Wednesday, November 20, 2019

Bariatric Surgery


I was recently treated to a scathing review of bariatric surgery (aka Stomach Stapling, Belly Banding, etc.) with regard to long-term outcomes.

The person who shared the review was privy to patient historys and had observed that the reality of bariatric surgery is rarely as good as the click-bait ads put out by the clinic.

I decided to do some followup research.

According to one, long-term longitudinal study, the median patient had a BMI of 47 versus a target range of 21-to-24. In simple language, they were twice their "healthy" weight.

NOTE: I will be committing statistical sins as I use medians and averages as if they were the same thing.

The 74% who underwent RYGB (the more drastic procedure) were still 50% overweight seven years later. That suggests a BMI of 34.

The 26% who underwent LAGB were still 78% overweight seven years later. That suggests a BMI of 40.

Another thing that is troubling is that almost 20% of the participants in this study dropped out by the seventh year. My perception is that people who lost weight are like vegans...they want to tell EVERYBODY. Further, my perception is that people who relapsed are less likely to remain with a study. So would the 20% that dropped out make the numbers more favorable or less favorable?

Bariatric surgery is not a silver bullet.

3 comments:

  1. I suspect the problem for most people who have this procedure is not a malfunctioning metabolism; it's what they are stuffing in their pie hole, i.e., no discipline.

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    Replies
    1. That was exactly the point of the person who went on the rant.

      The expert who trashed bariatric surgery made the point that a Snickers Bar an hour amounts to 3800 calories a day. Simply reducing stomach volume is not necessary, complete or sufficient to make a person lose weight. They will gain weight regardless if they have no discipline.

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