Even “safe” weight control surgery could be dangerous.[@@]

A research team led by Dr. P. James Dyck, a neurologist at the Mayo Clinic, Rochester, Minn., is about to publish a paper about a finding that 16% patients who got their stomachs stapled end up with nerve damage, according to the Mayo Clinic.

The patients developed “peripheral neuropathy,” or damage to the nerves outside of the brain and spinal cord. Symptoms ranged from numbness in the feet to pain serious enough to confine patients to wheelchairs.

Stomach stapling patients may suffer nerve damage because they eat so little food that they become malnourished, the Dyck team suggests.

Patients who participated in nutritional programs after undergoing bariatric surgery were less likely to develop nerve damage, and Dyck and other Mayo Clinic doctors concede that, for some patients, the benefits of overcoming morbid obesity may outweigh the risks associated with undergoing bariatric surgery.

“I’m not saying that people shouldn’t have this surgery,” Dyck says in a statement about the study findings. “But I am saying that there are real potential complications and that good follow-up care is necessary.”

The Dyck team findings could help health insurers that are skeptical about “bariatric surgery” defend themselves against demands for bariatric surgery benefits. Many insurance company medical directors and independent doctors say they want to know more about the long-term effects of weight control surgery before encouraging patients to have stomach surgery.

But surgeons who perform the weight control surgery and some doctors who treat morbidly patients have argued that health insurers should cover bariatric surgery for many morbidly obese patients. Although a typical stomach stapling costs about $25,000, it can improve the quality of a patient’s life and sometimes extend the patient’s life by many years, advocates say.

Doctors classify a patient as morbidly obese when the patient is at least 100 pounds overweight or has a body mass index of at least 40.

A team led by Dr. Henry Buchwald, a medical researcher at the University of Minnesota, recently published a study in the Journal of the American Medical Association that concluded that weight control surgery can help patients control diabetes, high blood pressure and other obesity-related conditions.

The Buchwald study found that 1 in 1,000 patients who had their stomachs stapled died from the procedure and that 1 in 200 patients who had a more complicated form of stomach surgery died. But, after 5 years, the patients who had the more complicated surgery were 89% less likely to die than morbidly obese patients who did not have the surgery, the Buchwald team reported.