Bariatric surgery 10 years on

Executive Summary

* A study was published in March 2021, which explored, in depth, patients' experiences of living with a bariatric surgery procedure for more than a decade.

* Between 2006-2007, a randomised controlled trial (RCT) had been conducted in Sweden whereby 60 people were randomly allocated to one of two bariatric surgery procedures. This March 2021 study interviewed participants in that RCT to elicit key themes about how they felt about their surgery.

* Numbers were not the focus of the paper, but the study included a table reporting pre-surgery BMI and BMI at the time of the interview (at least 10 years later) and the amount of excess BMI that had been lost. The average loss, and some of the individual losses, were impressive. There were differences between the two surgery procedures and between men and women, which were not reported in the paper.

* One key theme was captured by the researchers as "sustained effects." This included the fact that the majority of participants thought that they would have been dead or severely ill by now had they not undergone the surgery. Appetite seems to be most significantly impacted after surgery, but the effects were reported to be sustained a decade later. Surgery does impact appetite, and effects, such as dumping, provide a strong additional deterrent to eating too much or too quickly.

* The second key theme was called "continuing struggles". Participants reported an ongoing fear of weight gain. Activity/exercise was still difficult or painful for the majority. A quarter of participants had experienced relationship break-ups since the surgery. Seven out of 18 interviewees blamed themselves for not having made more of the opportunity that bariatric surgery should have given them.

* I have never been a fan of bariatric surgery, and I share why in the close to this note, but this study did make me think. The losses were impressive and people had thought provoking reflections on their years since surgery. With a BMI of 60, you have a risk of doing nothing and a risk of doing something. This review is of the people who chose to do something and they didn't regret it.

Introduction

 

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