Mortality Benefit in Surgery for Super Obesity?

A new analysis of cross-sectional data for bariatric surgery patients provides a case study in the hazards of punchy headlines for complex medical issues. Daniel Schauer and colleagues constructed a model for survival benefits from bariatric surgery. Their model raises the possibility that bariatric surgery for super obesity (BMI>60 in this case) might not help people live longer. They concede that the data for this segment of patients is very thin.

In the more robust part of their model, they found that “for most severely obese patients with diabetes, bariatric surgery seems to improve life expectancy.”

None of these nuances matter to headline writers. Here’s a sampling of the bottom line they presented:

Bariatric Surgery Doesn’t Extend Life for Super Obese
Super Obese Won’t Get Longer Life from Bariatric Sugery
Bariatric Surgery May Not Be Worth the Risk for Diabetics

One doesn’t have to look very far in the study to figure out how misleading these headlines are. The authors themselves point out that “at BMIs over 50 kg/m², the confidence intervals include zero.” That’s statistical talk for describing findings that aren’t significant.

For a more complete perspective, we went to John Morton, a professor of surgery at the Stanford School of Medicine and President of the American Society for Metabolic and Bariatric Surgery. He said:

The study is based on multiple hypotheticals — there is a large body of evidence supporting that bariatric surgery increases life expectancy including one published by the same authors in JAMA.

I think that what this analysis demonstrates is that BMI>60 patients have increased risk and should be referred earlier prior to worsening outcomes

The lesson here is: don’t get your health information from headlines.

Click here to read coverage of this study in USA Today. Click here to read the current study and here to read the earlier study by some of the same authors.

Vanitas, still life by Pieter Claeszoon from Wikimedia Commons

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