Obesity-Related Health Conditions

More About Bariatric Surgery Patient Testimonials What is Obesity? Obesity FAQ Am I a Candidate? Obesity Related Conditions Benefits of Surgery Bariatric Surgery Seminars

Morbid obesity can lead to a shorter life and many life-threatening health problems, known as co-morbidities. Recent studies show that the risk of an early death for those struggling with obesity is twice that of a non-obese person.

With treatment, there is a better chance for enjoying good health and a longer life. A clinical study shows that gastric bypass surgery improves life expectancy in patients by 89 percent.

Dedicating yourself to effective treatment is necessary for better health. Finding that treatment begins with learning how weight affects you.

If you find yourself struggling with one or more obesity-related health condition, bariatric surgery could be right for you.

If you choose to have bariatric surgery, your choice should be based on discussions between you and your doctor, including goals and strategy for long-term care. Patient selection for bariatric surgery is based on the National Institutes of Health (NIH) criteria:

• 100 pounds or more above ideal body weight or a BMI of 40 or greater
• BMI of 35 or greater with one or more obesity-related health condition

Other factors your doctor may consider include:

• History of documented dietary weight loss attempts
• Lifelong commitment to dietary, exercise, and medical guidelines and follow-up care
• Psychological evaluation

Studies show that bariatric surgery effectively can improve and resolve many weight-related health conditions. A review of more than 22,000 bariatric surgery patients showed improvement in or complete resolution of conditions including type 2 diabetes, hypertension, and sleep apnea.

Type 2 Diabetes

What is it?

Type 2 diabetes is a long-term metabolic disorder where the body produces insulin, but resists it. Insulin is necessary for the body to be able to use sugar.

Because of excess weight, obese individuals develop a resistance to insulin, which controls blood sugar.

A healthy weight is measured by your body mass index (BMI). A BMI of 25 or more is considered overweight. A BMI of 30 or more is obese.

While type 2 diabetes may occur regardless of someone's age, gender, or body mass, the disease tends to be more severe in the obese.

How is it affected by bariatric surgery?
Patients who had gastric bypass surgery had lower insulin resistance. Their risk for metabolic syndrome, high blood pressure, and a high amount of fats in the blood also decreased. In fact, a landmark study found that resolution of diabetes often occurred within days following gastric bypass surgery, even before marked weight loss was achieved.

What success have patients found through bariatric surgery?
A recent meta-analysis showed 76.8 percent of gastric bypass patients found complete resolution of type 2 diabetes, and 86 percent found improvement or resolution. Many gastric bypass surgery patients with type 2 diabetes have demonstrated little or no need for continuing medication.

High Blood Pressure/Heart Disease

What are they?

Excess body weight keeps the heart from working properly. The result can be high blood pressure (hypertension), which can cause strokes and heart and kidney damage.

Evidence shows that the age-related lifetime risk of hypertension in men and women ages 45 to 54 will double as their average BMI increases from 25 to 35.

While hypertension may occur regardless of someone's age, gender, or body mass, it tends to be more severe in the obese.

How are they affected by bariatric surgery?
Bariatric surgery reduces excess body weight over time, which takes away some of the strain on the heart. Changes in diet and exercise after surgery can lead to significant improvement of hypertension and other cardiovascular problems. Studies have shown reductions in total cholesterol and LDL levels and increased HDL levels. Even a weight loss of 10 percent can lower blood pressure significantly.

What success have patients found through bariatric surgery?
A recent meta-analysis showed hypertension was resolved or improved in 78.5 percent of patients. A study of 500 patients showed 92 percent resolution of hypertension.

Dyslipidemia/High Cholesterol

What are they?

Dyslipidemia is a disorder of lipids—the fat-like substances in the blood. A common form of dyslipidemia is hyperlipidemia ( high cholesterol), the condition that exists when someone has too much of certain lipids in the blood.

Doctors call this condition atherosclerosis or hardening of the arteries. While dyslipidemia may occur regardless of someone's age, gender, or body mass, the disease tends to be more severe in the obese.

What success have patients found through bariatric surgery?
Recent research on the impact of gastric bypass surgery found that hyper-lipidemia and hypercholesterolemia were improved in more than 93 percent of patients.

Osteoarthritis of Weight-Bearing Joints

What is it?

Osteoarthritis is one of the most common forms of arthritis. Known as the wear-and-tear kind of arthritis, osteoarthritis is a chronic condition in which there is a break- down of a joint's cartilage.

For anyone who is suffering from morbid obesity, the excess body weight placed on joints, par- ticularly knees and hips, results in rapid wear and tear, and pain caused by inflammation.

Similarly, bones and muscles of the back constantly are strained, causing disk problems, pain, and decreased movement ability. While osteoarthritis may occur regardless of someone's age, gender, or body mass, the disease tends to be more severe in the obese.

How is it affected by bariatric surgery?
As less weight is placed on joints, the strain placed on these joints is reduced. Bariatric surgery can reduce much of this weight over a long period of time and can be very effective in treating osteoarthritis.What success have patients found through bariatric surgery? A recent study of 500 patients showed a 90 percent resolution of arthritis among surgical patients.

Depression

What is it?

Depression is an illness that involves the body, mood, and thoughts. It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things.

There are many reasons people with morbid obesity experience depression. Many of the everyday activities people with healthy body weight take for granted are big challenges for a person suffering from morbid obesity.

These activities may include walking, social interaction, finding clothes that fit, and fitting in public seats. While depression may occur regardless of someone's age, gender, or body mass, it tends to be more severe in the obese.

