Should Bariatric Surgery always be a last resort?

June 11, 2014

There are some cases where bariatric surgery should be considered earlier on in a patient’s life.

For example, diabetes is a costly disease with poor long term outcomes including nerve, kidney and eye damage.  Preliminary evidence shows that bariatric surgery can achieve significantly better control of type 2 diabetes, independently of weight loss, than medication alone (1).  Consequently, it may be worth considering bariatric surgery in obese patients with type 2 diabetes earlier rather than later so the risk of long term complications is minimised.

The Australian Medical Association recognises obesity as an epidemic and national priority, suggesting the major focus for preventing obesity should be on children, starting with the mother bearing the child (2). Another application of bariatric surgery could be in obese women planning on conceiving, to try and prevent generational obesity. A small study in Canada showed that bariatric surgery changed the environment in which the embryo developed and this affected the baby’s genes, including the genes involved in blood sugar metabolism and heart disease risk (3). If further studies show this effect to reduce rates of obesity, diabetes and/or cardiovascular disease then this application could play a major role in tackling the obesity epidemic – albeit a generation later.

As rates of obesity continue to rise, and the debate between genetic and environmental factors continues, dietary, societal and surgical interventions are increasingly needed.

Further information.

  1. Nainggolan L & