Oct. 15, 2007— -- While gastric bypass surgery may help obese people improve their health by shedding weight, the procedure may have a darker flipside when it comes to patients' risk of death from suicide and a continued risk of heart disease.
According to a study published in the current issue of the journal Archives of Surgery, this increased risk may indicate that bariatric surgery patients may require more intense follow-up in the months and years after their procedures.
And while heart disease proved to be a major killer, most striking was the increase in suicide and accidental drug overdose after such surgeries, said Dr. Cori McBride, director of bariatric surgery at the University of Nebraska Medical Center in Omaha, who was not affiliated with the study.
"Bariatric surgery does not cure depression, and these patients need treatment for depression," she said.
Dr. Daniel Jones, director of the bariatric program at Beth Israel Deaconess Medical Center in Boston, agreed that the most startling finding is the risk of suicide after gastric bypass.
"This emphasizes the very important role of long-term follow-up, support groups and access to psychological services — which are not always covered by insurance companies," he said.
"Bariatric surgeons at accredited bariatric centers have committed to preoperative screening by multidisciplinary teams, and to long-term follow-up," he said. "Insurance carriers need to make the same commitment to health maintenance."
In this study, researchers examined records of 16,683 bariatric surgeries among Pennsylvania residents. They found a substantial number of excess deaths attributed to both suicide and heart disease after surgery.
The death rates appear higher in men than in women, and increase with age, especially among those over 65 years of age. As postsurgery time increased, so did the death rates, with heart disease topping the list.
"This study underscores that coronary heart disease is the leading cause of death in these extremely obese patients," said Dr. Anita Courcoulas, chief of minimally invasive bariatric and general surgery at the University of Pittsburgh Medical Center.