Bariatric surgery improves life expectancy for many obese patients with diabetes, but it may cut life expectancy for patients who are super obese with very high body mass indexes, according to a study published recently in the Annals of Surgery. "For most patients with diabetes and a BMI greater than 35, bariatric surgery increases life expectancy,” says Daniel Schauer, MD, Assistant Professor in the Division of General Internal Medicine at University of Cincinnati. "However, the benefit of surgery decreases as BMI increases. The patients with a BMI over 62 likely don’t gain any life expectancy with surgery.” Daniel Schauer and colleagues evaluated data on approximately 200,000 patients to compare life expectancy for patients with severe obesity and diabetes who underwent bariatric surgery with patients who did not undergo surgery.

In the main analyses of the study, researchers found that a 45-year-old woman with diabetes and a body mass index of 45 kg/m2 gained an additional 6.7 years of life expectancy with bariatric surgery (38.4 years with surgery versus 31.7 years without). However, the gain in life expectancy decreased once BMI hit 62 kg/m2 with bariatric surgery. Similar results were seen for both men and women in all age groups. The study did not look at differences associated with race. Super obese patients may have had diabetes for a longer duration and are more likely to have complications after surgery resulting in adverse health outcomes, explains Schauer.

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