Surgery
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Weight loss is very important in preventing metabolic syndrome. Medical indications for bariatric surgery (also known as weight-reducing surgery) include the following:
- Severely obese individuals (BMI greater than 40) who failed diet and exercise treatment
- Obeses individuals (BMI 35-40) with sleep apnea , high blood pressure , cardiomyopathy , osteoarthritis which interferes with life, severe diabetes or lipid disorders.
There are two types of bariatric surgery that can help you lose weight if you are very overweight. Click on the links for detailed fact sheets on each.
- Gastric bypass —This procedure involves stapling the stomach to make it smaller, allowing you to only eat small portions of food and preventing some of the calories from being absorbed.
Individuals with the following condition, SHOULD NOT, undergo gastric bypass procedure:
- Substance abuse (past or present)
- Major psychiatric disorder (past or present)
- End-state liver, heart, lung disease
- Individuals unwilling to make commitments with regards to long-term lifestyle changes.
- Laparoscopic vertical banded gastroplasty —Both a band and a staple are used to make the stomach into a small pouch, allowing you to only eat small portions of food and preventing some calories from being absorbed.
Studies have found that weight loss through bariatric surgery significantly reduced the risk factors for metabolic syndrome. The weight loss surgery helped to:
- Decrease insulin resistance
- Lower blood pressure
- Decrease amount of fats in the blood
You will have to discuss with your doctor the risks and benefits of surgery versus the traditional way of losing weight through diet and exercise.
References:
Bennett JMH, Mehta S, Rhodes M. Surgery for morbid obesity. Postgraduate Med J. 2007;83:8-15.
Cornier MA, Dabelea D, Hernandez TL et al: The metabolic syndrome. Endocr Rev. 2008;29:777-822.
Li Z, Maglione M, Tu W, et al. Meta-analysis: pharmacologic treatment of obesity. Ann Intern Med. 2005;142:532-546.
Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142:547-59
Morinigo R, Casamitjana R, Delgado S et al: Insulin Resistance, Inflammation, and the Metabolic Syndrome Following Roux-en-Y Gastric Bypass Surgery in Severely Obese Subjects. Diabetes Care. 2007;30:1906-08.
NIH Gastrointestinal surgery for Severe Obesity 9(1) NIH Consensus Development Conference March 25-27, 1991.
Robles-Cervantes JA, Yanez-Diaz S, Cardenas-Camarena L. Modification of insulin, glucose and cholesterol levels in non-obese women undergoing liposuction: Is liposuction metabolically safe? Annals of Plastic Surgery. 2004;52:64-67.
Shikora SA, Kim JJ, Tarnoff ME. Nutriton and gastrointestinal complications of bariatric surgery. Nutr Clin Pract. 2007;22:29-40.
Vásquez LA, Pazos F, Berrazueta JR, et al. Effects of changes in body weight and insulin resistance on inflammation and endothelial function in morbid obesity after bariatric surgery. J Clin Endocrinol Metab. 2005;90:316-322.
Wei-Jei L, Huang MT, Wang W, Lin CM, Chen TC, Lai IR. Effects of obesity surgery on the metabolic syndrome. Arch Surg. 2004;139:1088-1092.
Last reviewed February 2009 by David Juan, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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