Tuesday, June 28, 2016

Misleading study finds that gastric bypass is a good idea?

Most people only read the first paragraph of a news article and the media takes advantage of that fact, assuming most folks will not read the rest of the article and only a very small percentage will research the article.  Therefore, the news media can inform the public of anything they want to sell, pretty much assuring that their disinformation will hit the target audience.

The first paragraph of a recent Reuters news service article reads: 

"Ten years after gastric-bypass weight-loss surgery, patients in a recent study had managed to keep off much of the weight they'd lost."

That sounds impressive but even reading the rest of the article raises rather large doubts - for example they were only able to contact a little more than half the original patients who got RNY between 1985 and 2004.  The cohort was 1087 patients and they were able to contact 651 of them.  That raises the big question of how hard did they try to contact the cohort - did they, for example, check and see which ones had died?  (Obituaries are public domain and easily searchable on the internet).

And despite the impressive sounding first paragraph, 10 years after an invasive surgery which is known to cause malnutrition etc, patients contacted had only kept off 25% of their excess weight.  That is, if the excess weight was 100 lbs, then at the 10 year point, they only were 25 lbs lighter than when they had the surgery - hardly worth an invasive surgery which has a higher mortality rate than open heart surgery.

Another questionable thing, is, this was a contact by phone - in other words, the patients they did contact, self reported the results and it's common knowledge that patients when self reporting, especially after elective surgical procedures, can be extremely inaccurate or leave out very pertinent facts - like for example, it appears non of the patients were asked if they had metabolic bone disease, a common repercussion of gastric bypass surgery.

At the time of their surgeries, 59% had high blood pressure... but 10 years later, that percentage had only gone down a few points i.e. 47% still had high blood pressure, a risk factor for many things including stroke.

It appears that many surgeons are, for some reason, not learning the newer procedures like gastric sleeve which are safer than gastric bypass.

And one might question whether surgery is any longer a viable option since newer research suggests that the appetite centers are in the brain and not in the GI tract.  It should be noted that Dr Nowzaradan of TLC TV fame, admitted in an honest moment, that 5 years after a gastric bypass the surgery is no longer effective as far as weight loss.

Sadly most folks who read the Reuters article will only read the first paragraph and thus be impressed, perhaps making a life changing decision which while a questionable treatment for obesity, might endanger their health for life.