A recent study looked at the records of a large number of people who had bariatric surgery from the start of 1995 to the end of 2004 and discovered that approximately one percent of patients died within twelve months of surgery and approximately 6 percent died within 5 years. When these statistics had been adjusted for age and sex and matched against figures for the population as a whole they were discovered to be fairly high. So what does this tell us about the ability of weight loss surgery to lower the overall risk to our health?

If we want to find the answer this particular question then we need to look behind the headline figures and look at just why these deaths happened and where the true difference lies between the population at large and obesity patients.

If we examine the detailed figures two particular things stand out.

The first is the figure for deaths resulting from heart disease which is the major cause of death in the obesity patients and is substantially above that found in the general population.

The second is the figure for deaths resulting from suicide and from drug overdoses which, although not officially classed as suicide, must nonetheless raise the question of whether or not such overdoses were truly accidents. In the general population you might expect to see roughly 2 suicides in a group of the same size as the study group and yet the group of patients showed a total of 30 deaths from suicide and drug overdoses.

If we look at these findings and set them alongside our wider knowledge about people undergoing weight loss surgery then we may possibly explain this variation to a certain degree.

In spite of the fact that bariatric surgery is usually very successful it is often not carried out until people are at risk from other conditions or comorbidities and, while surgery will cure a number of these problems and lower the risks from others, many people still remain at some degree of risk following surgery. In many cases for example people continue to be troubled by such things as high blood pressure and diabetes and it is perhaps not surprising that this section of the population remains at higher risk from heart disease.

Furthermore, while weight loss surgery may result in a significant weight loss many people remain very much overweight for a considerable time following surgery and some people will stay that way for years to come.

Finally, the changes in lifestyle which follow surgery can be dramatic and many people find that depression sets during the weeks and months following their surgery. Indeed much attention is given to the physical affects of surgery and the requirement for such things as a strictly controlled diet and an exercise program but, frequently, very little more than lip service is paid to the psychological affects of surgery.

Time will reveal the extent to which this explanation holds water but there is little doubt that improvements to follow-up care for gastric bypass patients would go a long way to solving this variation.