Alabama Bariatrics & Minimally Invasive Surgery

Bariatric Diet Orbera Gastric Band Sleeve Gastrectomy Gastric Bypass

W. Jay Suggs, MD, FACS, FASMBS
Huntsville & Decatur
Phone: (256) 274-4523
Fax: (256) 203-8791

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Contact Us

W. Jay Suggs, MD, FACS, FASMBS
Huntsville & Decatur
Phone: (256) 274-4523
Fax: (256) 203-8791
EMail: drsuggs@alabariatrics.com

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Drug and Alcohol-Related Death After Surgical Weight Loss: Why We Shouldn't Panic

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A disturbing finding has made their way into the latest bariatric studies. A finding which, for the most part, can alarm the general public. Weight loss surgical procedures already suffer from various forms of stigma. Some patients are told that it is the "easy way out". Other patients are not given the proper psychological counseling or medication and wind up going through a depression that is enough to cause suicidal thoughts. There are even people in the world that assume that weight loss surgery is a cosmetic procedure that appeals to personal vanity.

So, I think it is prudent to figure out what the study specifically says. Especially to portray the information as accurately as possible. While we do have a vested interest in performing surgical weight loss, it is important that the patient's health and safety come first. It is the entire reason behind the Hippocratic oath that doctors take. So, let's look into it.

The Study

The scientific finding was recently published online in the journal Surgery for Obesity and Related Diseases. The authors of the first published paper were the scientists that were part of the study.  The source itself is easy to find in a citation, which is a good sign that the paper is more reliable than not. 

Aside: Scientific Journals are part of what universities would tell you is a primary source for information. This means that it is a first-hand account was written by a person witnessing an event. They write down their findings. Other scientists will go over their work to see if all of the results can be replicated. If the data can be replicated from the study, then it is more on the side of fact than fiction.

Wendy King, Ph.D., associate professor of epidemiology, University of Pittsburgh; John Morton, M.D., vice chair for quality, department of surgery, and division chief of bariatric and minimally invasive surgery, Yale School of Medicine, New Haven, Conn.; June 7, 2019. The study itself included 2500 people who specifically had a Roux-En Y procedure. According to that specific data pool, that included six accidental drug overdoses; one intentional drug overdose; one overdose where the intent was unknown; and two from alcoholic liver disease. 

What does this data mean?

Point 1: It Only Happens for Roux En Y Procedures

The reason that the deaths happened at all was that this specific procedure removed 95% of the stomach. It has been recently discovered within the last few years that our stomach has an ecosystem of bacteria, and when it is all removed, bad things happen. We need bacteria in our gut because it metabolizes things like food, drugs, and alcohol. Roux En Y is the only procedure that removes that much of the stomach. 

Even the closest counterpart to it, the gastric sleeve, leaves more of the stomach intact and might have a lower mortality rate because of it.  But the data is not recorded yet, so that is up in the air.

Point 2: Roux En Y Procedures are Falling out of Style

There are different types of surgical weight loss procedures that make up the market place. In the current weight loss surgery market, Roux En Y makes up 47% of the bariatric procedures that are done.  While it is true that it is the most popular procedure today, it might not be the case for long. Procedures rise and fall out of popularity because of newfound information or the introduction of a new procedure. In fact, this has already happened before with the now retired Roux en X procedure and jejunoileal bypass once Roux en Y became available. 

Once more of the other options like the Duodenal Switch, Ballooning, and Gastric Banding is perfected, there is a good chance that Roux en Y will suffer the same fate as its predecessor.

Point 3: The Statistic is Important But Lower than Obesity Mortality Rate

The idea of anyone dying after a surgical procedure is horrible. It will always be horrible. Still, this happened to a small number of people.  If you do the math, 1o people out of 2500 makes .4% of the group who had this problem. That is still remarkably low. Especially, when you compare it to the statistics of preventable deaths from obesity-related cardiovascular diseases. At 31.8 %, you are way more likely to die from being obese. You are even more likely to die from homicide at .7%, which is a rarity.  So, while this is a tragedy, it is not so large that it cannot be fixable.

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Conclusion

While the study is credible, and the facts are correct in these articles covering it, there is the same level of headline sensationalism that is in most news outlets. Weight loss surgical procedures are not without their controversy, and if something can get people to read and buy subscriptions, they will post it without regard for how the public would take the headline.  So, take a deep breath, go and if you think you might have an addiction problem, talk to a doctor about it.