Weight Loss Surgery Saves Lives? (But we're more likely to commit suicide.) Studies published tomorrow in NEJM.

We live longer, because we don't die from fat-related diseases, such as diabetes, cancer and heart disease.  We are more likely to die of non-disease related issues now, such as accidents and suicide.

Just as a devil's advocate over here: 

• I won't die of diabetes now (which I never had as a morbidly obese person) but, I might have a blood sugar low and crash my car and DIE due to the WLS.
• I wont have a heart attack due to my morbid obesity anymore, but my heart might stop beating if I get too anemic due to the WLS.

I see it as damned if you or don't.

From NEJM:

Background
Although gastric bypass surgery accounts for 80% of bariatric surgery in the United States, only limited long-term data are available on mortality among patients who have undergone this procedure as compared with severely obese persons from a general population. 

Conclusions
Long-term total mortality after gastric bypass surgery was significantly reduced, particularly deaths from diabetes, heart disease, and cancer. However, the rate of death from causes other than disease was higher in the surgery group than in the control group.

From WedMD:

Weight loss surgery is known to help severely obese people shed pounds and lower their risk of diabetes, heart disease, and other obesity-related diseases. Now two landmark studies show that the surgery also saves lives.

In one study, deaths decreased by more than 90% from diabetes and 50% from heart disease in severely obese people who had weight loss surgery compared with those who did not.    

In separate research, weight loss surgery was associated with a 29% reduction in deaths over an average follow-up of 10 years, compared to those who did not have weight loss surgery.  Both studies are published in the Aug. 23 issue of The New England Journal of Medicine.    

Longtime obesity researcher George Bray, MD, of Louisiana State University, tells WebMD that the new research provides the important "missing link" showing that weight loss surgery reduces mortality.

Weight loss surgery, says Bray, "is associated with a dramatic reduction in diabetes and other diseases associated with obesity, so it stands to reason that it would positively impact survival. But there has been some question about this, and a few studies have even suggested the opposite."    

Weight Loss Surgery vs. No Surgery

In the larger of the two studies, roughly 8,000 gastric bypass patients and 8,000 people who did not have weight loss surgery matched for sex, age, and weight were followed for an average of seven years.    

University of Utah School of Medicine researchers reported a 40% overall reduction in deaths among the surgery patients compared to the patients who did not have weight loss surgery. 

Surgery patients' deaths decreased by 92% from diabetes, 56% from cardiovascular disease, and 60% from cancer.

Researcher Ted D. Adams, PhD, MPH, tells WebMD that the difference in cancer mortality was very surprising.

"We did not anticipate such a large reduction in cancer deaths in such a short time, and we aren't really sure what to make of it," he says, adding that his research team is currently exploring the issue.

Death Rates From Causes Other Than Disease    

There was yet another surprise in the findings. While surgery patients had a lower death rate from diabetes, cancer, and other diseases than nonsurgery patients, death rates from causes other than disease, such as accidents and suicide, were greater.

Patients who had weight loss surgery had death rates from nondisease causes that were 58% greater than people who did not have surgery.    

The study offered few clues about the reason for this. But several previous studies have suggested a link between weight loss surgery and an increase in drug and alcohol abuse and other risk-taking behaviors.  Adams says the findings highlight the need for better ways to identify psychological "red flags" in patients who are considering weight loss surgery and for assessing mental status after surgery.