Each study considered between 1,000 and 8,000 morbidly obese patients who sought various forms of bariatric surgery, including laparoscopic gastric banding (LapBand®), sleeve gastrectomy, Roux-en-Y gastric bypass and duodenal switch, in an effort to achieve an effective weight loss of more than 25%. Data released by the four groups showed that bariatric surgery reduced the mortality rates of patients anywhere from 31.6% (Sweden) to 62% (Italy).

The United States’ collaborative research project conducted in Utah determined that of the 8,172 people who participated in the study, the gastric bypass patient had a 40% reduction in mortality and, more importantly, a significant decrease in death related to coronary artery disease, diabetes and cancer. Australia showed the most promising results to date, with a 73% average reduction in mortality rates due to LapBand® surgery.

Asked for his reaction to the results, Dr. Paul T. Cirangle, surgeon at the Hawaii Weight Loss Center and Laparoscopic Associates of San Francisco, stated, "Hard evidence is what the medical community needs to demonstrate that bariatric surgery is far more effective than dietary and exercise programs in changing the lives of severely obese patients."

"The initial results of these four studies demonstrate that bariatric surgery is not only a powerful tool but a procedure that should be offered to appropriate patients sooner in an attempt to reduce the toll that obesity has on society," continued Cirangle. "The only way to save more lives is to educate ourselves, primary care providers and the public."

As a result of these initial studies, the International Congress on Obesity will meet again at the end of 2007 to discuss further research opportunities that will aim to make more specific discoveries about bariatric surgery and its ability to reduce the onset of obesity-related mortality.

Dr. Mathias A.L. Fobi also implanted 185 patients with an experimental device before receiving approval to do so from either the Food and Drug Administration or the institutional review board overseeing the study, amid other violations of federal regulations, according to the Jan. 24 letter. The FDA posted a largely blacked-out copy of the letter to its Web site on Tuesday.

The copy did not make clear if the same device was used in all the patients.

Fobi, of the Center for Surgical Treatment of Obesity in Hawaiian Gardens, Calif., invented the Fobi pouch. This type of gastric bypass surgically reduces the size of the stomach to a one- or two-tablespoon pocket, vastly restricting the amount patients can eat. It’s been credited with helping obese patients shed hundreds of pounds.

It wasn’t clear from the redacted letter what sort of medical device or devices Fobi was studying. However, the Fobi pouch surgery includes the placing of a band around the stomach pouch’s opening to limit stretching over time that can allow patients to eat more.

Fobi was performing an operation late Tuesday and wasn’t available for comment. The FDA gave him 15 working days to reply to the warning letter.

The FDA inspected Fobi’s clinic Sept. 19-29, according to the five-page letter signed by Timothy Ulatowski, director of compliance for the agency’s devices division.

Nowhere along the line did a doctor or an insurance company question whether she had the "intelligence" necessary to make the decision about having the surgery to help her lose weight and reclaim her health.

Now, BlueCross BlueShield of Tennessee is requiring patients prove just that.

In April 2006, the company introduced a controversial new stipulation, requiring IQ screening for all morbidly obese patients looking to undergo gastric bypass surgery. (Read Here)

In 1998, 772 people aged 55 to 64 had gastric bypass, stapling or some similar procedure known as bariatric surgery to help weight loss. But that number ballooned to 15,086 in 2004, according to the Agency for Healthcare Research and Quality.

"Among the reasons for the extremely dramatic increases is that the mortality outcomes from obesity surgery have improved greatly," the agency said in a statement.

"The national death rate for patients hospitalized for bariatric surgery declined 78 percent, from 0.9 percent in 1998 to 0.2 percent in 2004."

Agency director Dr. Carolyn Clancy said the report shows "more Americans are turning to obesity surgery and that an increasing number of younger people are undergoing these procedures."

More than 103,000 of the 2004 operations were on patients aged 18 to 54, the study found, and 349 were performed on youngsters aged 12 to 17.

"As the rate of obesity continues to climb, the health care system needs to be prepared for continued escalation in the rate of this surgery and its potential complications," she said.

The average hospital cost for an obesity surgery patient stay, excluding physician fees, was $10,395 in 2004 as compared with $10,970 in 1998, adjusted for inflation, according to the report. (Via Reuters)

In 1998, 772 people age 55 to 64 had gastric bypass, stapling or some similar procedure known as bariatric surgery to help weight loss. But that number ballooned to 15,086 in 2004, the Agency for Healthcare Research and Quality reported.

"Among the reasons for the extremely dramatic increases is that the mortality outcomes from obesity surgery have improved greatly," the agency said in a statement. "The national death rate for patients hospitalized for bariatric surgery declined 78%, from 0.9% in 1998 to 0.2% in 2004."