Is Weight Loss Surgery Safe? - All You Need to Know

Surgery of any kind carries risk, and weight loss surgery is no exception. Important safety takeaways include:

  • Weight loss surgery has a 99.9% survival rate
  • The long-term risks of remaining obese is much greater than the risks of weight loss surgery
  • Most reputable health/governmental organizations recommend/endorse surgery for individuals who qualify
  • Complications ranging from minor (more common) to serious (less common) are experienced by 1 in 10 patients

Read and click the sections below for everything you need to know about the risks of weight loss surgery.

Click here to find out if you qualify and which procedures are best for you.

01 Risk of Surgery Vs. Remaining Obese

Risk of Surgery Vs. Remaining Obese

Risk of dying from bariatric surgery is close to 0% (99.9% survival rate) Individuals suffering from morbid obesity are 85% more likely to die over any 5 year period than weight loss surgery patients Surgery ‘cures’ or improves diabetes, sleep apnea, hypertension, and at least 13 other conditions

Before reviewing the risks and complications of weight loss surgery, let’s consider the implications of being morbidly obese and NOT having the surgery. Factors explored in our Cause and Effect of Obesity section include the following… 

Bariatric surgery may be the best (or only) treatment for those who are morbidly obese.4 For example, following weight loss surgery…

  • Quality of life improved in 95% of patients
  • Asthma – 82% improved or resolved
  • Cardiovascular disease – 82% risk reduction
  • Depression – 55% improved or resolved
  • Dyslipidemia hypercholesterolemia – 63% resolved
  • Gastroesophageal reflux disease – 72 – 98% resolved
  • Hypertension – 52 – 92% resolved
  • Metabolic syndrome – 80% resolved
  • Migraines – 57% resolved
  • Non-alcoholic fatty liver disease – 90% improved steatosis; 37% resolution of inflammation; 20% resolution of fibrosis on repeat biopsy
  • Orthopedic problems or degenerative joint disease – 41-76% resolved
  • Polycystic ovarian syndrome – 78% resolution of hirsuitism; 100% resolution of menstrual dysfunction
  • Pseudotumor cerebri – 96% resolved
  • Sleep apnea – 74 – 98% resolved
  • Stress urinary incontinence – 44 – 88% resolved
  • Type 2 diabetes – 83% resolved
  • Venous stasis disease – 95% resolved

In addition, morbidly obese patients who received bariatric surgery were 89% less likely to die over any 5 year period than morbidly obese individuals who didn’t have the surgery.5

NOTE: Results vary greatly by procedure. See the Buchwald, et al meta analysis paper for a procedure-based and much more thorough analysis.

BARIATRIC SURGERY RELATIVE MORTALITY RATE

02 Official Statements About Safety

Official Statements About Safety

From 10 reputable national and international organizations All endorse or recommend weight loss surgery for qualifying patients

Before getting into the more specialized institutions’ take on weight loss surgery, let’s start with some direct quotes from a few reputable organizations in the United States that are broader in focus…

  • “Only bariatric surgery can provide substantial and maintained weight loss, which in turn results in improvement of obesity-related co-morbidities and quality of life.”
    Journal of the American Medical Association1
  • “We count these [study] results as a milestone in our understanding of the benefits of bariatric surgery for obesity. We are confident in the results and believe this will lead to an acceptance that bariatric surgery is a viable, life-saving option for severely obese patients.”
    Pennington Biomedical Research Center2
  • “The [quality of life] score for the obese group was much lower, suggesting a substantially lower quality of life. The researchers concluded that nearly 3 million quality years are lost in this country each year from obesity and associated conditions.”
    American Journal of Preventive Medicine3

Below are official position statement excerpts from several of the most trusted obesity and obesity-related conditions organizations in the world… (links will take you directly to published statements about bariatric treatment)…

American Diabetes Association (ADA) Official Position: Is Weight Loss Surgery Safe?

  • Bariatric surgery should be considered for adults with BMI 35 kg/m2 and type 2 diabetes, especially if the diabetes is difficult to control with lifestyle and pharmacologic therapy.
  • Patients with type 2 diabetes who have undergone bariatric surgery
    need life-long lifestyle support and medical monitoring.
  • Although small trials have shown glycemic benefit of bariatric surgery in patients with type 2 diabetes and BMI 30–35 kg/m2, there is currently insufficient evidence to generally recommend surgery in patients with BMI <35 kg/m2 outside of a research protocol.
  • The long-term benefits, cost effectiveness, and risks of bariatric surgery in individuals with type 2 diabetes should be studied in well-designed randomized controlled trials with optimal medical and lifestyle therapy as the comparator.

American Heart Association (AHA) Official Position: Is Weight Loss Surgery Safe?

Substantial long-term successes of lifestyle modifications and drug therapy have been disappointing in [the obese] population…

…When indicated, surgical intervention leads to significant improvements in decreasing excess weight and comorbidities that can be maintained over time. These include diabetes mellitus, dyslipidemia, liver disease, systemic hypertension, obstructive sleep apnea, and cardiovascular dysfunction. Recent prospective, nonrandomized, observational, or case-control population studies have also shown bariatric surgery to prolong survival in the severely obese.

