This podcast explores metabolic bariatric surgery, including its efficacy, eligibility criteria, and preoperative assessment. It also discusses the long-term outcomes and impact on fertility and pregnancy. The chapter highlights misconceptions and barriers surrounding the surgery and suggests rebranding as behavior change surgery.
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Quick takeaways
Metabolic surgery can lead to significant and sustained weight loss, with patients maintaining 50% of their excess weight loss after 10 years post-op.
Metabolic surgery has positive effects on various medical comorbidities such as diabetes and high blood pressure, leading to long-term remission and rapid improvements in blood pressure control.
Metabolic surgery is a highly effective intervention for weight loss and improving health, reducing the risk of obesity-related diseases and providing substantial benefits for chronic conditions like cardiovascular disease and sleep apnea.
Deep dives
Weight Loss Expectations
Metabolic surgery, such as Ruen Y gastric bypass and sleeve gastrectomy, can lead to significant and sustained weight loss. After two years, Ruen Y gastric bypass patients can expect to lose approximately 70% of their excess weight, while sleeve gastrectomy patients can lose around 60%. These weight loss percentages translate to about 30% to 70% of their total body weight, depending on the procedure. A plateau in weight loss is typically seen around 10 years post-op, with patients maintaining 50% of their excess weight loss.
Impact on Medical Comorbidities
Metabolic surgery has positive effects on various medical comorbidities. For diabetes, surgery can lead to long-term remission, especially for those with recent onset diabetes and those not on insulin. Remission rates can be as high as 80-90% within days to weeks of surgery. For high blood pressure, surgery results in rapid improvements in blood pressure control and the need for medications. Remission rates range from 40-80% at one year, though individual responses can vary depending on severity and duration of hypertension. In general, metabolic surgery provides substantial benefits for these chronic diseases and can lead to improvements or remission in other conditions such as cardiovascular disease and sleep apnea.
Metabolic surgery for weight loss and health improvement
Metabolic surgery, also known as metabolic bariatric surgery, is a highly effective intervention for weight loss and improving health. The procedures have shown significant and sustained weight loss over decades, reducing the risk of obesity-related diseases like diabetes and high blood pressure. Complications and mortality rates have decreased over time, with the current risk being very low. However, there are barriers and stigmas surrounding these procedures, leading to underutilization. By increasing knowledge and challenging misconceptions, metabolic surgery can be viewed as a valuable tool in comprehensive obesity management.
Benefits and outcomes of metabolic surgery
Metabolic surgery yields substantial weight loss and improves or remits various obesity-related conditions. The procedures can reduce the risk of heart disease, cancer, and other health issues. Long-term weight maintenance after surgery is possible, with a low rate of weight regain. While there may be considerations for mental health and substance use disorders, such as alcohol, research highlights the overall safety and effectiveness of metabolic surgery in the management of obesity.
Overcoming barriers and stigmas
Despite the effectiveness and safety of metabolic surgery, barriers and stigmas persist. Misconceptions about weight regain and surgical risks, as well as under-referral by clinicians, contribute to the underutilization of these procedures. By providing accurate information, addressing stigmas, and promoting comprehensive obesity management, metabolic surgery can be seen as a valuable option.
Exercise and nutrition after metabolic surgery
Nutritionally, the post-surgery diet follows gradual stages, incorporating protein and emphasizing healthy dietary patterns. While exercise guidelines for metabolic surgery patients are similar to general recommendations, exercise can be challenging due to musculoskeletal pain and psychological barriers. Research suggests that exercise can aid in weight loss maintenance, improve strength, and preserve fat-free mass. Supportive measures can help individuals overcome barriers to exercise and optimize their post-surgery lifestyle.
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