Bariatric surgery improves life expectancy for many obese patients with diabetes, but it may reduce life expectancy for patients who are super obese, according to a study published in the online edition of the Annals of Surgery.
“For most patients with diabetes and a BMI [body mass index] greater than 35, bariatric surgery increases life expectancy,” said Daniel Schauer, MD, Division of General Internal Medicine, University of Cincinnati, Cincinnati, Ohio. “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 researchers developed a decision analytic model to compare life expectancy in a group of severely obese patients with diabetes who had bariatric surgery with a group that did not have bariatric surgery.
In the main analyses of the study, researchers found that a 45-year-old woman with diabetes and a BMI of 45 kg/m2 gained an additional 6.7 years of life expectancy with bariatric surgery (38.4 years with surgery vs 31.7 years without). However, the gain in life expectancy decreased once BMI hit 62 kg/m2 with bariatric surgery. Similar results were seen for both men and women in all age groups.
“This was surprising,” said Dr. Schauer. “We expected those with higher BMIs to benefit more from bariatric surgery.”
Super obese patients may have had diabetes for a longer duration and are more likely to have complications after surgery resulting in adverse health outcomes, he said.
References
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