Longevity (Lifespan) after gastric bypass - some expert opinions and studies
When asking about how long you live after WLS, the common answer for the lack of either long term patients or studies showing longevity is that the older procedures are not done any more and the newer procedures are too new for that type of evidence. Any surgeon that I have asked, does not know any patients over 10 years post op.
Many surgeons answer the longevity question as Dr Alan Wittgrove of the Alvarado Clinic did in the online interviews at the time of Carnie Wilson's gastric bypass:
The bottom line is no one seems to know. It's likely true that some longer term patients have merged with the general population and do not identify themselves as patients. To what extent this is true is again, unknown.
The survival rate for the Billroth II, a surgery which is similar to the gastric bypass (but leaves more of the stomach so may be less risky), was an average of 20-25 years. I have seen Billroth II patients live 40 years after surgery but not without serious health issues.
It is thought that some surgeons are keeping track of patients on a longer term basis. But to date, little to no longevity data has been released on the gastric bypass surgery despite the fact that it's been done for 40 years.
Dr Paul Ernsberger, Associate Professor of Nutrition at Case Western Medical School, stated, on a Donahue show:
The ASMBS will tell you that the immediate death rate from bariatric surgery is 1 individual for every 1000 surgeries. This seems be different depending on which surgeon you talk to. For example, Pories in Sabiston's Manual On Surgery, medical school text book, stated the death rate as 1 in 100, a percentage which other surgeons have agreed with. Dr Flancbaum feels the death rate is about 1 in 200 surgeries.
The difference between the ASMBS figures and those found in the David Flum study, may be that many gastric bypass deaths are not attributed to gastric bypass but rather to other reasons.
In the Fresno Bee investigation (Fresno, CA, 2001), it was discovered that 27 deaths directly linkable to gastric bypass surgery in the last three months of 2001, were recorded as deaths from other causes.
But even at the optimistic, 1 death in 1000 surgeries, gastric bypass surgery is much more risky than other types of surgeries like a hysterectomy. One reason often given to prospective patients for the higher risks is that bariatric surgery, in general is done on a higher risk population (obese people). While there is some truth in this, note in the comparison below that the adjustable lap band surgery, done on the same population as the gastric bypass surgery, has a MUCH lower death rate:
Table death rates (death after surgery or within 3 days of surgery):
Hysterectomy: 1 death in 100,000
Adjustable Lap Band: 1 - 3 deaths in 7000
Liposuction : 1 death in 5000
gastric bypass: 1 death in 50 (Dr David Flum study of 62,000 gastric bypass patients ).
What about long term complications possibly leading to death?
The Mayo Clinic study in 2000 on gastric bypass reported that 20-25 percent of the patients had developed life threatening complications within five years. Those are similar odds to the medication, Phen-Fen which was considered risky enough to take off the market.
But the rate of life threatening complications may be even higher:
Edward Mason, inventor of the gastric bypass wrote this in an article in 1999:
Dr Terry Simpson commented about the RNY (gastric bypass):
The Dartmouth-Hitchcock study ran a statistical analysis and concluded that gastric bypass patients who kept their weight off might live 3 years longer than obese people. However about this study, Dr Pope warned:
Several people who are very large (called "supersized") have stated that they have outlived both the doctor's dour predictions about their lifespan as supersized and also have outlived many of their similarly sized friends who had WLS.
The AMA does offers no guarantees for weight loss surgery:
From the information we have at present, it appears that a decision to have weight loss surgery may not be a decision involving longevity but rather a quality of life decision.