17 March 2011

AHA "Sets the Record Straight" on Bariatric Surgery

The American Heart Association (AHA) on March 14, 2001 published a statement declaring that the AHA only supports bariatric surgery for the severely obese patients who have exhausted all other options to lose weight to lessen their cardiovascular risk.

This I am happy to see as after yesterdays announcement by the International Association for the Study of Obesity in London, United Kingdom suggests bariatric surgery for the pediatric population. While the statement was issued with the appropriate cautions, I was beginning to wonder where the bariatric surgeons were going to stop in their quest for additional patients to increase their cash flow.

At least now there is a voice of reason for not having this extreme surgery. The obesity committee of the AHA Council on Nutrition, Physical Activity, and Metabolism summarizes the most current data on bariatric surgery. "Medical experience acquired up to now supports the efficiency and safety of surgery for weight loss in severely obese patients on the basis of metabolic profile, cardiac structure and function, and related disorders," including diabetes, dyslipidemia, liver disease, systematic hypertension, and sleep apnea. However, the surgery has historically carried an operative mortality risk between 0.1% and 2.0%, and complications include pulmonary embolus, anastomotic leaks, bleeding, anastomotic stricture, anastomotic ulcers, hernias, band slippage, and behavioral maladaptation.

A lot of medical terms are part of the statement, but looking them up was a good lesson in the types of problems encountered and left out of many discussions because people (bariatric surgeons and advocates) intentionally do not want to scare people away.

The definition for anastomotic is derived from anastomosis which means in anatomy, communication between blood vessels by means of collateral channels, especially when usual routes are obstructed. Another meaning is Surgery, Pathology, a joining of or opening between two organs or spaces that normally are not connected. Hope this helps in your understanding.

With this from the AHA, hopefully other medical organizations will add their voice to the discussion against bariatric surgery except for extreme cases. It is time that some science has been added to the discussion and that we can rely on something beside emotion and desire to add to retirement accounts. Hopefully the FDA is listening, but don't count on them soon.

Read the article by the AHA here and the British article here.

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