric bypass? Has your health improved since the surgery? I just got my appt. to see surgeon and haven't got a surgery date yet. I like yourself have tried every diet known to man and have sibling with normal weight same issues as yourself. I am curious did they make you get your AC1 level down to normal before surgery? I 've had testing done and no one mentioned anything abut ac1 number but on another chat room site someone said they had to get there number below 7 before surgery. Yikes, anyway any advice or ideas will be glady appreciated. Wishing you continued good health. Thanks

      March 17, 2012 at 10:37 | Report abuse |
  5. Ellen

    My daughter had the surgery and died 6 months later from a aortic anyurism after gall bladder surgery. I will never belive that it wasn't associated wih the surgery as the surgeon found her gall bladder to be fairly normal. She had lost 80 puounds and was doing well, the surgery did a tremendous job in giving her the confidence she had lost with the wait gain, but our lives were forever changed at her death. She left a beautiful 5 year old daughter who now has no mother. If you are planning on this surgery make sure you have a confident surgeon and great follow up care.

    June 13, 2011 at 10:02 | Report abuse | Reply
  6. Adam H

    Poor study. Veteran's especially ones with comorbidities have a higher rate of death d/t multiple confounding factors. The population was limited so therefore was the study. Take a group of 18-60 year olds of all walks of life and show me that study.

    June 13, 2011 at 10:18 | Report abuse | Reply
    • Paul

      I think you fail to understand the study. The two groups being compared were identical- both veterans groups with similar comorbidity profiles. This means that your dismissal as a poor study is actually a poor understanding of what the study was supporting. With many medical interventions the ideal testament is that your drug or surgery decreases mortality (death) with a decrease in morbidity being a nice benefit. It is rare to find isolated obesity without comorbidities in any age group and veterans are a convenient population to study.

      June 13, 2011 at 11:05 | Report abuse |
    • A P

      While Adam H's assessment that this is a poor study because it was simply a veteran population is a little short sighted, he is not incorrect in questioning the validity of the data. This was a retrospective review of patient charts. Retrospective reviews are inherently prone to error. Medical records, even electronic medical records are notoriously incomplete, this becomes especially apparent when going back and trying to extract data for analysis in the quasi-experimental fashion of a retrospective review. The authors of this article even point out that this is a limitation of this data. Additionally, they too agree with Adam H in that the population is likely not very similar to the general population in that these are all patients who utilize the VA system. As a general surgeon who has performed many retrospective chart reviews I am well aware of the limitations of retrospective reviews. To definitively answer the question of whether or not bariatric operations can decrease mortality, a prospective randomized trial would need to be performed. Elligible patients would either be assigned to operation or no operation and followed prospectively.

      This is directly copied from the JAMA article
      Our study is subject to several limitations. First, we focused on a cohort of older, predominantly male, sicker patients, so results may not generalize to nonveteran, younger, female, or healthier populations. It is possible that bariatric surgery reduces mortality for younger patients and not for older male patients, but we did not have sufficient sample size to examine whether the association varied across subgroups. Second, our study does not include patients who underwent laparoscopic banding procedures; thus, we cannot generalize our results to such patients. Third, the sample size was restricted in the 1:1 propensity-matched analysis such that large CIs were generated, which cannot rule out that bariatric surgery provides clinically significant benefit or harm to some patients. However, 4:1 propensity-matched analysis yielded similar results. Future studies with larger samples should also consider stratification across clinically relevant patient factors to fully understand which subgroups benefit most from bariatric surgery. Fourth, these results do not account for unobserved confounding that may persist even after propensity score matching because this analysis was based on a quasi-experimental design from administrative data, not a randomized trial.37​ The estimated treatment represents an association and not necessarily the causal effect of bariatric surgery on survival. We were able to effectively reduce imbalance in observed covariates via one-to-one propensity score matching, without a significant loss in surgical sample size. This finding was also robust to alternative propensity score approaches, which suggests we strengthened the internal validity of our results without sacrificing generalizability

      June 13, 2011 at 11:33 | Report abuse |
    • ranier

      It being retrospective does not allow the data to be applied in a causal sense. They observed this result, but they can't say that doing X will cause Y since the study wasn't designed to do so. It's a pretty big limitation in the grand scheme of things.

