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Study supports NICE bariatric surgery recommendations

Newspage: SurgeryExtremely obese patients could gain around three years life expectancy if they undergo bariatric surgery, US research suggests.

The findings add to growing evidence supporting the use of weight loss surgery and back up NICE obesity guidelines which recommend surgery for severely obese patients who have been unable to control their weight through other weight loss treatments.

The NICE guidelines state that bariatric surgery should be offered to patients with a body mass index (BMI) of 35-40 who have other conditions caused by being overweight, such as diabetes and obstructive sleep apnea, those with a BMI of 40-50 with no other weight related conditions or those with a BMI of 50 and over, as a first-line treatment.

However, an audit conducted by the British Obesity Surgery Patient Association has shown that some PCTs in England are reluctant to offer the treatment because of the initial costs of the surgery which can reach up to £14,000.

For this latest study, Dr Daniel Schauer and colleagues from the University of Cincinnati Academic Health Centre developed a computerised model to estimate the benefits and risks of surgery for patients with morbid obesity.

The model included data from 23,281 patients undergoing bariatric surgery to calculate the effects of surgery on survival rates.

Overall, the researchers found that an average 42 year old woman with a BMI of 45 would gain an estimated three years of life expectancy as a result of undergoing bariatric surgery. A 44 year old man with the same BMI would gain an estimated 2.6 additional years.

Younger patients were found to benefit the most from surgery as they have a lower surgical risk and have longer to realise the benefits of the surgery, the researchers said.

They concluded: “Our model indicates that gastric bypass increases life expectancy for most patient subgroups; however, for those at high surgical risk or in whom efficacy of surgery is likely to be low, benefit will be minimal.

“We believe that results of this analysis can be used to better inform both patients and doctors' decisions regarding gastric bypass surgery.”

See our guidelines on Obesity: the prevention, identification, assessment and management of overweight and obesity in adults and children.

Arch Surg 2010; 145:57-62

19 January 2010

This page was last updated: 14 April 2010

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Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.