Medically Reviewed by:John Rabkin, MD, FACSBoard Certified Bariatric Surgeon
Yes, weight loss surgery is safe.
It has almost a 100% survival rate, and the most reputable health and governmental organizations in the country endorse it for those who qualify.
Further, the long-term risks of remaining morbidly obese is much greater than the risk of weight loss surgery. For example, people suffering from morbid obesity are 85% more likely to die over any 5 year period than weight loss surgery patients.
However, as many as 1 in 10 patients does experience non-life-threatening complications.
Read the sections below for everything you need to know about the risks of weight loss surgery.
TABLE OF CONTENTS
Click on any of the topics below to jump directly to that section
- Risk of Surgery Vs. Obesity
- Official Statements
- Risk of Complications
- Patient Community & Expert Advice
- Find a Weight Loss Surgeon
- The 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…
- Obesity discrimination
- Quality of life – According to a study by the Mercer University School of Medicine, individuals who were obese had a significantly lower health-related quality of life than those of normal weight.
- Obesity health problems ranging from minor to severe
Bariatric surgery may be the best (or only) treatment for those who are morbidly obese (1). 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 (2).
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
The risk of dying from bariatric treatment does exist, but advances in medicine have made its safety equal to that of any other routine surgical procedure. Here’s a comparison of bariatric surgery to heart surgery and common causes of death in the U.S…
|Cause||Mortality (Death) Rate||Clarification/Timeframe|
|Major Heart Surgery||1 out of every 40 (2.5%)||from the surgery|
|Car Accident||1 out of every 261 (0.3%)||in their life|
|Bariatric Surgery||1 out of every 743 (0.135%)||from the surgery|
|Falling on/from stairs||1 out of every 2,255 (0.044%)||in their life|
|Airplane Accident||1 out of every 6,460 (0.016%)||from the surgery|
See our Bariatric Surgery Risks page for additional details about mortality risks.
- Read statements from 10 reputable national and international organizations below - 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 Association (3).
- “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 Center (4).
- “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 Medicine (5).
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.
- 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.
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- You can attend a free in-person seminar or an online webinar offered by a local weight loss surgeon
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