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Super Obesity Ups Risk of Dying After Weight-Loss Surgery

Deaths also more common among those with chronic diseases, study finds

WEDNESDAY, Oct. 21, 2009 (HealthDay News) -- People who are super obese and those with the most chronic health problems face an increased risk for dying within a year after weight-loss surgery, a new U.S. study has found.

The research involved 856 men and women who had bariatric (weight-loss) surgery at 12 Veterans Affairs medical centers between 2000 and 2006. They averaged 54 years old and had an average body-mass index (BMI) of 48.7. BMI is a measurement based on height and weight, and a BMI of 40 or greater is considered class 3 or morbid obesity.

About 36 percent of the group was considered super obese, with a BMI of 50 or higher. In addition, 8 percent also had such chronic diseases as diabetes and heart disease.

During the follow-up, 54 people died, including 1.3 percent who died within 30 days of their surgery, 2.1 percent who died within 90 days of surgery and 3.4 percent who died within a year, the study found.

Those who were super obese and those with co-existing chronic diseases had the highest risk for early death. Super obese people accounted for 30 of the 54 deaths and had 30-day, 90-day and one-year death rates of 2 percent, 3.6 percent and 5.2 percent, respectively. People with co-existing health problems had death rates of 1.5 percent after 30 days, 5.8 percent after 90 days and 10.1 percent at one year.

The chances of dying after bariatric surgery may be greater for people who are super obese, according to the researchers, because the added abdominal fat makes the procedure more difficult, wound complications and blood clotting are more likely and they're more apt to have obesity-related illnesses.

"The results of this study should inform discussions with patients with regard to the potential risks and benefits of bariatric surgery," wrote co-author Dr. David Arterburn, of Group Health Research Institute in Seattle, and his colleagues in their report, published in the October issue of Archives of Surgery.

"These findings also suggest that the risks of bariatric surgery in patients with significant comorbidities, such as congestive heart failure, complicated diabetes and chronic obstructive pulmonary disease, should be carefully weighed against potential benefits in older male patients and those with super obesity," they concluded.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about bariatric surgery for severe obesity.

SOURCE: JAMA/Archives, news release, Oct. 19, 2009
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