Should more people be getting bariatric surgery, which involves reducing the size of the stomach to help lose weight? A study published in PLoS Medicine suggests that performing bariatric surgery on a much greater proportion of the estimated 1.4 million morbidly obese people in the United Kingdom could “prevent or resolve many tens of thousands of cases of hypertension and type 2 diabetes” as well as preventing many other obesity-related illnesses. Does this mean that bariatric surgery is a solution if you are obese? Not necessarily. Does this mean that people who could benefit from bariatric surgery are not getting the surgery? Yes.
Bariatric surgery entails reducing the size of the stomach so that less food is absorbed. There are different types of bariatric surgery such as using a band to tie off part of the stomach (gastric band), removing a portion of the stomach (sleeve gastrectomy or biliopancreatic diversion with duodenal switch) or re-connecting part of the stomach to the small intestine so that food does not go through the entire normal length of the stomach (gastric bypass). The study used an existing database (the UK Clinical Practice Research Datalink) to follow (for an average of 3.4 years) what happened to 3,882 patients after bariatric surgery. The researchers found after surgery there was a lower incidence of type 2 diabetes, hypertension, angina onset, myocardial infarction and obstructive sleep apnea, but no change in the risk of death. Since the study did not follow the patients through the course of their lifetimes, there remains the possibility that these findings would not be sustained throughout their lives.