Parachute in Switzerland

A Parachute for Obesity in the Midst of a Pandemic

Just how important is bariatric surgery for someone living with obesity in the midst of a pandemic? We’re getting all kinds of advice about how to best take care of ourselves in this stressful time. Barely a day passes without another study confirming the reasons for concern. Obesity raises the risk for hospitalization and death if a person has COVID-19. A very preliminary publication of data about bariatric surgery and COVID-19 outcomes prompts us to think hard about bariatric surgery in the pandemic.

Preprint: COVID-19 Outcomes with a History of Bariatric Surgery

Antonio Iannelli and colleagues examined electronic medical records for more than four million French patients. This cohort included any patient hospitalized from 2010 through 2019 for severe obesity. Then, within the cohort, they identified patients with a history of bariatric surgery. Finally, they identified hospital admissions for COVID-19 in 2020 through May 15.

In the end, they had a total of 8,226 patients with a history of severe obesity and a hospital admission for COVID-19. Of that total, 541 had a history of bariatric surgery in the last decade. In a logistic regression model, they found that patients with a history of bariatric surgery were about a third less likely to become intubated. They were about half as likely to die.

Caution Required

Note that this paper is pre-publication. That means it has not passed the test of peer review. Professor Francesco Rubino tells us that people should view these results “with ultra caution.” He tells us:

Although it is plausible that bariatric surgery may be protective I am not sure the study is sufficient to prove it.

In fact, to provide definitive evidence that bariatric surgery can improve the odds of surviving COVID-19 would be quite challenging indeed. Rubino says it would be difficult to find a meaningful cohort of patients with bariatric surgery exposed to the virus to see how often infection causes severe illness among them. Maybe not impossible, but possibly not feasible.

What We Already Know

At this point, however, we must recount what we already know. Even without the added threat of COVID, we know bariatric surgery can improve and extend a person’s life. We know that it can put type-2 diabetes into remission. In fact, it provides that result more often than the best available medical options for treating that disease. Finally, we know bariatric surgery is the most effective option for reducing the health impact of obesity.

If diabetes and obesity increase the odds of a bad outcome with COVID-19, it’s reasonable to think that outcomes might be better when those diseases are well-controlled. For some people living with obesity, especially in the midst of this pandemic, bariatric surgery can be like a parachute. We know that it works.

Click here for the study by Iannelli et al. For more on the value of bariatric surgery in obesity and diabetes, click here and here.

Parachute in Switzerland, photograph © Dennis Jarvis / flickr

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August 4, 2020

One Response to “A Parachute for Obesity in the Midst of a Pandemic”

  1. August 04, 2020 at 7:18 am, Cathy Arsenault said:

    We have to find a way to work together. Obesity is a reality just as COVID 19 is and they are both pandemics. To turn a blind eye on Obesity intervention is ignorance of well defined scientific evidence. Let’s begin to change the landscape and look at the scientific data.

    Let’s remember that we are people, asking for help.