All-Cause and Cause-Specific Mortality Associated with Bariatric Surgery: A Review.
The question of whether or not nonsurgical intentional or voluntary weight loss results in reduced mortality has been equivocal, with long-term mortality following weight loss being reported as increased, decreased, and not changed. In part, inconsistent results have been attributed to the uncertainty of whether the intentionality of weight loss is accurately reported in large population studies and also that achieving significant and sustained voluntary weight loss in large intervention trials is extremely difficult. Bariatric surgery has generally been free of these conflicts. Patients voluntarily undergo surgery and the resulting weight is typically significant and sustained. These elements, combined with possible non-weight loss-related mechanisms, have resulted in improved comorbidities, which likely contribute to a reduction in long-term mortality. This paper reviews the association between bariatric surgery and long-term mortality. From these studies, the general consensus is that bariatric surgical patients have: 1) significantly reduced long-term all-cause mortality when compared to severely obese non-bariatric surgical control groups; 2) greater mortality when compared to the general population, with the exception of one study; 3) reduced cardiovascular-, stroke-, and cancer-caused mortality when compared to severely obese non-operated controls; and 4) increased risk for externally caused death such as suicide.
Division of Cardiovascular Genetics, University of Utah and Intermountain LiVe Well Center, 389 South 900 East, SLC, Salt Lake City, UT, 84102, USA. ted.adams@imail.org.
Ted D
TD
Adams
Department of Physical Therapy, Nutrition Obesity Research Center, University of Alabama at Birmingham, School of Health Professions Building 370, 1705 University Blvd, Birmingham, AL, 35294, USA. tapan@uab.edu.
Tapan S
TS
Mehta
Department of Exercise Sciences, Brigham Young University, 271 SFH, Provo, UT, 84602, USA. lance.davidson@byu.edu.
Lance E
LE
Davidson
Department of Genetic Medicine, Weill Cornell College of Medicine, P.O. Box 24144, Doha, Qatar. steve.hunt@utah.edu.
Steven C
SC
Hunt
D000818:Animals; D050110:Bariatric Surgery / Q000009:adverse effects*; D002423:Cause of Death; D015897:Comorbidity; D006801:Humans; D009765:Obesity / Q000601:surgery
Adjustable band; Bariatric; Cancer; Cardiovascular; Gastric bypass; Mortality; Surgery