How is it affected by bariatric surgery?
Emotional health goes hand in hand with physical health. Lifestyle improvements and renewed health can help resolve depression. Weight loss, combined with counseling, can be very helpful in improving mental health.

What success have patients found through bariatric surgery?
Patients who have had bariatric surgery report improved quality of life, social interactions, psychological well-being, employment opportunities, and economic conditions. Psychological screening before surgery may help prepare you for the changes that come with surgery, and help you set realistic goals and expectations.

Sleep Apnea and Respiratory Problems

What are they?

Obstructive sleep apnea is when breathing suddenly stops because soft tissue in the rear of the throat collapses and closes during sleep.

Morbid obesity can cause sleep apnea and other respiratory problems. The greater your excess body weight, the greater the amount of fat pressing down on your chest and lungs.

When you are morbidly obese, you are likely to have a greater buildup of fat deposits in the tongue and neck. While sleep apnea may occur regardless of someone's age, gender, or body mass, the disease tends to be more severe in the obese.

How are they affected by bariatric surgery?
Reducing overall excess body weight reduces fat deposits in the tongue and neck that cause sleep apnea. Clinical data show that sleep apnea is present in 60 percent of patients undergoing bariatric surgery.

What success have patients found through bariatric surgery?
Recent research found that obstructive sleep apnea was resolved in 85.7 percent of patients through gastric bypass surgery. Many people suffering from sleep apnea go undiagnosed. If you are obese and feel tired and fall asleep during the day, talk to your physician about sleep apnea.

Gastroesophageal Reflux Disease (GERD)

What is it?

Gastroesophageal Reflux Disease is injury to the esophagus caused by chronic exposure to stomach acid. While the symptom of heartburn is often associated with this disease, GERD is more than an annoyance. It is a serious disease that can cause esophagitis, Barrett's esophagus, and esophageal cancer. Occasional heartburn does not indicate GERD.

Excess body weight may weaken the valve at the top of the stomach, allowing acid to escape into the esophagus. This escape is known as gastroesophageal reflux. While GERD may occur regardless of someone's age, gender, or body mass, the disease tends to be more severe in the obese.

A five- to 10-year follow-up study that included 16,191 participants showed that there is an independent relationship between obesity, night time GERD and habitual snoring, and the onset of asthma and respiratory symptoms in adults. A 130-patient study found that people who suffer from GERD experienced a worsening of symptoms as their weight increased.

How is it affected by bariatric surgery?
Obesity increases a person's risk of GERD. Bariatric surgery improves GERD by reducing the amount of stomach acid produced.

What success have patients found through bariatric surgery?
A 2000 study of 500 patients showed complete resolution of GERD in 98 percent of patients. While there is anti-reflux surgery, it fails more often in people with morbid obesity and only addresses one co-morbidity. Another study found that all participants who had gastric bypass surgery reported an improvement in or no symptoms of GERD.

Urinary Stress Incontinence

What is it?

Among women, morbid obesity is a big risk factor for urinary stress incontinence, or uncontrollable urine loss.

A large, heavy abdomen and relaxation of the pelvic muscles due to morbid obesity may cause the valve on the urinary bladder to weaken, leading to leakage of urine with coughing, sneezing, or laughing.

While urinary stress incontinence may occur regardless of someone's age, gender, or body mass, the condition tends to be more severe in the obese.

How is it affected by bariatric surgery?
Bariatric surgery has been found to improve urinary stress incontinence. Less weight is placed on the bladder, and other physical changes take place to improve this condition.

What success have patients found through bariatric surgery?
A 2000 study of 500 patients showed 97 percent resolution of urinary stress incontinence in patients after gastric bypass surgery.

Asthma and Pulmonary Conditions

What are they?

Asthma is a disease of the respiratory system in which the airways unexpectedly narrow. Adult-onset asthma is closely associated with GERD. Common symptoms of asthma include wheezing, coughing, and chest tightness. While asthma may be found regardless of someone's age, gender, or body mass, the disease tends to be more severe in the obese.

What success have patients found through bariatric surgery?
While asthma remains a treatable but incurable disease, research has shown improvement in asthmatic symptoms through significant weight loss.

Reproductive Health

What is it?

Reproductive health can be a concern for women struggling with morbid obesity. Issues such as infertility (the inability to produce children) and menstrual irregularities may occur due to morbid obesity.

Menstruation issues include cycle interruption, abnormal flow, and additional pain during your menstrual cycle. Fertility issues include possible miscarriage, reduced success with fertility treatments, and polycystic ovarian syndrome (PCOS).

PCOS is an endocrine disorder in women of childbearing age that can cause infertility and other reproductive health conditions. Classic symptoms include obesity, an increase of facial and body hair (hirsutism), acne, irregular menstrual cycles, and infertility.

How is it affected by bariatric surgery?
Bariatric surgery has been found to improve or resolve conditions that may interfere with pregnancy, such as PCOS and hypertension. This procedure also reduces weight on reproductive organs and influences other physiological changes affecting fertility.

Surgeons commonly will request that female bariatric patients take steps to prevent pregnancy during the first year after surgery. Therefore, it's important to know about any changes in fertility after surgery so that you don't become pregnant too soon.

What success have patients found through bariatric surgery?
A recent study of women following gastric bypass surgery showed improvement of multiple clinical problems related to infertility and PCOS. All women continued to have normal menstrual cycles after about three months following surgery. Of the women who experienced hirsutism, 52 percent had complete resolution. In overweight women, weight loss (as little as 5 percent) may restore ovulation and fertility.