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Reducing mortality risk and comorbidities in obesity

Bariatric Surgery News & Research | Adelaide Bariatric Centre

31 Oct 2017 12:24 PM

The increase of obesity within the population has brought with it a rise in reduced life expectancy.

Numerous studies over the past three decades have sought to understand the correlation between obesity and mortality risk. While there is no general consensus, the results from studies in the United States have indicated that between 5% and 13% of deaths occur due to obesity.[1]

Although the exact figures vary, there is widespread consensus that obesity creates an increased risk of early mortality. A study by the National Health and Medical Research Council in 2003 found that mortality risk doubles with a BMI of 35.[2] However, the greatest mortality risk associated with obesity arises from the relationship between obesity and comorbidities.

Correlation between obesity and comorbidities

Comorbidities are additional diseases or disorders that occur at the same time as the condition in interest.

Common comorbidities associated with obesity compound the risk of early mortality. Obesity is a risk factor for heart disease, type 2 diabetes, osteoarthritis, some cancers, breathing problems and many more conditions.[3] This is often exacerbated by factors such as lifestyle, diet and the shape of a person’s body and where fat is predominantly stored.[4]

Permanent weight loss is generally the best treatment that will help obese and morbidly obese people lose weight will help to decrease the symptoms of pre-existing comorbidities whilst also reducing the risk of further conditions.

Bariatric surgery

Generally, calorie restriction and an exercise regime targeted towards weight loss can help to reduce comorbidities and lessen the risk of early mortality.

However, these can often be difficult to maintain and often are only a temporary solution for those who suffer with obesity. Surgery has been found to be the most effective treatment for motivated morbidly obese people.[5]

Bariatric surgery is an excellent option for people with a BMI of 35 and over who are looking for a safe solution that will help them improve their health and quality of life.

Many people have an initially negative perception of weight loss surgery due to misconceptions about complications associated with the procedures. While there are always risks associated with any surgery, many bariatric procedures are generally safe, with minimal complications when performed by an experienced surgeon.

There are a couple of different bariatric surgery options that are performed in Australia.

Gastric banding is the attachment of a silicone band to the top of the stomach, creating a small pouch that limits the amount of food the patient can eat and increases feelings of fullness. Gastric sleeves remove the lateral part of the stomach, leaving a narrow tube instead of a stomach sack. Gastric bypass surgery creates a small stomach pouch that is attached to the small intestine.

All these surgeries will help patients lose a significant amount of their excess weight within 2 years of the procedure. This helps lessen or eliminate some of the diseases and disorders that are associated with obesity.

Studies by the Centre for Obesity Research and Education at Monash University found that bariatric surgery had an effect on some common comorbidities associated with obesity. The bariatric surgery helped reduce, or in some cases remove, some of the symptoms of:[6]

  • Type 2 diabetes
  • Hypertension
  • Reflux oesophagitis
  • Asthma
  • Depression
  • Non-alcoholic steatohepatitis
  • Polycystic ovarian syndrome
  • Sleep apnoea

A study in 2000[7] that followed the progress of patients who underwent bariatric surgery found that over 95% of the significant comorbidities were resolved. Specifically:

  • Gastro-oesophageal reflux dis-ease – 98% eliminated
  • Type 2 diabetes – 98% eliminated
  • Sleep apnoea- 98% clinically resolved
  • Stress incontinence – 97% eliminated
  • Hypercholesterol – 97% reduced
  • Hypertension – 92% clinical remission
  • Symptomatic arthritis – 90% reduced

Those comorbidities that did persist after surgery were found to be significantly reduced in severity. All these benefits help to reduce the risk of mortality in obese people.

Adelaide Bariatric Centre

These benefits can be life changing for those who are suffering from obesity and any of the common comorbidities. However the treatment needs to be supplemented with a holistic approach that will support patients before and after surgery, to help them adjust. 

Adelaide Bariatric Centre believes the best way to achieve significant and sustained weight loss coupled with an increased quality of life, is to combine bariatric surgery with a complete support program. Their multidisciplinary focus includes patient access to dietitians, exercise physiologists, and bariatric nurses who will help patients adjust to life post-surgery and get the best results possible.

[1] Zheng, H., Tumin, D. and Qian, Z. (2013). Obesity and Mortality Risk: New Findings From Body Mass Index Trajectories. American Journal of Epidemiology, 178(11), pp.1591-1599.

[2] National Health and Medical Research Council (NHMRC). (2003). Clinical practice guidelines for the management of overweight and obesity in adults. [online] Available at: The Department of Health [Accessed 26 Jun. 2017].

[3] Schelbert, K. (2009). Comorbidities of Obesity. Primary Care: Clinics in Office Practice, 36(2), pp.271-285.

[4] Wilkinson, L. (2013). A Second Look at the Link Between Obesity and Mortality | THCB. [online] Available at: The Health Care Blog [Accessed 26 Jun. 2017]. 

[5] National Health and Medical Research Council (NHMRC). (2003). Clinical practice guidelines for the management of overweight and obesity in adults. [online] Available at: The Department of Health [Accessed 26 Jun. 2017].

[6] Brien, P., Brown, W. and Dixon, J. (2006). Management of obesity: the role of surgery. Australian Family Physician, 35(8), pp.584-586. Availability: Adelaide Uni [cited 26 Jun 17]

[7] Wittgrove, A. and Clark, G. (2000). Laparoscopic Gastric Bypass, Roux en-Y - 500 Patients: Technique and Results, with 3-60 month follow-up. Obesity Surgery, 10(3), pp.233-239.