Is Bariatric Surgery Successful in the Long Term? Research Says Yes

If you’ve ever watched someone who has had bariatric surgery making dramatic progress in weight loss, you might wonder whether these effects are long-lasting.  So many people who lose weight in other ways gain it back in a few years:  Will the same thing happen to those who have weight loss surgery?

A recent study by two doctors at Northwestern University indicates that bariatric surgery is the most effective weight-loss treatment for people with extreme obesity. The study, published in the Mayo Clinic Proceedings, also indicates that patients who have bariatric surgery enjoy other important health benefits.

Where Did the Data Come From?

Dr. Robert Kushner and Dr. Courtney Noble, the authors of the study, drew their findings based on an analysis of the recent long-term studies of bariatric surgery, including the major types of surgery currently in use: gastric band or lap band, vertical banding gastroplasty (stomach stapling), and gastric bypass (also called Roux-en-Y).  The clinical trials they analyzed included a large long-term study of obese people in Sweden and other studies that compare the outcomes for obese patients who undergo surgery with the outcomes for those who do not.

How Strong Is the Evidence Supporting Weight Loss Surgery?

Bariatric surgery is the best available treatment for severely obese patients, according to Kushner and Noble.  Weight loss is greater in patients who have bariatric surgery than in patients who pursue other methods of weight loss, and the difference in weight loss remains significant over the long term (10 years).  Although the evidence is less clear-cut regarding which type of weight-loss surgery is best, this study concluded that gastric bypass seemed to be the most effective.

Other Health Benefits of Bariatric Surgery

The Northwestern study found significant health improvements in several areas for patients who underwent weight loss surgery.  Patients with diabetes had improvements in their blood sugar levels or were able to reduce their reliance on medications; the majority of patients with diabetes actually improved to the point that they no longer had diabetes.  Positive effect on diabetes was most pronounced for a procedure called BPD (biliopancreatic diversion), but was also strongly positive for gastric bypass, stomach stapling, and lap banding. 

Patients who have high blood pressure also see marked improvement after weight loss surgery; within 1 to 2 years, many patients see improved blood pressure levels and are able to stop taking medications.  In addition, patients experience improvements in their lipid levels, with levels of both bad cholesterol and good cholesterol improving after surgery.  Gastric bypass appears to have greater long-term positive effect on cholesterol levels than lap banding.

Sleep apnea has also been shown to improve, with more than 85% of patients who underwent bariatric surgery having their apnea completely cured after weight loss surgery.  Other conditions, including circulatory problems, congestive heart failure, acid reflux, asthma, osteoarthritis, metabolic syndrome, and PCOS have all been shown to improve following weight loss surgery as well.

With these health benefits, it isn’t surprising that several studies have shown that patients who undergo bariatric surgery have lower rates of premature death.

Good News for Our Wallets, Too

Less data is available to evaluate the economic benefits of bariatric surgery, but Kushner and Noble say weight loss surgery is cost-effective because it reduces the cost of health care for patients who are able to stop taking medication for diabetes, heart disease, and high cholesterol and who no longer need medical care for other conditions. 

Weight loss surgery looks like a good investment for your economic health and your physical health.