      June 13, 2011 at 15:40 | Report abuse |
  7. Paul

    Don't read too much into the study, this was done on "OLDER" severly obese patients. If they had the surgery when they were older then most of the damage has already been done.

    Also – although they may not live longer, they have a much better chance of living better and with less need for other surgeries and medications due to ailments brought about by obesity. So in the end the surgery may save money.

    June 13, 2011 at 10:24 | Report abuse | Reply
    • mandee

      THANK YOU! You are among the few that actually read the article. This study is not indicative of all age groups and genders, and it is just one study. I'd want to see more research, including more longitudinal studies, before I would take all of this to heart.

      Also, as you have said, although length of life may not be greater the quality if life will greatly improve!

      June 14, 2011 at 18:17 | Report abuse |
  8. calico

    The problem with this study is that it drew conclusions by looking at "similar patients". What makes a person similar? Are we comparing them in their pre-surgery health and matching them to diabetic, heart-disease counterparts? Or are we comparing them to the general population? In other words, why are they measuring success by comparing with PATIENTS (the definition of which implies he has a health problem)?

    Here's the reality: these things save lives. I've known at least 6 people who were morbidly obese, got the surgery, and returned to functional life. And before anyone whines about who pays for their surgery, keep in mind a 350 lb person who struggles to walk is going to be on Disability - so the taxpayer is already paying for him. Getting these people well and back to the workforce is not only a good thing, it turns them back into taxpaying members of society.

    In a perfect world nobody would need it. But until we understand why some people have the compulsion to eat themselves literally to death, this is their only hope. And in a world where our food is now almost completely processed, sugar-coated, and engineered: it's hard for the people who lose weight slowly to do so, even with the best will power.

    June 13, 2011 at 10:28 | Report abuse | Reply
    • Paul

      Unfortunately you are a prime example of the fallacy that many people fall into. The assumption that this data is incorrect because you have seen 6 cases that saved lives is a poorly formed conclusion. The study looked at hundreds of patients! It is arrogant to think that your sample of six people is better than over 800. While it is easy to believe that this surgery should be beneficial it remains to be seen how effective it is over a long period of time.

      June 13, 2011 at 11:10 | Report abuse |
  9. Smexy

    I am sorry to say that this study seems to be factual. When I had this surgery 3 years ago my eventual death came as a complete shock to my friends, family and doctor.

    June 13, 2011 at 10:35 | Report abuse | Reply
  10. Jonathan

    For me the key line in this story is the last one: “bariatric surgery does not appear to be associated with survival during a mean of 6.7 years of follow-up.”

    6.7 years is simply not long enough to make a statement that Bariatric surgery doesn't prolong lives. When I had my surgery done 3.5 years ago it was because I wanted to do something that would let me live at least another 20 years, because the way I was I didn't think I would last 5 more years. So it's still way too early to tell. But now I've dropped more than 70% of my desired weight and at least I FEEL as if I will live another 20 years, at least.

    June 13, 2011 at 10:41 | Report abuse | Reply
  11. Uhhhhhhh

    Isn't bypass just a forced diet anyways? Smaller stomach, less intestine available to absorb food... fewer calories can be ingested and processed. It stands that if you're eating less, but still eating the 'wrong' things (not enough veggies, lean protein sources), then maybe life expectancy wouldn't be prolonged as much... or maybe by the time people have surgery, it is too late and damage to the body has already been done? Either way, these would be unfortunate findings. I imagine, though, that the change to quality of life might be reason enough to pursue the surgery.

    June 13, 2011 at 11:05 | Report abuse | Reply
    • Jose

      CarlesJanuary 24, 2011 at 01:50 The web doesn't have the right answer and most deietinfly it doesn't meant that it gets it right.What I really like about it is the ability to knowledge myself about a pain or disease, etc. No need to trust my doctor blindly either as people would have done before for the lack of knowledge or the ability to research it easily.It may not be always right but at least could can perform you own research, find out as much as you possibly can and then make your mind up about what course of action you want to take. I think this is the real important of the web:Information and the diversity of it!!!!

