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Benefits of bariatric surgery decrease as BMI increases
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Life expectancy may be reduced after bariatric surgery for patients with a BMI more than 62 kg/m2, according to study findings published in the Annals of Surgery.
Daniel Schauer, MD, assistant professor in the division of general internal medicine at the University of Cincinnati, and colleagues evaluated data on approximately 200,000 patients to compare life expectancy for patients with severe obesity and diabetes who underwent bariatric surgery with patients who did not undergo surgery.
“For most patients with diabetes and a BMI greater than 35, bariatric surgery increases life expectancy,” Schauer said in a press release. “However, the benefit of surgery decreases as BMI increases. The patients with a BMI over 62 likely don’t gain any life expectancy with surgery.”
The main analysis revealed that a 45-year-old woman with diabetes and BMI of 45 kg/m2 had an additional life expectancy of 6.7 years after bariatric surgery. However, once BMI hit 62 kg/m2, the gain in life expectancy decreased. Similar results were found for a 45-year-old man with diabetes and BMI 62 kg/m2 whose life expectancy increased by 6.5 years with bariatric surgery.
“This was surprising,” Schauer said. “We expected those with higher BMI to benefit more from bariatric surgery.”
The researchers noted that the declining benefit of bariatric surgery with increasing BMI may have several causes.
“Patients with higher BMIs may have had diabetes for a longer duration and thus may be less likely to experience resolution of their diabetes after bariatric surgery, resulting in less potential benefit from surgery,” they wrote. “Similarly, patients with higher BMIs are more likely to have complications after the perioperative period that potentially lead to death that are not explicitly captured in our model.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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