Surgery to treat obesity far more risky for men

Oct 19 2005

Researchers say that using stomach-shrinking surgery to treat severe obesity is riskier than previously thought for men, the elderly and people with conditions such as hypertension.

According to Dr. David Flum of the University of Washington, patients are told the risk of death is anywhere from one in 500 to one in 1,000 for the increasingly common procedure, but for those on Medicare, the federal health insurance program covering people over age 65 and those disabled by problems including obesity, the risk of death is more like one in 50.

Flum says there are certain people who are higher risk within that Medicare group; men apparently have a much higher risk, almost double that of women, and people with other medical conditions such as high blood pressure, and diabetes, are at higher risk than those without those conditions.

However he does add that this higher risk of death than was previously estimated, should not deter the procedure from being an effective tool for selected people who need it.

Flum's study found that for people over age 65, 11 percent of patients died after stomach-shrinking surgery, a mortality rate higher than that following heart surgery, while men undergoing bariatric surgery were twice as likely to die, 7.5 percent within a year, than women, even though women make up roughly 4 out of 5 people opting for it.

Apparently in some bariatric surgery procedures, large portions of the intestine are bypassed to lessen the absorption of nutrients from food.

Another risk factor is having a less experienced surgeon.

In another study published in the journal it is said that bariatric surgery has grown exponentially since 1998, and forecasts that 130,000 procedures will be performed this year in the United States and 218,000 by 2010.

Surprisingly a growing number of these patients are women, and nearly two-thirds live in neighborhoods with the highest household incomes.

Study author Dr. Heena Santry of the University of Chicago says the ballooning obesity rate between 1986 and 2000, has increased demand for the surgery, with 1 out of 20 U.S. adults having a body mass index 40 or higher.

Body mass index is computed by measuring height and weight, and a figure of 40 or above constitutes so-called morbid obesity.

The study is published in this week's issue of the JAMA: The Journal of the American Medical Association.