Bariatric Surgery May Reduce Life Expectancy for Super Obese Diabetics

by Barbara Hewitt on February 11, 2015

Bariatric surgery improves life expectancy for many obese people with type 2 diabetes but it is not as effective for the super obese, new research has found.

Indeed this kind of surgery may cut life expectancy for patients who are super obese with very high body mass indexes, according to the study undertaken at the University of Cincinnati in the United States.

Efforts should be made to minimise  an increase in BMI, research shows

‘For most patients with diabetes and a body mass index (BMI) greater than 35, bariatric surgery increases life expectancy,’ said Daniel Schauer, assistant professor in the Division of General Internal Medicine at the university.

‘However, the benefit of surgery decreases as BMI increases. The patients with a BMI over 62 likely don’t gain any life expectancy with surgery,’ he added.

Schauer and a team of researchers developed a decision analytic model to compare life expectancy in a group of severely obese diabetic individuals who had bariatric surgery to a group that did not have bariatric surgery.

They used data involving approximately 200,000 patients from three HMO Research Network sites as well as data from the Nationwide Inpatient Sample and the National Health Interview Survey linked to the National Death Index.

In the main analyses of the study, researchers found that a 45 year old woman with diabetes and a body mass index of 45 kg/m2 gained an additional 6.7 years of life expectancy with bariatric surgery amounting to 38.4 years with surgery versus 31.7 years without.

However, the gain in life expectancy decreased once BMI hit 62 kg/m2 with bariatric surgery. Similar results were seen for both men and women in all age groups. The study did not look at differences associated with race.

‘This was surprising. We expected those with higher BMIs to benefit more from bariatric surgery,’ said Schauer. He added that super obese patients may have had diabetes for a longer duration and are more likely to have complications after surgery resulting in adverse health outcomes.

About 15 million adults in the United States suffer from severe obesity, which is defined as having a body mass index of greater than 35 kg/m2. Obesity and diabetes are closely linked and severe obesity increases the risk of diabetes by more than seven fold, according to Schauer.


The opinions expressed in this article do not necessarily reflect the views of the Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

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