Cohort studycited by the Tayebat archiveabstract only checked★ key study A-BAR-03 in-depth review

Gastric bypass: fewer deaths overall, but more accident and suicide deaths

Long-term mortality after gastric bypass surgery.

Overview

Adams TD et al.. N Engl J Med 2007 · PMID 17715409 · DOI 10.1056/NEJMoa066603

Total deaths were 40% lower after surgery, while deaths from accidents and suicide were higher (11.1 vs 6.4 per 10,000 person-years).

Does the study support the specific claim? Partly · Methodological quality: moderate

Study explained simply

What did the researchers want to find out?: Long-term mortality
How was the study done?: Matched retrospective cohort
How many people, animals or samples were studied?: 15,850 people
What was actually found?: Total deaths down, external-cause deaths up
How large was the observed effect?: 37.6 vs 57.1 total; 11.1 vs 6.4 non-disease per 10,000 PY
What do the results mean in everyday life?: Net survival benefit with a specific mental health and accident risk
What are the study's limitations?: Observational
What does it say about Elawady's specific claim?: Supports self-harm concern, contradicts 'lethal'
Do the results apply to Germany and Europe?: Comparable to Nordic findings
What can explicitly not be concluded from this study?: Causation of suicide excess

Authors: Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD, Lamonte MJ, Stroup AM, Hunt SC
Journal: N Engl J Med
Year: 2007
Identifier: PMID 17715409 DOI 10.1056/NEJMoa066603
Verification: verified – PubMed E-utilities efetch, 2026-10-25
Retracted: no
Corrections: none
Extent checked: abstract only
Conflicts of interest and funding: COI: not stated in record | Grants: NCI NIH HHS, NCRR NIH HHS, NIDDK NIH HHS

Long-term mortality after gastric bypass vs severely obese persons

Study design: Cohort study – Retrospective matched cohort (Utah): gastric bypass patients vs severely obese driver's licence applicants
Population: Severely obese adults, Utah
Country: USA
Period: 1984-2002
Sample size: 7925 surgical vs 7925 matched controls
Inclusion and exclusion criteria: Matched on age, sex, BMI

Results: All-cause mortality 37.6 vs 57.1 per 10,000 person-years (40% lower, P<0.001); CAD -56%, diabetes -92%, cancer -60% (5.5 vs 13.3). Deaths not caused by disease (accidents, suicide) 11.1 vs 6.4 per 10,000 person-years (58% higher, P=0.04).
Absolute risks: Non-disease deaths: absolute excess about 4.7 per 10,000 person-years (11.1 - 6.4, calculated from reported rates); total deaths about 19.5 fewer per 10,000 person-years (57.1 - 37.6, calculated)
Authors' conclusion: Total mortality significantly reduced, but deaths from causes other than disease were higher in the surgery group.

Orienting tool: ROBINS-E
Type of assessment: simplified assessment (abstract only)
Full formal assessment: no
Overall risk of bias: some concerns
Rationale: Selection and confounding possible; matching only on age, sex, BMI.

The 58% relative increase in non-disease deaths is a small absolute excess compared with the larger absolute reduction in total deaths.

Supports the claim of increased non-disease deaths; contradicts the claim that surgery is lethal overall.

SOS 2020 found non-disease deaths HR 1.85 (full text) while overall mortality fell.

US data; Swedish data similar.

Correctly cited; the archive's numbers match the abstract.

Multidimensional assessment
Multidimensional assessment
Authenticity of the source	verified
Methodological quality	moderate
Risk of bias	some concerns
Precision of results	moderate
Directness	direct
Reproducibility	replicated
Consistency with the overall evidence	consistent
Regional transferability	moderate
Adequacy of the interpretation (by the archive)	essentially correct but incomplete

Mechanisms of excess suicide/accident deaths.

Note: according to the archive, the studies were compiled by the archive operators. Whether Dr. Elawady himself cited this study is not established.

What the archive says about the study: Gastric bypass reduced overall mortality by 40%, but non-disease deaths (accidents and suicide) were 58% higher (11.1 vs 6.4 per 10,000 person-years).
A. What was actually studied?: Long-term mortality after gastric bypass vs matched severely obese controls
B. What did the authors find?: 40% lower all-cause mortality; 58% higher non-disease deaths
C. What conclusions do the authors themselves draw?: Total mortality reduced; non-disease deaths increased
D. What does the archive derive from it?: Used to document suicide/accident risk after surgery.
E. Is this derivation scientifically justified?: Numbers are quoted correctly and the 40% total reduction is mentioned. The archive does not state that the absolute excess of non-disease deaths is much smaller than the absolute reduction in total deaths.
Adequacy of the interpretation (by the archive): essentially correct but incomplete