Different types of bariatric procedures are being performed. Historically, operative mortality was between 0.1% and 2.0% with more recent data not exceeding 1%.
Early complications include pulmonary embolus (0.5%), anastomotic leaks (1.0% to 2.5%), and bleeding (1.0%). Late complications include anastomotic stricture, anastomotic ulcers, hernias, band slippage, and behavioral maladaptation.

The number of bariatric operations being performed is increasing tremendously as a result of increasing medical need and the evolution of safer surgical techniques and guidelines. Currently, bariatric surgery should be reserved for patients who have severe obesity in whom efforts at medical therapy have failed and an acceptable operative risk is present.

Centers for Medicare and Medicaid (CMS) Official Position: Is Weight Loss Surgery Safe?

“The Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is adequate to conclude that open and laparoscopic Roux-en-Y gastric bypass (RYGBP), laparoscopic adjustable gastric banding (LAGB), [laparoscopic sleeve gastrectomy (gastric sleeve surgery – added to covered bariatric surgeries in 2012)], and open and laparoscopic biliopancreatic diversion with duodenal switch (BPD/DS), are reasonable and necessary for Medicare beneficiaries who have a body-mass index (BMI) > 35, have at least one co-morbidity related to obesity, and have been previously unsuccessful with medical treatment for obesity.”

International Diabetes Federation (IDF) Official Position: Is Weight Loss Surgery Safe?

  • In addition to behavioural and medical approaches, various types of surgery on the gastrointestinal tract, originally developed to treat morbid obesity (“bariatric surgery”), constitute powerful options to ameliorate diabetes in severely obese patients, often normalising blood glucose levels, reducing or avoiding the need for medications and providing a potentially cost-effective approach to treating the disease.
  • Bariatric surgery is an appropriate treatment for people with type 2 diabetes and obesity not achieving recommended treatment targets with medical therapies, especially when there are other major co-morbidities.
  • Surgery should be an accepted option in people who have type 2 diabetes and a BMI of 35 or more
  • Surgery should be considered as an alternative treatment option in patients with a BMI between 30 and 35 when diabetes cannot be adequately controlled by optimal medical regimen, especially in the presence of other major cardiovascular disease risk factors.
  • In Asian, and some other ethnicities of increased risk, BMI action points may be reduced by 2.5 kg/m2.
  • Strategies to prioritise access to surgery may be required to ensure that the procedures are available to those most likely to benefit.
  • Available evidence indicates that bariatric surgery for obese patients with type 2 diabetes is cost-effective.

National Heart Lung and Blood Institute (NHLBI) Official Position: Is Weight Loss Surgery Safe?

Weight-loss surgery might be an option for people who have extreme obesity (BMI of 40 or more) when other treatments have failed. Weight-loss surgery also is an option for people who have a BMI of 35 or more and life-threatening conditions, such as: Severe sleep apnea (a condition in which you have one or more pauses in breathing or shallow breaths while you sleep) Obesity-related cardiomyopathy (KAR-de-o-mi-OP-ah-thee; diseases of the heart muscle) Severe type 2 diabetes

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Official Position: Is Weight Loss Surgery Safe?

Bariatric Surgery for Adults

Currently, bariatric surgery may be an option for adults with severe obesity. Body mass index (BMI), a measure of height in relation to weight, is used to define levels of obesity. Clinically severe obesity is a BMI > 40 or a BMI > 35 with a serious health problem linked to obesity. Such health problems could be type 2 diabetes, heart disease, or severe sleep apnea (when breathing stops for short periods during sleep).

Bariatric Surgery for Youth

Rates of obesity among youth are high. Bariatric surgery is sometimes used to treat youth with extreme obesity. Although it is becoming clear that teens can lose weight after bariatric surgery, many questions still exist about the long-term effects on teens’ developing bodies and minds.

The Obesity Society Official Position: Is Weight Loss Surgery Safe?

Over the past ten years a consensus has emerged that surgery can produce substantial weight loss and may markedly improve a number of health outcomes. This consensus is supported by the findings of the National Heart, Lung and Blood Institute (NHLBI) in 1998, the AHRQ 2003 Technology Assessment, and the CMS MCAC panel in November of 2004, among others. NAASO supports these conclusions, and believes that surgery does have its place in the obesity treatment continuum.


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03 Risk of Complications

Risk of Complications

About 1 in 10 patients experience complications Complications range from minor to severe, but are rarely fatal Possible complications and side effects vary by procedure

The risk of complications both during and after surgery range from minor to severe. About 10% of bariatric surgery patients (1 in 10 people) have some sort of complication, with the most common being nausea and vomiting.

Our Bariatric Surgery Complications page will take you through the complete list and compare complications relating to each bariatric surgery procedure.

04 Help & Support

Help & Support

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05 Find a Top Weight Loss Surgeon

Find a Top Weight Loss Surgeon

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[ Last editorial review/modification of this page : 05/09/2017 ]

* Disclaimer: The information contained in this website is provided for general information purposes and your specific results may vary depending on a variety of circumstances. It is not intended as nor should be relied upon as medical advice. Rather, it is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her existing physician(s). Before you use any of the information provided in the site, you should seek the advice of a qualified medical, dietary, fitness or other appropriate professional. Read More