Bariatric surgery for severely obese individuals can significantly reduce the risk of cardiac and other diseases, outweighing the disadvantages of the procedure, researchers wrote in the journal Circulation. According to lead author, Paul Poirier, M.D., Ph.D., from the Quebec Heart and Lung Institute, Laval University Hospital, Canada, this is the first statement by the American Heart Association which concentrates solely on bariatric surgery and cardiac risk factors.
Dr. Poirier said:
“The statement is not an across-the-board endorsement of bariatric surgery for the severely obese. It is a consensus document that provides expert perspective based on the results of recent scientific studies.”
According to the American Heart Association, bariatric surgery is an option which should be considered on a patient-to-patient basis. It encompasses several procedures to reduce appetite while limiting food consumption and/or causing food to be absorbed or digested less fully by the body.
Somebody who is severely obese has a BMI (body mass index) of over 40.
Dr. Poirier said:
“Obesity has reached epidemic proportions in the United States, as well as in much of the industrialized world. The most rapidly growing segment of the obese population is the severely obese. The health consequences of severe obesity are profound. In comparison with normal-weight individuals, a 25-year-old severely obese man has a 22 percent reduction in his expected lifespan.”
Physicians as well as their severely obese patients have found the challenges of treating obesity frustrating.
Dr. Poirier said:
“Substantial long-term successes from lifestyle modifications and drug therapy have been disappointing, making it important to look at surgical options.”
The authors had reviewed scientific literature and concluded that bariatric surgery results in considerable weight loss and a reduced risk of developing diabetes, liver disease, hypertension, obstructive sleep apnea, and cardiovascular dysfunction, if the patient is suitably indicated for the procedure.
Some studies have suggested that severely obese patients who undergo bariatric surgery live longer.
Some surgical risks are associated with bariatric surgery – some of them may even be fatal, the authors add. There are also long-term post-surgical lifestyle implications. Some long-term behavior changes have to occur, and the patient needs to be carefully followed up.
Poirier said:
“Bariatric procedures are generally safe; however, this is not a benign surgery. At the moment, bariatric surgery should be reserved for patients who can undergo surgery safely, have severe obesity and have failed attempts at medical therapy.”
Poirier said that further research is required regarding this type of procedure in adults and young individuals. No effective sustainable treatment appears to be available today for the ever-growing number of adolescents who are obese.
The value of psychological evaluation in bariatric cases is uncertain, the authors write. There is no current data supporting compulsory psychological evaluation. Psychological evaluations, however, are often carried out and the environmental and behavioral factors that may contribute to a person’s obesity should be assessed. The individual’s ability to adapt to specified diets should also be assessed.
Circulation, Mar 2011; doi:10.1161/CIR.0b013e3182149099
Written by Christian Nordqvist