Additional analyses revealed that younger women with higher BMIs are projected to gain the most life expectancy from surgery. Younger men with higher BMIs might also gain more life expectancy after surgery, but the gain would be less for men than for women in each subgroup. "Younger patients have lower surgical risk and more time over which to realize the benefits of surgery," the authors write. "For older patients, the gain is smaller, and for some, gastric bypass surgery will decrease life expectancy."

"The decision analysis presented here is a step forward in understanding optimal patient selection but also highlights some of the areas for which better data are needed," they continue. For instance, the risk-benefit balance changes based on how effective bariatric surgery is likely to be. More information is needed about how individual patient characteristics-for example, having diabetes-affect the efficacy of the procedure.

"In conclusion, while not all patients are guaranteed a good outcome, our model indicates that gastric bypass increases life expectancy for most patient subgroups; however, for those at high surgical risk or in whom efficacy of surgery is likely to be low, benefit will be minimal," the authors write. "We believe results of this analysis can be used to better inform both patients' and physicians' decisions regarding gastric bypass surgery."

Source: JAMA and Archives Journals