Typically body mass index or BMI is used as the determinant for eligibility in terms of bariatric surgery. However, a new study found that other factors including diabetes status and age are better predictors related to the 10-year mortality rate for obese and morbidly obese people. The study was published in the Journal of the American Medical Association magazine in October 2013.*
The study evaluated 15,394 obese patients within the UK General Practice Research Database. Patients were 18 to 65 with BMIs of over 35 kg. They also included patients with a BMI of 30 to 34.9 kg who had a disease related to obesity including heart failure, Type II Diabetes, heart disease or sleep apnea.
The researchers of the study created a rule for 10-year mortality that included sex, smoking, age and diabetes status. They found that all of these elements were primary predicts of mortality in terms of obese patients. They hoped to show how BMI is not the only or a reliable predictor in terms of remission after several surgery types including Roux-en-y gastric bypass surgery.
This study challenges medical professionals to develop a more calculated plan in determining if patients qualify for bariatric surgery. Their overall health and 10-year mortality risk should be major factors in this decision. The researchers challenge the conventional thought of using BMI as the major or only indicator if a patient is eligible for surgery. It dives deeper to make professionals think in terms of the bigger picture and the future health and life expectancy of each patient.
Many experts believe that BMI doesn’t always reflect why a person is obese. Some believe the overall average BMI used in this study is low and could skew data. However, the overall consensus is that the protocol for determining whether a patient should or shouldn’t have bariatric surgery needs to evolve. The study found that 2.1% of patients studied ended in a fatality. Some experts believe this number is high; however, the number shows a dangerous trend for those in that particular BMI bracket.
Ultimately, this study demonstrates that there are other factors other than the general body mass index that will predict the risk of death in patients who undergo weight loss surgery. This can occur from various medical conditions or diseases they may have, their age, their gender or if they have or do smoke. The factors questioned regarding eligibility will be determined by the surgeon, doctor or medical facility themselves.
*https://www.ama-assn.org/ama Oct 2013