There are many different ways to manage weight, but which is better for our long-term health? A new study has found a link between multiple types of weight loss surgery and lower all-cause mortality rates overall.
The most common ways to manage excess weight are dieting, physical exercise, weight loss drugs, and bariatric, or weight loss, surgery.
Individuals aiming to get back into shape may opt for one or a combination of these treatments, depending on what choices are most suitable for them.
This surgery type aims to make the stomach smaller, so that a person's appetite — as well as the amount of food that they can ingest — is reduced.
Types of bariatric surgery include:
- laparoscopic banding, during which a ring is placed around a segment of the stomach so as to "section off" part of it, thereby reducing how much of the stomach a person can use to ingest food
- gastric bypass, or Roux-en-Y gastric bypass, which requires both "sectioning off" the stomach so that less food can be ingested, and cutting the low intestine so that it can be attached directly to the now-smaller section of the stomach
- laparoscopic sleeve gastrectomy, in which much of the stomach is removed, with only a smaller "wedge" left, which can hold a lower amount of food
Recently, Orna Reges, Ph.D., and others from Clalit Health Services in Tel Aviv, Israel, conducted a study that explored which types of weight loss strategy and procedures are associated with a lower risk of all-cause mortality.
Surgery versus nonsurgical management
Reges and her team conducted a retrospective cohort study that involved 8,385 people diagnosed with obesity, all of whom had had some type of weight loss surgery (either laparoscopic banding, gastric bypass, or gastrectomy) between 2005 and 2014, and 25,155 people who followed alternative obesity management programs, as advised by their physicians.
Obesity management interventions included counseling sessions that targeted diet and working to improve eating behaviors. The participants in the two groups were matched as closely as possible for age — with a median age of 46 — and biological sex.
The final follow-up date for all of the participants was December 31, 2015.
After analyzing the data obtained from these cohorts over a period of approximately 4.5 years, Reges and colleagues found that the individuals diagnosed with obesity who had undergone bariatric surgery had a lower rate of all-cause mortality than those who had opted for nonsurgical management.
The researchers argue that their study is relevant in the context in which much research has been conducted about the short-term outcomes of weight loss surgery, but information about its long-term outcomes is limited.
Specifically, they were interested in gathering more data about the associations between this type of intervention and all-cause mortality rates.
A 'unique' study offering important insights
This kind of information, they say, had not been reliably available before, because previous studies were unable to compare the data for patients of bariatric surgery with those of individuals who had opted for nonsurgical interventions.
"This study is unique in that it is demonstrates lower rates of all-cause mortality during up to 11 years of follow-up compared to non-surgical patients," Reges told Medical News Today.
"The present study has the largest aggregation of patients undergoing the three popular types of bariatric procedures," she added, noting that the research team was "somewhat surprised to see how similar the impact on mortality was for all three types of surgery."
Reges and her team, however, warn that their study is observational, so it is difficult to infer a direct causal relationship between bariatric surgery and lower death rates. The findings, they say, could be influenced by a range of different factors that the researchers were unable to control.
Other limitations include "group imbalance" created by matching the participants based on their age, sex, BMI, and an existing diagnosis of diabetes.
Nevertheless, the authors conclude that their study will enrich the existing resources addressing the health outcomes of various obesity treatments. They write:
"The evidence of [the] association [between bariatric surgery and lower all-cause death rates] adds to the limited literature describing beneficial outcomes of these three types of bariatric surgery compared with usual care obesity management."
Following these "reassuring results," Reges told MNT, the team plan to "study in depth each specific outcome and population subgroup to reach further insights and inform local and global policy."