      September 11, 2012 at 05:46 | Report abuse |
  12. Paula

    There need to be more studies involving more people over a longer period of time. I have encountered people in my disability law practice who did great for about 7 or 8 years. Then the long term effects caught up of something called malabsorption syndrome, meaning that their bodies did not absorb enough nutrients and osteoporosis and the long-term effects of nutrional deficiencies became obvious and they developed very serious health problems. These operations are not a panacea. The people whom I saw had not gone back to the original doctor who had done the surgery so these doctors may not be aware of these long term problems. My thinking is that if you have to follow a severely modified diet afterwards, you might be better off giving it more of a chance to start with and avoid the surgery.

    June 13, 2011 at 11:15 | Report abuse | Reply
    • Crowded

      Wow, see my comment right below yours! I must've been typing when you were typing as the comments are only two minutes apart. And yes!!! This surgery is killing people. When will the medical community realize we need rehab plans for the critically obese, not surgery.

      June 13, 2011 at 11:19 | Report abuse |
  13. Crowded

    One of my best friends had this surgery about five years ago. She had it done at the highest rated hospital, and by a surgeon who pioneered one of the techniques. She developed malabsorption syndrome, and has to take massive injections of vitamin D along with other medications to try to save her bones. She has become almost completely disabled, whereas before she was vibrant and active both in the community and in her career, even though overweight. Now at 40 years old, she has the bones of an eighty year old and fights for her life on a day to day basis. Rehab is the answer to obesity, not surgery.

    June 13, 2011 at 11:17 | Report abuse | Reply
  14. John

    I love all of the people who say they eat right and exercise but didnt lose the weight until they had this surgery. If you ate right before you would have lost the weight because the only thing this surgery does is keep you from over eating. Just limit the calories you take in every day and exercise daily.

    June 13, 2011 at 11:17 | Report abuse | Reply
  15. motherof3

    I love how people assume that diet and exercise is always the answer. I did the whole diet and exercise thing. I'm still doing it, but now I'm actually getting results. Our bodies are not designed to eat the small amount of food that was required for me to lose weight. I opted to act before I reached 220 lbs. My metabolism barely functions, and though I can exercise I don't really lose weight because I can't spend 5 hours in the gym to burn the calories necessary to lose the weight. Now that my body is being forced to use up the stores of fat I have a fighting chance of getting my life back on track. Since I didn't eat junk food prior to surgery and I didn't drink sodas or juice or other sugary drinks, the only thing I really can't have that I used to eat is raw veggies (for now) and breads, pastas, and rice (of which I always ate whole grain or whole wheat) I have had a couple of minor complications from my surgery but I knew what to expect and before they become a huge problem I call and speak to my doctor and we work our a treatment plan.

    If you have tried diets and exercise, and I mean really tired them and have failed, maybe this surgery or another similar surgery is right for you, but do your homework and research everything until you know everything there is to know about the surgery. Don't just take your doctor's word, go in there with questions and if the doctor cannot answer those questions before you even ask or doesn't appear to have a good answer to a question you feel the need to ask, look for a different surgeon. If you know the risks and discuss your concerns with your doctor, you will likely have a good outcome. However, all surgery has risks and you have to prepare for those risks so that you won't be surprised if and when they happen.

    June 13, 2011 at 11:35 | Report abuse | Reply
  16. ann

    @Pennswoodsman, first how dare you call this the "lazy way" out? I haven't had the by-pass surgery, but have had the gastric lap band. The challanges after this surgery are very difficult and it is truly life changing. I know there are people who go back to their old habits and gain the weight back, however there are many more who move on to a better life. How dare you berate a human being for trying to make a better life. Until you've been in these shoes, you do not have the right to call someone "lazy".

    June 13, 2011 at 11:41 | Report abuse | Reply
  17. imissmickey

    I have been overweight up until 1 1/2 years ago. My weight was fine until age 20 when I moved out on my own and starting eating unhealthy. I was not much into exercise and as the years passed my weight continued to climb. I was 50 lbs overweight – not obese "enough" to qualify for bariatric surgery. Then after a few checkups I managed to attain Type 2 Diabetes.

    Living in denial I did go to the pharamacy and pick up the prescription but instead of taking the meds I opted to join my co-workers in working out. I didn't change the way I ate so it took almost a month to lose 3lbs. Fast forward 6 months and I finally lost 20lbs. At my checkup I had reversed the diabetes and had never taken the meds. I continued my workouts and finally changed the way I ate – eating the bulk of my calories at lunch and eating a light dinner then the weight really dropped quickly.

