Bariatric surgery safe and effective?

We've been there before.  Every so often they have a new study "proving" gastric bypass (particularly) is "safe and effective".  And when one looks at the studies more closely, one sees, that studies which turn out with positive results are not exactly, what they seem to be.

The new study published in the JAMA of September 19, 2012 (

Ted D. Adams, PhD, MPH; Lance E. Davidson, PhD; Sheldon E. Litwin, MD; et al.

JAMA. 2012;308(11):1122-1131. doi:10.1001/2012.jama.11164)  is no exception.  The American Medical Assn, publisher of this journal, offers a free read on this study (because it's basically an advertisement for gastric bypass surgery).

First of all, the mean BMI of the surgical group was 45.  However, the average BMI of the gastric bypass patient is over 50.

At the 6 year point, continue the researchers, 76% of the gastric bypass patients had maintained a weight loss of at least 20% (this was erroneously reported by the news services as 28%).  Apparently the 27.7% reported by the news service, actually referred to the weight initially lost and not that maintained! 

Doing the math, the average patient, 5'5" likely weighed 270 (BMI 45).  If they maintained a weight loss of 20%, they maintained a loss of 54 lbs leaving their weight at 216 and a BMI of 35 i.e. still clinically obese and if they are diabetic, still qualified for weight loss surgery!

And for this modest maintenance, they take the chances of the long term repercussions of severe vitamin deficiencies, including the B complex vitamins which can cause many symptoms from seizures to mental fog and gastro paresis (paralysis of the stomach), leaky bowel, lessened immunity, micro-nutrient shortages (zinc etc) and a host of other issues.

Doing the math on this doesn't make any sense, does it?  Of course, the news services and some providers hope you won't do the math!

Best if you want to have weight loss surgery, to choose a less invasive option but it should be noted that weight loss surgery patients do the same work that non surgical patients do, to keep off the weight. That is, if they do not diet and exercise, they will regain the weight, regardless of how invasive the surgery.  Al Roker, a gastric bypass patient, started to regain and told the "Today Show" folks that he not only runs several days a week but also counts his calories every day to keep off his weight. That behavior will keep off weight without any weight loss surgery.

The whole idea of weight loss surgery, how it is sold is, that it will make you normal and you can eat whatever you want and never have a weight problem again. At seminars, they often, parade 2 year (and more recent) post ops who are success stories but the small print on every surgeon's web site and in the consent forms, says you have to diet and exercise to keep off any weight at all. And if you have to diet and exercise, you can do that without surgery!

If it's too good to be true - it probably isn't.