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Modeling the impact of adjustable gastric banding on survival in patients with morbid obesity
journal contribution
posted on 2023-05-17, 09:29 authored by Sendi, P, Andrew PalmerAndrew Palmer, Hauri, P, Craig, BA, Horber, FFObjective: Morbid obesity is associated with premature death. Adjustable gastric banding may lead to substantial weight loss in patients with morbid obesity. Little is known about the impact of weight loss on survival after adjustable gastric banding. We therefore developed a mathematical model to estimate life expectancy in patients with a body mass index (BMI) > 40 kg/m 2 undergoing bariatric surgery. Research Methods and Procedures: We developed a non-homogeneous Markov chain consisting of five states: the absorbing state ("dead") and the four recurrent states BMI > 40 kg/m 2 , BMI 36 to 39 kg/m 2 , BMI 32 to 35 kg/m 2 , and BMI 25 to 31 kg/m 2 . Scenarios of weight loss and age- and sex-dependent risk of death, as well as BMI-dependent excess mortality were extracted from life tables and published literature. All patients entered the model through the state of BMI > 40 kg/m2. Results: In men aged either 18 or 65 years at the time of surgery, who moved from the state BMI > 40 kg/m 2 to the next lower state of BMI 36 to 39 kg/m 2 , life expectancy increased by 3 and 0.7 years, respectively. In women aged either 18 or 65 years at the time of surgery, who moved from the state BMI > 40 kg/m 2 to the next lower state BMI 36 to 39 kg/m 2 , life expectancy increased by 4.5 and 2.6 years, respectively. Weight loss to lower BMI strata resulted in further gains of life expectancy in both men and women. Discussion: Within the limitations of the modeling study, adjustable gastric banding in patients with morbid obesity may substantially increase life expectancy.
History
Publication title
Obesity ResearchVolume
10Issue
4Pagination
291-295ISSN
1071-7323Department/School
Menzies Institute for Medical ResearchPublisher
North Amer Assoc Study ObesityPlace of publication
8630 Fenton St, Suite 918, Silver Spring, USA, Md, 20910Repository Status
- Restricted