    It ultimately took 18 months to lose the 50 lbs. My initial change of adding exercise improved my state of mind and once I finally changed the way I ate I saw improved results.

    I have read alot lately on nutrition etc and am primarily a vegan. Most recently I watched Food Matters – Wow! And it all makes sense. Our bodies aren't made to handle the volume of meat – poultry, pork included and the bigger news to me is that eating Raw vegetables, fruit – At least 51 % of the time is best for our bodies. After all when mankind started out cooked food wasn't normal.

    To sum it up, see Food Matters and try to eat Raw for a week – then a month and go from there. It certainly can't hurt you and as long as you don't add much in terms of dressings, dairy products etc to the raw food you will be able to eat ALL you want.

    Our health care system is imploding and those that eat the SAD (Standard American Diet) are experiencing the fallout of obesity, diabetes, heart disease, cancer etc that are the result.

    Watch the movie, eat Raw and spread the word about how great you feel and how your health has improved as a result.

    June 13, 2011 at 11:45 | Report abuse | Reply
  18. nicksgramma3301@aol.com

    I am a 57 yr old woman who had gastric bypass 6 yrs ago. I weighed in at 273 pounds and am now 135. I had high blood pressure, diabetes and sleep apnea. I was fat since I was a child and I was outside running, riding bikes, building tree houses getting plenty of exercises. I truly believe most of it is genetics. My paternal grandmother was obese as was my aunt. I had lost weight over the years, but it always came back. I could not be happier with the results. To me this surgery was a godsend

    June 13, 2011 at 11:46 | Report abuse | Reply
  19. Chris

    Just because the surgery helps people lose weight does not mean it's a healthy choice. (Cancer causes weight loss, too.) Disrupting the digestive system volume and function has long-term devastating consequences. We don't have extra or non-essential parts. Yes it is up to the individual to make such a choice, but I wish they would require a holistic physician's input as well as the team of medical physicians'. It is too easy to dupe desperate people into making a life-altering change.

    June 13, 2011 at 11:52 | Report abuse | Reply
  20. Ummm...

    The surgery causes the body to lose weight because it makes a person anorexic (as in not able to take in adequate calories)... by drastically cutting down on the amount of food the person can take in. Not taking on adequate nutrition and calories causes the body to use excess fat AND MUSCLE as fuel... just as would happen if the person cut down portion sizes on their own. It is a forced portion control. The health problems caused BY THE SURGERY are from malnutrition because of the forced portion control. Sure, the weight is lost... however... it is not typically the healthy weight loss of someone eating normal portions (as in not super-sized portions) of healthy food. These people are having less than normal portions of many times, unhealthy foods. So... it isn't news at all that the people having this surgery aren't having their lifespan extended. It is trading obesity for starvation. And yes... they are starving their bodies of needed nutrients although they may not feel "starved". Someone who loses more than 2 pounds per week on a consistant basis is not losing just fat... they are losing and weakening their muscles as well. The main muscle that tends to fail on those who starve themselves is the heart. With a weakened, damaged heart muscles... their life will be shortened.

    If gastric bypass works for you... it is only because you cannot overeat... it isn't a magic cure... it is a dangerous procedure that trades obesity for anorexia. Not mental anorexia... but physical anorexia.

    Look up the side effects of gastric bypass (not the ones having to do with the week or two after surgery, but the longer term effects)... compare them to the physical symptoms of anorexia... you will see what I'm talking about.

    June 13, 2011 at 12:02 | Report abuse | Reply
  21. TC

    Gastric bypass doesn't change what you eat, it doesn't affect your metabolism, it doesn't force you into a gym. It ONLY affects how much you can eat. Read that again: All it does is force you to EAT LESS. Are there people out there with slow metabolisms? Absolutely! Are there people that can eat a box of Twinkies and never gain weight? Absolutely! Do we get to pick which one we are? Absolutely not? What we DO have to do, is face up, and own up, to whichever we are, and TAKE CARE OF OUR BODIES. If you have to eat only 500 calories a day to avoid becoming a diabetic, asthamtic 300-pounder, then I guess you better do it. No, you can't have the 1,000 calories caramel mocha smoothie for breakfast and afternoon snack and still be surprised that you're not losing weight. Paying $20,000...$30,000...or whatever (or your insurance paying it) for a band around your stomach that ONLY provides a 'eat less or vomit/blow a staple and bleed out' motivational tool, is a waste of our health care system. And if anyone doesn't believe that costs EVERYONE, then you better educate yourself.

