Heart attacks and suicide higher in those who have surgery for obesity

New research has revealed that deaths due to suicide and coronary heart disease are higher among people who have undergone bariatric surgery for obesity.

A study by researchers at the University of Pittsburgh examined data on all Pennsylvania residents who underwent a bariatric operation such as stomach stapling or gastric bypass between 1995 and 2004.

They then compared the death rate amongst these patients with those in the general population.

They found there were a total of 440 deaths following 16,683 weight loss procedures during the study period, and in all groups the death rate was much higher in bariatric surgery patients than in the general population.

Dr. Lewis H. Kuller and his colleagues say being male or a senior were both associated with increased death rates.

The biggest difference was seen in patients between 25 and 34 years of age; in this group, the death rates for male and female patients were 13.8 and 5.0 per 1000 persons per year, respectively, compared with rates of 1.3 and 0.6 per 1000 persons per year in the general population.

Though the most common cause of death was coronary heart disease, there were 16 suicides, 10 of them women and the authors estimate that only three suicide deaths would have been expected in this number of people.

Dr. Kuller says the excess deaths after bariatric surgery could be reduced by better control of high blood pressure, diabetes, high cholesterol, and smoking, along with efforts to prevent weight regain by diet and exercise, and psychological support to treat depression and prevent suicide.

Another new study by researchers at the Geisinger Health Care System has found that people who lose between 5 and 10% of their body weight before undergoing bariatric surgery were more likely to experience increased and speedier weight loss after the operation.

The study, which is the largest to look at the relationship between pre-operative weight loss and the subsequent outcome, says that bariatric surgery remains a highly effective treatment option for morbidly obese patients.

Experts suggest that successful preoperative weight loss could be a measure of a patient's compliance and potential for success following weight loss surgery.

According to statistics, 5% of the U.S. population are considered to be morbidly obese.

The studies are published in the Archives of Surgery, October 2007.