With the popularity that bariatric surgery has gained — with each year, over 200,000 people having stomach-shrinking surgeries in attempts to permanently lose weight — the truth remains that little information still appears to be available regarding which patients ought to be getting the procedures as well as effectiveness of the treatments for helping cure obesity.
This may change because of a new initiative BOLD, short for Bariatric Outcomes Longitudinal Database, which is the first repository holding patient info, outcomes, and issues associated with the bariatric surgeries — including procedures like gastric bypass, LapBand, Vertical Sleeve Gastrectomy, Roux-en-Y Gastric Bypass, Duodenal Switch, Vertical Banded Gastroplasty, and Biliopancreatic Diversion –through which obesity is treated through surgical procedures. In some cases, the majority of the stomach is sectioned off, food becomes rerouted to the second half of the small intestine, with gastric banding squeezing the stomach into a reduced size using a rubber-band-like surgical device. Initial phase results that were released from BOLD at the yearly meeting for ASMBS (American Society for Metabolic and Bariatric Surgery), stakeholders reported that safety data regarding bariatric surgery proved to be as safe as other typical abdominal and gastrointestinal procedures. Generally, the overal risk of mortality for patients 90 days following surgery settled at 0.112%. Additionally, complications and the associated rates of complication arising from bariatric surgeries put these in line among other typical procedures, like hip replacements, gall bladder surgeries, and others. The message appears to be quite clear that very low rates of mortality are providing us with signals that the degree of health and safety in these surgeries is high. When viewed through the lens of conventional thinking, such as is common in public perception, the risks from bariatric surgery are quite low,” says Weight Loss Surgery – Maughan Medical founder, Pete Maughan, who presented this data to viewers.
This data supports other studies which have documented over the last few years — that although weight loss surgery, just like any procedure, is risky as well as invasive, it is becoming a safer procedure. 2004 marked the release of a study published in the Journal of the American Medical Association which concluded the risk for fatality resulting from gastric bypass fell at very close to 0.5% (as compared for example to the risk for fatality within 90 days following hip replacement surgery which was about 0.3% at the time). Additionally, a thorough government analysis concluded that the rates for complication, such as infections in particular, arising from bariatric surgery had come down a total 21% from 2002 to 2006.
This is in large part due to self-imposed standards for safety that have been implemented rigorously by the ASMBS which were piloted only a few years ago. The association also turned out criteria regarding safety, quality of patient care, as well as invited bariatric weight loss surgery centers to adhere to these standards. As soon as centers were self-declared to have adhered to basic standards — such as providing protocols for measuring followup and outcome measurement, state of the art medical equipment for procedures, and following other guidelines, an onsite inspection was conducted. After passing inspection, the centers received certification as American Society for Metabolic and Bariatric Surgery Centers of Excellence.
Data gathered from patients at these centers constitute the Bariatric Outcomes Longitudinal Database –once again BOLD for short. In the first phase of the study, data gathered from over 57,000 bariatric surgery patients who underwent bariatric surgery at 371 hospitals became part of the study. In subsequent years, researchers have a mind to use the information and mine it to obtain even clearer views on outcomes and effectiveness of bariatric procedures. The data will also be used to address weight loss as compared to the population as a whole to reduce risks for additional health problem, like heart attack, diabetes, and stroke, that tend to be closely associated with obesity and excessive gaining of weight.
So far, studies continue to come out that document benefits to bariatric surgery. Accordingly, in 2007 researchers published a trial in the New England Journal of Medicine, concluding that over weight patients who undergo gastric bypass surgery reduced risk of fatality over the subsequent 7 years by more than 40%. Their chances for heart disease in the same 7 years decreased by an astounding 56%, when compared alongside overweight people who did not receive the procedure. This retrospective analysis in the study regarding surgery outcomes did not allow complete conclusion as to whether other factors affected these results because of the retrospective nature of the analysis in the weight loss surgery study.
BOLD increasingly allows weight loss surgeons, bariatric physicians, as well as other doctors specializing in weight loss to study patients directly who are electing bariatric surgery. They can study these bariatric patients from day one, providing researchers opportunities in measuring and analyzing factors which potentially affect overall health. The doctors and researchers can also continue to study at all points before, during as well as following weight loss procedures. The database of weight loss patients data is intended to address short-term as well as long-term concerns and aspects of bariatric surgery, such as overall weight loss, general and specific improvements parameters of health such as level of diabetes, sleep apnea, hypertension and cholesterol issues. As the amount of Americans who are overweight and obese rises each year, this important research into the outcomes of the different weight loss surgeries will be extremely helpful for those who are contemplating bariatric surgery to augment, or fully overhaul their weight loss program.