    June 13, 2011 at 12:03 | Report abuse | Reply
  22. Toeknee

    Marie – An ounce of [money for] prevention is worth a pound of [money for] cure (modified from the original, which is ascribed to Henry de Bracton). Some people seem to think the Healthcare Savings Act, is all about government control and spending big bucks, but the research shows that preventing illness (such as having access to health care [insurance, in our culture] to pay for routine tests or get treated early in an illness) is far cheaper in the long run. I agree that the treatment does need to be effective, but the one you're reading is not the only one on the subject (of bariatric surgery).

    June 13, 2011 at 12:16 | Report abuse | Reply
    • BreZzy

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      September 13, 2012 at 22:17 | Report abuse |
  23. Adam

    This type of "band-aid" fix is for the ignorant, weak and lazy.
    Your poor choices got you to consider doing this idiotic procedure to yourself.
    Take responsibility and get out and eat responsibly and go for a walk.

    I know people that have had this surgery, sure, they are happy at first, but then talk about what a miserable life it is.
    But hey, at least you will look good in a normal size coffin.

    June 13, 2011 at 15:22 | Report abuse | Reply
  24. mouselol

    I'm sorry, and I don't mean to sound harsh, it's just the way it's going to come out. You want to make sure that your future generations won't be obese, teach them to eat healthy, and give them a healthy start. You being an example is the best way to teach them. Teach them to say no to sugar cereal, soda, fast food, preprocessed everthing that we have been shoving in our mouths for how long now? The end result is what we are dealing with now. If you don't know where to start, go see a nutritionist and follow their advice to the letter. Good health is better than any doughnut out there. Showing your children where to start and give them a firm foothold on healthy eating is the best thing you can ever do for them.
    Foods which feed your body are bright in color and are full of fuel for your body. Foods that are prepackaged, have you noticed they are mostly beige and void of what your body is begging for.
    Most obese people yes, eat far too much, but everything they eat goes to fuel the fat in their bodies, not the lean muscle which also needs energy. It's never too late to start being a role model.

    June 13, 2011 at 15:54 | Report abuse | Reply
  25. skeptic

    The best weight loss surgery is to put a zipper on the mouth.

    June 13, 2011 at 21:50 | Report abuse | Reply
  26. LukeTunyich

    Weight loss surgery is a terrible medical practice based on a misunderstanding of the biological basis of fat formation, and the mechanisms underlining fat mass distribution.

    For bariatric surgeons, it is very comfortable to talk about weight loss surgeries because weight loss surgeries are not for medical doctors.

    To my knowledge, no medical doctors or their family members have had to undergo weight loss surgery.

    If you know any medical doctor or his member of family that have had to undergo weight-loss surgery please let me know.

    They should ask the question; why have patients experienced weight loss if any other program/method for weight loss has not caused any meaningless weight loss.

    In the end, WLS isn’t so effective weight loss treatment because after WLS patients lose mostly muscle mass and bone mass. Fat in excessive skin has to be surgically removed in at least one additional (cosmetic) surgery.

    The mechanism underlining weight loss induced by WLS is explained in the article: “Weight Loss Surgeries, Weight Loss, Diabetes and the Biomechanics of Sitting and Walking”. The same article explains the mechanism underlining remission/cure of Type 2 Diabetes. The link to the article is: http://www.biomechanicsandhealth.com/wlsandtype2diabetes.htm

    The human society has to confront with the terrible blunder in medical science and medical practice.

    Luke Tunyich
    The Modern Science of Biomechanics – The Real Science of Weight Gain/Weight Loss http://www.biomechanicsandhealth.com/

    June 14, 2011 at 05:16 | Report abuse | Reply
    • Here's one


      He had a sleeve gastrectomy several years ago, now does Bariatric Surgery himself. A great guy!

