Thursday, March 23, 2017

Higher rate heart attack and suicide after gastric bypass

In the gastric bypass, the stomach is very compromised and the duodenum, a vital part of digestion, is bypassed.  This is why it causes nutritional deficiencies in most patients.

Yesterday's broadcast "My 600 lb life", was unsettling, especially in my watching it for the second time.  I'm assuming because the patient died from heart disease, soon after they had stopped following him, they haven't shown this episode much because of the possible negative effects on the audience of prospective surgical patients.

What was interesting to me is that he apparently, had heart disease before surgery because during his excess skin removal surgery, he suffered a total cardiac arrest.  "I actually died on the table," the patient tells the camera, but they were able to resuscitate him.

He called his resuscitation, a miracle but a year or two after these procedures, he had a heart attack while driving a school bus and crashed the school bus.  He was D.O.A. when he got to the hospital. We weren't told how many kids were injured but since he'd had a heart attack a year or two earlier, while driving a shuttle bus, one questions why he was again driving and then, a school bus.  One of many questions with this case.

One question that arises was - was this person who obviously already had heart disease, really a good candidate for a procedure like the gastric bypass which tends to raise the risk of heart disease? 

A study published in the "Archives of Surgery" in 2007, found that gastric bypass actually increased the risk of both heart attack and suicide in post ops.  The study examined the records of 16,683 weight loss surgeries among Pennsylvania residents.  They found a substantial number of excess deaths attributed to both heart disease and suicide.  As post surgery time increased, the researchers continued, so did the death rates with heart disease topping the list.  The bariatric industry basically ignored the study, pointing out that these ailments are higher among the obese anyway.

The Dr on TV requires prospective patients to lose 50 to 100 lbs before surgery which they all diligently do, pointing out that diet and exercise are needed to continue weight loss after surgery, but of course, diet and exercise also work well to effect a weight loss without surgery and often, the patient, anxious for the surgery, loses weight at a faster rate before surgery, than after.

When the gastric bypass was promulgated in the 1960's, it was thought that the stomach controls appetite and thus, mutilating this vital digestive organ, would help the person to control their overeating.

They didn't realize then, that the stomach, although a key player in the digestion of proteins, fats and vitamin B12, does NOT control the appetite centers which we now know, are located in the brain.  Moderns who have the gastric bypass are disappointed that their cravings (which originate in the brain) have not been affected by the surgery.

Interestingly, if we look at the repercussions of the gastric bypass more closely, we see that although the weight loss effects are temporary (according to TV bariatric surgeon, Dr Nowzaradan), the complications not only last much longer but increase in the years after surgery.

Happily, less and less surgeons are doing gastric bypass - hopefully, we will see the end of this invasive but not that effective procedure in the near future.

One doctor told his patients to diet and exercise before surgery and then, when they'd had a substantial weight loss, he told them "Now, go home and continue what you are doing!  You don't need surgery!"

2 comments:

Jackie smith said...

I've always been suspicious of this seemingly miracle cure. Is a gastric band as dangerous or is it just the bypass?. And even skinny celebs say they are always hungry or craving food. Food cravings are more emotionally linked in my experience. A hurting person craves comfort which is spot of the time food. Even skinny people crave comfort food.

Sue Joan said...

Funny you should ask. Tonight's "600 lb" show detailed some pretty gnarly complications after a gastric sleeve requiring multiple additional surgeries. Hmmm