An impressive new study of ten-year outcomes for bariatric surgery makes us wonder whether it’s caution or fear that is holding people back from choosing to have bariatric surgery. Caution makes perfect sense in thinking about this surgery. Fears are not such good guides.
The new study shows that bariatric surgery patients in the VA system lost substantially more weight than matched controls and that they kept most of that weight off, even after ten years. Only 3.4% of 564 surgery patients regained weight to within 5% of their starting weight after all that time.
In an invited commentary on these results, Jon Gould calls them “remarkable.” He notes that they are especially remarkable because follow-up was so high (82%) in this study.
One of the great concerns for someone considering bariatric surgery the fear of regaining weight after the surgery. This study puts that fear into perspective. Likewise, ample data put the fear of complications into perspective. Complication rates for bariatric surgery are no worse (and perhaps better) than complication rates for gall bladder surgery or knee replacement.
Still, as Gould notes, less than one percent of people with severe obesity elect to have bariatric surgery. More than two-thirds won’t even consider it, citing concerns about complications, as well as expressing some denial about having obesity. The benefits – a longer life, better quality of life, and a healthier life – are clearly defined by good long-term data. But those data are no match for the emotions that surround this surgery.
So we are left to ponder the difference between caution and fear. Caution is rational. Fear is not. It seems that fear is winning.