November 20, 2015

Bariatric Surgery Often Leads to Suicide

Surprise, this information has made many medical papers and they all refer to this Los Angeles Times article. This is another case of bariatric surgeons not giving their patients all the information they need to make informed decisions. They are so interested in the money they make that many push patients to make bad decisions. Vital information is not given to the patient and good questions patients do ask are often brushed aside.

Now I can't put all the blame on the surgeons although they shoulder most of it for not recognizing this group. I am referring to those that are so determined to lose weight that even good sense goes out the window and they often lie to the surgeons to make sure they get the surgery. They are often so vain that they will do anything to rid themselves of a few pounds. Most may have type 2 diabetes, but a few do not.

According to the study, in the three years after they go under the knife, patients who have bariatric surgery to aid in weight loss are more likely than they were before the operation to attempt suicide or end up in the hospital after doing harm to themselves.

A Canadian study that tracked 8,815 bariatric surgery patients found that in their three post-surgical years, 1.3% of those patients landed in the hospital following a self-harm emergency, which included intentional drug overdoses or suicide attempts by other means. However, that rate of self-injurious behavior represented a 54% increase over that seen in the same patient population during the three years before these patients had surgery.

Among those most likely to experience self-harm events following surgery were low-income patients and those living in rural areas. The research highlights a little-recognized challenge patients face in the wake of surgery that replumbs the stomach but also drives far-reaching changes beyond the digestive system.

The authors of the current study suggest that changes in patients' ability to metabolize alcohol in the wake of bariatric surgery might be implicated in some patients' worsening mental health. Certain bariatric surgery procedures that bypass parts of the stomach, patients who drink alcohol often find their tolerance low and become inebriated quickly. Such changes, wrote the study's authors, may affect some patients' risk-taking behavior and ability to suppress self-destructive impulses while under the influence.

Following surgery that limits stomach capacity, in the current study, 68% of the 168 self-harm emergencies noted were attributed primarily to medication overdoses. The study's authors also urged further research into the possibility that altered brain chemistry wrought by the surgical replumbing of the digestive tract might contribute to depression or suicidal behavior.

Most surgeons don't think of this and most ignore questions about this. The research also underscores the need for bariatric surgery practices, a specialty seeing rapid growth, to tend to the mental health of their obese patients not just before surgery, but for several years beyond. Most of the bariatric patients' psychological crises occurred in the second and third years after surgery, a period when there's little interaction between patients and the practices that provided their bariatric services.

The surgeons in the United States were of the opinion that they screened their patients more carefully and had contact with their surgery patients longer than the study indicated. It could be interesting to have a study done on patients in the United States to see if the surgeons really know what they are talking about and actually do what they say.

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