Dr. Henry Buchwald and his colleagues at the University of Minnesota combined data from 136 separate studies involving 22,094 patients and concluded that the procedures, which range from simple rubber bands that reduce the size of the stomach to more complicated procedures that bypass large parts of the digestive system, are remarkably effective at restoring health and improving quality of life.
They found that patients typically lost more than 60% of their excess weight, usually more than 100 pounds. Diabetes was cured in nearly 77% of patients and either cured or improved in 86%. Cholesterol levels were lowered in at least 70% of patients. High blood pressure was returned to normal in nearly 62% of patients and improved in an additional 16%. Obstructive sleep apnea was cured or improved in 83.6% of patients.
"The overwhelming majority of patients responded positively," said Dr. Eric Dutson of UCLA, who performs the surgery. "This is a huge chunk of data that gives us very strong indications of what the reality is."
At least 8 million Americans are morbidly obese and have at least one other risk factor for heart disease that would make them eligible for the surgery. Most of them have tried dieting and failed.
The popularity of the surgery has increased dramatically in recent years, spurred by the success stories of celebrities such as NBC weatherman Al Roker, singer Carnie Wilson, television personality Sharon Osborne and others. The number of procedures has increased from about 25,000 in 1998 to an estimated 144,000 this year.
The procedures typically cost at least $25,000. Most insurance companies will pay for bypass procedures if they are deemed medically necessary, but few are willing to cover the banding procedures, which are a more recent development.
The procedures have a range of side effects, including a small risk of death during the surgery, ranging from about 0.1% for banding procedures to 1.1% for the bypass operations.
Other complications can include bleeding from the surgical site, infections, vitamin deficiencies, diarrhea and nausea.
Counterbalancing those, however, are the severe side effects associated with obesity, including diabetes, heart disease, strokes, arthritis and a host of other infirmities. Researchers estimate that a 25-year-old man who is morbidly obese will lose about 12 years of life as a result.