For many patients gastric bypass surgery is very much a last resort and something to be put off as long a possible while they explore all of their other options. Indeed, in most cases patients are assisted in this by their doctor who, following tradition, will insist on an extended program of diet and exercise before even considering referring a patient for surgery. But is this approach sensible?
Apart from the fact that most people agree that diet and exercise don’t work and are a complete waste of time for the vast majority of patients, there is strong evidence to suggest that delaying surgery is actually putting patients at risk.
In a recent study the records of more than 2,000 patients who underwent gastric bypass surgery between 1995 and 2004 in one particular medical center were examined. The team carrying out the study wanted to see whether there were any factors which would have predicted the risks for these patients before they underwent surgery and they identified 5 things which they believe increased a patient’s risk of surgery.
The first of the five factors was gender, with men being at higher risk than women. The second was a body mass index (BMI) of more than 50. The third was age, with patients over the age of 45 being at higher risk. The fourth was the presence of hypertension (high blood pressure), often related to cardiovascular disease. The final factor was previous evidence of pulmonary embolus (a blood clot in the lungs) or a propensity for this condition.
The team then awarded one point for the presence of each factor and divided the overall study group into those at low, medium and high risk according to their scores. Next, they examined the death rate for each of these three groups and found that in the low risk group the death rate was 0.31%, in the medium risk group it was 1.9% and in the high risk group it was 7.56%.
Now there’s not much you can do about your gender but, as far as the other four factors are concerned, the effects of delaying surgery are obvious. Getting older, continuing to put on weight and developing health problems all increase the risks for surgery. So, if you are morbidly obese, then perhaps you should consider early surgery and balance the risks involved in waiting against the chances of finding a successful alternative.
