[DocSanae]

Okay, I've been browsing through the ASBS (American Society for Metabolic and Bariatric Surgery) site, and have been picking up some stuff here and there.

One of them is an article that is primarily information for post ops to share with their surgeon and PCP for their post op care. I have put that up in the thread, Bariatric Surgery: Postoperative Concerns. If you haven't checked it out yet, I sure hope you will soon.

So, here are some other stuff that I have picked up.

The estimated number of weight loss surgery in the US for the year 2006 is 177,600. In 1998, it was 12,775, in 2002, 70,256.

ASBS Centers of Excellence in the US: 429 surgeons, 234 hospitals.
Requirements to be designated as COE: at least 125 bariatric surgery per year collectively, the surgeons having performed at least 125 bariatric surgeries, and are perfoming at least 50 per year. The hospitals/institutions must have a dedicated multi-diciplinary team of various specialities as listed specifically in requirement.

Impact of surgery on obesity-related diseases.
(originally from JAMA Oct. 2004, the total number of patients assessed in this study, 22,000)
Type 2 diabetes eliminated in 76.8% of patients,; 86% eliminated or improved.
Hypertnesion eliminated in 61.7% patients and resolved or improved 78.5%
Obstructive sleep apnea or sleep-disordered breathing eliminated in 85.7% of patients
High cholesterol levels or hyperlipidemia decreased in more than 70% of patients
Average weight loss was 61.2% for all patients

Risks (JAMA Oct 2004)
Mortality: LAGB (lap band) 0.1%, gastric bypass 0.5%, BPD/DS 1%
In-patient death associated with bariatric surgery declined from .89% in 1998 to 0.19% in 2004.

Effectiveness
Weight loss continues up to 18 to 14 months after the procedure.
Patients MAY lose 30-50% of their excess weight in the first 6 months, and a total of 77% of their excess weight as early as 12 months after surgery. Another study showed that patients can maintain a 50-60% loss of excess weight 10-14 years after weight loss surgery.

[Kenyar]

I dont know what to say. Maybe i am interpreting this wrong but I have to be honest and say that i am a little disappointed in the numbers. I dont mean to be negative. Yes I am healthier for what I have done, BUT is it really worth only being able to maintain 50% of what i lose over 10 years? hmmmmm...

[DocSanae]

Not 50% of what you lose, 50% of your excess weight, so, ah, you're interpreting it wrong.
The other data I have put up is, 77% loss of excess weight in the first year. Say, your weight loss levels out there, then, 50% of what you lost is going to be 38.5% of your excess weight.
Also, this is a conservative data. With more post ops, and with better support, I think the more recent numbers will be better. I have an article on hand that came out this year, but I haven't had the time to go throught it yet, but at a cursory look, the number seems to be about 10% higher.
Another data has it that you will hit your lowest at sometime, then regain around 20lb and stay there.

[Kenyar]

yesh i saw something about that. regaining 10- 20lbs is fine but gosh if i gain back 50lbs im gonna be MAD lol!

its very confusing though. i have to say to myself "i will be the exception" and do whatever i have to to NOT regain too much. hopefully by then i will be completely re-trained in terms of diet and exercise so at least i'll have a fighting chance

[Daveinsapporo]

Hi Folks,

There are a lot of guys beating the statistics every day on the OH Men's Board by exercising several times a week. Many say that they *can't* gain weight.

Dave

[DocSanae]

There is something you will need to understand.
That is, the total NUMBER of people having trouble post op will increase, has increased.

The reason behind this is as follows.
10 years ago, the number of weight loss surgery was less than 13,000. Last year, it was up to 177,000.
Now, say, certain post op complications developed in 5% of the post ops 10 years ago. That will put the actual number of people who had the post op complication at 650 persons. Say the ratio of this particular complication was reduced to 1% with the most recent procedures and conscientious follow up and the resulting data has improved. Because the total of surgery is 177,000, 1% of that is 1,770. That's 1,770 people with the said complication from last year, so the number of people with the complication is actually more than twice, closer to three times the number 10 years ago. However, the ratio of complications has come down to 5 times lower than before, which means the results from the surgery are more favorable than 10 years ago.

This can confuse a lot of people when only certain numbers are cited in various data. You will have to look at the number of people included in the entire study, how they were grouped, and what conditions were set in collecting the data. It is very easy to sway the outcome of statistical data when you know how to do it, and how to set up studies so the results will be favorable to a forgone conclusion.
Also, as the absolute number of people with unwanted results from the surgery increases, their voices in experssing opinions will also increase. Those who are satisfied with the results are understandably more silent, for various reasons.

Bad news travels fast, far and wide. Good news don't.

[DocSanae]

The August 23, 2007 issue of The New England Journal of Medicine, which is one of the most widely respected and read medical journal in the word, carried two articles on the results of long term follow up study on weight loss surgery. The average years of follow up in one study is 10.9 years, and 7.1 in the other.
Access to the articles are limited to subscibers of the journal, but the American Society for Bariatric and Metabolic Surgery has up a summary and assessment of the two articles. This may help alleviate your fears on the outcome of the surgery, and whether weight loss can be sustained long term. Below is the link to the article.
ASMBS Summary and Implications of Long-term Mortality Studies for Bariatric Surgery in NEJM Aug 23, 2007

[luvRdogs]

Thank you so much for the great information. Much appreciated. Are most bypasses laproscopic now? Haven't seen stats on that.

[Perfesser]

Doc,

Do you have an update on these stats?

Thanks,
CT

[DocSanae]

NO. These kind of stats usally come out every 5 years or so, long term follow up studies are tricky, and so many patients drop out of sight, too, so to have vailid statistics takes time and careful study. To get the stats for the people who had surgery in, say, 2005, the first long term numbers won't be able to be accessed and analysed until this year ends. When you are looking at 10 year results, well...you get the picture

Oral reports of more recent stats probably are presented at various medical conferences, but unless one has access to the resumes of the particular societies and conferences, it's not easy to come by them.