Bariatric surgery associated with longer life expectancy

People who have undergone obesity (bariatric) surgery live three years longer, on average, than those given conventional treatment for their obesity, a University of Gothenburg study shows. Compared with the general population, however, both groups' excess mortality is high.

The results published in The New England Journal of Medicine (NEJM) are based on the Swedish Obese Subjects (SOS) study, which started in 1987 and is led from the Sahlgrenska Academy, University of Gothenburg.

The study comprises data on 2,007 adult patients who had undergone bariatric surgery and a control group of 2,040 given conventional (nonsurgical) treatment for obesity. Also included was a representative reference group of 1,135 people from the general population.

Among those who underwent surgery, estimated average life expectancy was 3.0 years longer than in people treated with non-surgical obesity care, but 5.5 years shorter than in the general population.

It has been known for some time that bariatric surgery brings about lasting weight loss and lowered risks of cardiovascular disease, type 2 diabetes and cancer, leading to lower mortality. On the other hand, to what extent this translates to extension of life expectancy after bariatric surgery has been unknown.

Dr. Lena Carlsson Ekander, Professor of Clinical Metabolic Research at Sahlgrenska Academy, has been responsible for the SOS study since 2005 and is the lead author of the article.

"Now, for the first time, we've got a measure of how much bariatric surgery prolongs life expectancy for the average patient. But it's important to point out that it's a matter of averages. Not all patients are the same, so you can't draw the conclusion that everyone who gets the operation done lives three years longer," she says. Despite the beneficial effects of bariatric surgery -- the reduced risk of worsening health and premature death -- still only a minority of the patients eligible for surgery actually undergo an operation. The researchers emphasize the importance of patients getting appropriate information to make an informed choice when considering obesity treatment.

In this study, we investigated mortality over as long as three decades. In addition, we estimated life expectancy after bariatric surgery and regular obesity treatment and compared it with life expectancy in the general population."

Dr. Lena Carlsson Ekander, Professor of Clinical Metabolic Research at Sahlgrenska Academy

"Obesity has long been known to reduce average life expectancy by some five to ten years. Our study shows that bariatric surgery prolongs it by three years. But even after surgery, patients still have a shorter life expectancy than the general population. That's why it's very important for bariatric patients to be offered adequate postoperative monitoring and follow-up," she concludes.