Morbidly Obese Patients Who do not Undergo Weight-loss Surgery

NEW YORK (Reuters Health) Jun 29 - Morbidly obese patients who do not undergo weight-loss surgery face a substantially greater mortality risk than patients who undergo bariatric surgery, according to a presentation this week at the 23rd annual meeting of the American Society for Bariatric Surgery in San Francisco.

"There has been a lot of controversy regarding morbidity and mortality due to bariatric surgery, and if it worked, but we were drawn to see what happens to these patients if they decide to not undergo bariatric surgery," Dr. Randolph B. Reinhold told Reuters Health.

Dr. Reinhold, chairman of the Department of Surgery at the Hospital of Saint Raphael in New Haven, Connecticut, and his colleagues reviewed the records of patients who were morbidly obese and had been seen in their clinic between 1997 and 2004. According to their meeting abstract, 1438 patients were evaluated, and 207 never returned for surgery.

During follow-up the investigators were able to contact 101 patients or their family members to document outcomes of those who went untreated, and they also examined registries for information on patients who had died.

"The survival rate at 1 year was 99% in the surgery group and 97% in the no-surgery group," Dr. Reinhold said. "After that, the mortality due to morbid obesity increased significantly compared to those who underwent surgery because the consequences of obesity continue to accrue."

"By year 3, the survival rate was 98% in the surgery group versus 88% among those who remained untreated," the surgeon continued. And at 5 years, the corresponding survival rates were 97% and 78%.

"Morbid obesity is so dangerous that if it is left untreated, patients face a mortality rate more than 10 times the expected rate," Dr. Reinhold added. In his group's study, the average age at death among nontreated patients was 54. For those in the general population at that age, the expected mortality rate is < 1%.

He pointed out that "occasionally some patients in this population can lose weight by dieting alone, but for the vast majority the weight is regained.

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