By Anthony M. Sola, Esq. and Emma B. Glazer, Esq.
Patients who come in seeking bariatric surgery often present with a multitude of health problems in addition to obesity. These patients typically have complicating disease processes, such as hypertension, obstructive sleep apnea and diabetes. Of course, the most obvious benefit of bariatric surgery is weight loss. While weight loss is the short-term goal, studies have shown that long term, patients who successfully undergo bariatric surgery and embrace lifestyle changes such as diet and exercise to maintain weight loss also experienced general improvements in their other health conditions and quality of life.
Acknowledging Risks
When consenting patients for surgery, it is imperative to advise them of the potential risks of surgery, including thromboembolic events, infection, bleeding, adverse nutritional consequences, anastomotic leaks, an unsuccessful surgical outcome, and even death. Physicians must also present patients with the option not to have surgery. While bariatric surgery may be “elective,” it can also be the last option for patients who have struggled with obesity for many years and were unable to lose weight with diet and exercise. For these patients, it certainly may not feel elective. They may be referred for surgical consultation as a “last resort” option to lose weight to improve their overall health. Perhaps they need an organ transplant and their BMI makes them ineligible. Whatever the reason the patient presents to your office for consultation, all surgeons must be mindful of the critical importance of advising their patients of the risks and alternatives to surgery.
True Quality of Life Benefits
However, the focus on the potential complications may overshadow the real benefits that bariatric surgical patients may sustain if surgery is successful. A recent study published in JAMA found that patients who underwent bariatric surgery and who had an aggressive form of fatty liver disease saw a nearly 90% reduced risk of developing advanced liver disease or liver cancer in comparison with patients who did not have surgery. Another recent study from the Cleveland Clinic has indicated that bariatric surgery can improve the overall health of patients with diabetes and potentially even “reverse” the course of the disease. Specifically, patients who underwent bariatric surgery and previously had been insulin dependent were able to achieve insulin independence. Research shows patients also experience improvement in orthopedic problems.
Patients who successfully have bariatric surgery and lose weight and keep it off will have increased energy, may see improvements in blood pressure, stamina and breathing abilities, and reduce the risk of further obesity-caused conditions that may decrease their life expectancy. This translates to more fulfilling and active lives that these patients can experience for many more years in the future. All of this is to say that bariatric surgery has true quality of life impacts beyond the short-term goal of weight loss. While there are serious potential risks and complications of bariatric surgery, these improvements in physical health, quality of life and associated mental health should not be lost during consent conversations with potential surgical patients.
Partners Anthony M. Sola and Emma B. Glazer are attorneys at Martin Clearwater & Bell LLP, where they focus their practice on the defense of medical malpractice matters. For more information, visit mcblaw.com.
Source: MD News January 2022, Long Island Edition