      March 14, 2013 at 14:06 | Report abuse |
  27. HAES

    The debate you are all having on this forum is whether the surgery works or whether calories in/calories out and willpower works. Both sides are wrong and based on faulty science. The problem is not "why can't fat people lose weight" or "what is the best way" the problem is that we hate fat people. Study after study shows that people live longer when they are fit, regardless of whether they are thin or fat. The size and shape of someone's body is unrelated to their health. There are plenty of thin unhealthy people. Are we going to start injecting them with fat? NO...our society cares more about how someone looks, blaming the individual, and not thinking about how systemically, we have created a situation whereby people are willing to risk their lives to look a certain way. Visit the Health at Every Size website to read about how you all can stop contributing to the useless debates about weight loss and focus on helping people live happy and healthy lives IN ANY SIZE OR SHAPED BODY.

    June 15, 2011 at 00:48 | Report abuse | Reply
    • Meaghan

      THANK YOU, HAES!! http://www.ars.usda.gov/is/AR/archive/mar06/health0306.htm

      July 7, 2011 at 09:15 | Report abuse |
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  30. Kathleen M Isabell

    It would have saved my best friend's life, more than likely. She died at the age of 29. She weighed over 500 pounds. She was afraid to get the surgery. I believe she would be alive if she would have gotten the surgery, because she would have been under a doctor's care instead of sitting at home in front of her tv, isolated and alone. I got the surgery and it saved my life. I lost more than 150 pounds and reversed a serious cardiac problem like my best friend's. I am now 51 years old and I can hike over six miles at a time, I walk nearly 30 miles a week and I work three days a week at a physically strenuous job. Plus I am the curator of a private park and bird sanctuary. I came this far from being unable to walk without a cane, unable to fit in an airline seat, couldn't even get in and out of my own vehicle without great effort and needed a handicap sticker. My cholesterol was 325 and my triglycerides were 458. Now? 176/215. So don't tell me it doesn't help people live longer. I have gotten at least 10 more years since the surgery and I'm looking at another 25 if the numbers on my blood work are any indication.

    July 15, 2012 at 19:43 | Report abuse | Reply
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  33. Bob L

    Really? it took how many intelligent people to figure out what anyone with common sense already knew??
    Bariatric surgery is not for prolonging your life, it's to help the body heal and recover from all the problems that go with being obese and living longer is one of the benefits.

    December 30, 2013 at 19:17 | Report abuse | Reply
  34. My Bariatric Life

    Hi, I was a processed food junkie and couch potato on 10 prescription medications for obesity related diseases. I was wasting my life and headed toward an early grave.

    I had gastric bypass weight loss surgery in 2003 (covered by insurance) and body contouring plastic surgery and facial plastic surgery in 2013 (self pay). I eat a PALEO diet, no red meat, and I engage in cardio a few times per week. All told, I have lost 135 pounds and 11 pants sizes.

    But that's not all that changed. I reclaimed my life. I got off all of those prescriptions and no longer have diabetes and hypertension. Removing the excess skin was extremely transformative for me. I lost 50 inches and 50 pounds, going from a size 14 to a size 2 (before my gastric bypass I was a size 24W). The emotional transformation that took place for me was miraculous. Nowadays I am all about breaking through my boundaries and living life fully. I've been able to do things never possible before, either because of the skin and fat that inhibited my movement or the self confidence and fear that inhibited me emotionally.

    Here is a video of my before and further photos that I created for my one-year Surgiversary from plastic surgery http://vimeo.com/mybariatriclife/mybariatriclife-transformation-video

    I have been an obesity health activist, writing on the web as My Bariatric Life, since 2011. I have inspired many people to take control of their health and their lives. In all those years I have come across people who have not only extended the quality of their lives but it is projected that they also have increased their longevity. That is statistically significant data that has been backed up in numerous studies. So contrary to this singular study, there is both scientific data and anecdotal data that show that significant weight loss from Bariatric surgery cures obesity related disease and increases life span. Add to that, it reduces healthcare costs and unemployment costs because patients are healthier and more productive. There are lots of data to support that, too!

    My Bariatric Life

    November 10, 2014 at 10:23 | Report abuse | Reply
  35. RealityCheck

    First, the study is nonsense. Studies show that most people lose weight and keep at least some of it off even if they don't keep it all off. Not all of them but this surgery is cheaper and more cost effective than cancer treatment.

