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Bariatric procedures on the rise

Increasing use of bariatric procedures is helping to reduce deaths in morbidly obese patients, evidence in The Lancet has revealed.

Bariatric surgical procedures have increased fivefold in the past five years in most developed countries and evidence shows that they have reduced mortality in morbidly obese patients by 29%.

Traditionally the effectiveness of obesity surgery has been measured in terms of excess weight loss. But today the authors say the emphasis is more on what affect surgery has on obesity-related comorbidities.

"New data indicate that at least some bariatric procedures exert their beneficial metabolic effects not only by weight loss but also through a change in hormone release from the gut," say the authors.

"This finding corresponds to clinical observations that obesity in patients with diabetes is especially amenable to bariatric surgery."

The authors believe that surgical team expertise is crucial in determining outcome, and call for knowledge and skills to be concentrated in bariatric surgery centres.

They conclude: "In summary, there is good evidence to show that bariatric surgery is more effective than non-surgical approaches in the therapy of morbid obesity.

"However, no single operation is ideal for every morbidly obese patient, and all operations also entail some disadvantages."

The Lancet