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Study doubts long-term benefits of weight loss surgery

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The weight loss and type 2 diabetes benefits of bariatric (weight loss) surgery decline rapidly over time, according to new research. The study, conducted by researchers at Beilinson Hospital in Israel, examined the data of almost 450 patients undergoing weight loss surgery performed by the same team between 2006 and 2013. The researchers followed up their weight, blood test results, and medication information. Excess weight loss percentages declined significantly over time: 77 per cent in the first year; 70 per cent in the third; and 56 per cent in the fifth. The figures for type 2 diabetes remission were similar: 51 per cent, 38 per cent, and 20 per cent. After three years, there was significant reduction of low-density lipoprotein (LDL) cholesterol. "The longer follow-up data revealed weight regain and a decrease in remission rates for type 2 diabetes mellitus and other obesity-related comborbidities," said Dr. Andrei Keidar. "These data should be taken into consideration in the decision-making process for the most appropriate operation for a given obese patients." Dr. Keidar stressed the importance of lifestyle changes following weight loss surgery, explaining that the surgery does not suppress appetite forever: "The main reason [for the weight regain] is that the stomach dilates, meaning you can eat more. The appetite comes back so patients can eat more and they want to eat more. "If you don't change your behaviour, you are to regain weight." According to Dr. Anita Courcoulas, of the University of Pittsburgh Medical Centre, more studies are needed to assess the long-term effects of weight loss surgery. She said: "These critical gaps in knowledge pose a significant problem for people considering a potential surgical option to treat severe obesity."

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I suppose the long term effect will be tempered by the long term effects on behavior!
If the patient continues to have a bad way of eating then they are likely to return to the original bad state! if alternatively they have changed to a better way of eating, they may be more likely to avoid relapse!
 
Yes, people need to be very careful to change their lifestyle, so the benefits are maintained. However, I still think that for the super-obese (over 160kg) surgery is a good option. When you are so heavy that your life is at risk in the next 5 years, something drastic is often needed.
 
Unfortunately my great-niece is one of the failures - had lap band surgery, lost a heap of weight and got back to normal weight - took her eye off the ball and is now heavier than she was beforehand. Now she has to start from scratch again and I can't help but think it will be a lot harder the second time around.

She was young enough the first time not to end up with lots of sagging skin (though the stretch marks are something to behold) - can't help but wonder how often you can get away with that. It's certainly not possible with my ageing skin
 
I'm sure that life style change is important.
I think that the report should have made clear that the results are from one specific type of surgery; Laparoscopic sleeve gastrectomy (and one hospital) Certainly in the short term, different procedures have different success rates for diabetes remission.
I think this is one of the first studies to look at longer term outcomes.
 
I'm sure that life style change is important.
I think that the report should have made clear that the results report the follow up from one specific type of surgery
; Laparoscopic sleeve gastrectomy. Different procedures have different outcomes. The report (maybe not the actual paper)doesn't say what percentage of patients achieved diabetes remission in the first place .
I don't think theres much long term data on any of the methods though.
 
Also, I think it's important to remember that even though there is a considerable failure rate after 5 years, if these people had not had the surgery, some of them would not have lost any weight, or much weight, and of those that did, almost all of them would have regained it anyway. Statistically, bariatric surgery is still more successful, because the 5 year success rate for ordinary weight loss is so small, around 5-10%.
 
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