    It is frightening how ignorant so many people are. I was 400lb+ and I got down to 175lb without any surgery in about a year. Yes, over 225lb in a year. First, the universal truth is that if you are fat it is because you eat too much. Evidence? Do you see any fat poor people in Somalia? Not eating makes you starve and die. They have every condition that we have there. People who don't eat enough get skinny and people who eat too much get fat. This isn't rocket science. Sure, some people are more efficient at storing energy than other people but the fact still remains that it is a math equation. If you eat 2000 calories a day but you only burn 1500, you retain 500 calories a day and you will gain a pound a week. This isn't negotiable. This isn't something that you can say "well... but... " It just is. If you are fat it is because your math equation is wrong. It doesn't mean you are a terrible person. It doesn't mean you are weaker than anyone else. Everyone has their own problems, fat people just have a visible one.

    I gained that 225lb back in the 10 years after because I did a job that I was unhappy with and that had a high level of stress. I drank too much and when I drank I ate too much. For 10 years, even though I ate massive amounts, I was very active even when 400lb. I burned a ridiculous amount of calories. So even though I might have been eating/drinking 4-5k calories a day, I only added about 250 calories a day average to my frame over the 10 years. You gain weight slower as you get fatter because it takes more calories to maintain your body as you get fatter. This means even a 3000 calorie diet a day would have taken me back to below 200lb. Every person has different calorie needs based on their age, height, weight, and sex so the number is different with each person but it still works the same exact way. If you try to justify your situation is otherwise then you are simply lying to yourself and refuse to admit the problem.

    My wife and I both got the surgery done in July of 2017. I've lost about 125lb in 11 months. My wife has lost over 100.

    The surgery isn't magic, it simply restricts how much you can intake. It won't work for some people simply because of their lifestyles. If you are a binge eater or eat a lot at one time then it will work for you even if you really don't change anything else. The people it won't work for are people who work in an office sitting down next to a bucket of candy. I could eat ice cream all day long and candy without ever filling up because they essentially turn to liquid. Even when I feel super hungry I can only eat maybe 3 chicken wings with no sides. My stomach is about as stretched as it will ever get.

    I paid for mine and my wife's surgery out of pocket. $5500 a piece in Tijuana including everything while there and flying from FL to Mexico.

    Sure, the problems are mental, I get that. I recognize my problem. The shaming of people who get surgery is pretty stupid though. You are essentially saying "Work through it. Live with who you are and fix it." Well, apply that to YOUR problems. Broken leg? Work through it. Diabetes? Tough, work through it. Cancer? No treatment for you! Old? Stupid? Bald? Arthritis? Miners lung? Pregnant? PTSD? Liver failure? STDs? Heart failure? Appendix ruptured? Got the flu?

    Yes, all those things are your fault too. Whether it was doing a job you knew was killing you, playing sports, riding a motorcycle, eating junk, drinking, doing drugs, not washing your hands, and so on and so forth. If you could solve your problems with a relatively cheap and simple surgery, wouldn't you?

    There are other surgeries that would work and do the same job in the short term. There are balloons that go in your stomach and restrict your intake and cost about nothing to make and install. You literally swallow a pill. It could be a very cheap thing that could be done in strip malls for hundreds of dollars instead of thousands and is about as dangerous as getting a pedicure. This is the real problem with health care in the USA. The government has run the price up by restricting even safe procedures from being done by qualified people in safe settings. This raises the price of the services to the point where you can't just pay for them like you would a normal service(like that $30 pedicure) and you have to have super expensive insurance just to pay to get it done. There is no reason you couldn't get the balloon weight loss surgery at your doctors office for a few hundred dollars or even one of the other new surgeries. As it is, my weight loss surgery had the cost of a 4-5 star hotel for a week, traveling thousands of miles, and other costs built in. There is no reason this can't be done in America for much less cost that would make this a cost effective surgery.

    June 6, 2018 at 08:36 | Report abuse | Reply
  36. Roger Vivier Flats

    Bariatric surgery doesn't help obese live longer, study says – The Chart – CNN.com Blogs
    Roger Vivier Flats http://www.rogervivier-paris.com/roger-vivier-flats-c-2.html

    June 13, 2019 at 21:32 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.