There was a nearly sixfold increase in the number of weight loss surgeries performed in the U.S. between 1998 and 2002, a new study shows.
Roughly 14,000 gastric bypass surgeries were conducted in 1998, compared with nearly 82,600 such surgeries in 2002.
Using hospital discharge data, researchers concluded that the number of American adults having surgical weight loss procedures rose from 7 percent 100,000 to 38.6 per 100,000 during the four-year period.
They attribute the dramatic increase to the introduction of a laparoscopic adjustable gastric banding surgical procedure following approval by the FDA in 2001.
“Although this surgery is more costly and time intensive, patient recovery times are shorter, and the surgery itself is less invasive,” researcher Tonya M. Smoot, PhD, and colleagues wrote.
Best Treatment for Obesity Diseases
Weight loss surgery is increasingly being recognized as the most effective treatment for a host of obesity-related diseases, bariatric and general surgeon William Richards, MD, tells WebMD. Richards is chief of laparoendoscopic surgery at Vanderbilt University Medical Center in Nashville, Tenn.
He points out that at Vanderbilt, 75 percent of the morbidly obese patients with type 2 diabetes who have gastric bypass or gastric banding surgeries are essentially cured of the disease within a year of having the surgery.
“I consider these procedures less weight loss surgeries than surgeries to reverse the many deleterious metabolic consequences of being morbidly obese,” Richards says.
“We are treating diabetes, sleep apnea, congestive heart failure, atherosclerosis, nonalcoholic liver disease, and many other obesity-related conditions that are life threatening. Surgery is by far the most effective treatment for these conditions in people who are morbidly obese.”
Women Have Surgery More Than Men
Between 80 percent and 86 percent of gastric surgeries conducted between 1998 and 2002 were performed on women, according to the new study, which was conducted by researchers from the University of Louisville in Kentucky, and published in the July issue of the American Journal of Public Health.
Roughly one in five patients had type 2 diabetes, with men more likely to have the disease than women (30 percent vs. 17 percent). The next most commonly seen medical condition among the obese patients was chronic pulmonary disease, seen in 14 percent of women and nearly 4 percent of men.
The average age of both the male and female surgery patients was 40. In 2002, the most gastric weight loss surgeries were performed in the South, with 47 procedures for every 100,000 adults, followed by the Northeast and Midwest with roughly 37 surgeries each, and the West with 28 surgeries for every 100,000 adults.
Bypass vs. Banding
Laparoscopic gastric bypass surgery is still the most commonly performed weight loss surgery in the U.S. But more and more patients are opting for gastric banding, which restricts the amount of food a person can eat by closing off a portion of the stomach.
Banding has the advantage of being less invasive than bypass surgery. It is also reversible with removal of the band system. A disadvantage is that banding requires frequent postsurgical medical visits for band adjustment.
Gastric bypass tends to be a better option for diabetes patients, Richards says, because the procedure not only restricts the amount of food the stomach can hold, but restricts calorie and nutrient absorption.
“Gastric bypass has been shown to have a profound effect on diabetes that is independent of weight loss,” he says. “Patients also tend to lose more weight with this procedure. But if a patient is highly motivated and is willing to see their surgeon once a month for the first year after surgery and then four or five times the second year, laparoscopic adjustable gastric banding may be the best option.”
By Salynn Boyles, reviewed by Louise Chang, MD
SOURCES: Smoot, T.M. American Journal of Public Health, July 2006; vol 96: pp 1-3. Tonya M. Smoot, PhD, University of Louisville, Ky. William O. Richards, MD, professor of surgery, chief, laparoendoscopic surgery, Vanderbilt University Medical Center, Nashville, Tenn.