What are the real medical reasons for weight loss surgery? Perth bariatric surgeon Dr Jon Armstrong explains.
Most important medical risks with obesity
There are many reasons patients might consider weight loss surgery or bariatric surgery but it’s really important to know the medical reasons why it makes sense. We know being significantly overweight is associated with risks to patients. There is a long list of medical risks with obesity but I will try to highlight the important ones.
If you are a diabetic you are at risk of many complications such as kidney failure, blindness and vascular problems. Survival is reduced. Bariatric surgery can put patients in complete remission from their diabetes and many patients get off all their meds.
60% of patients will be able to stop their blood pressure meds or be on a reduced dose after surgery.
This is a big problem for many overweight patients and it is often underdiagnosed. It can lead to tiredness all the time and falling asleep at work or not being able to concentrate well. Ultimately sleep apnoea can cause an excessive load on the heart. Symptomatically sleep apnoea improves fairly rapidly after weight loss surgery. Many patients will be able to get rid off their CPAP machines.
Arthritis and joint issues
So many of our patients are troubled with back, hip, knee and ankle pains, or chronically sore feet. Much of this will be weight related and after weight loss surgery it usually will improve.
A significant number of our patients are on statins for high cholesterol and other lipid problems. Most patients will have significant improvements in their lipid profile at 6 months from surgery and will reduce their cardiac risks.
It seems many cancers occur more commonly in obese patients, particularly oesophageal, stomach, pancreas, colon, breast, ovarian and uterine cancer. Significant weight loss would be expected to reduce cancer risk. Also if a patient has already had one of these cancers their risk of recurrence, particularly for breast, ovarian and uterine cancers may well be reduced after successful weight loss surgery.
Fertility issues and Polycystic Ovarian Syndrome (PCOS)
At Advance Surgical we do receive many referrals from fertility clinics and from women struggling with fertility problems. We know that having a BMI over 35 can significantly reduce fertility and increase the risk of both maternal and foetal complications. After weight loss surgery we have had many happy patients who have had successful pregnancies. It is important to weight a year from surgery before trying to get pregnant.
That's just a small summary of common problems with obesity that tend to improve after surgery. Overall we know that patients with a BMI over 35 have an increased mortality from all known causes. Long term studies have shown weight loss or bariatric surgery would be expected to increase the quality of life of most patients as well as giving a survival benefit, i.e patients would be expected to live longer and healthier.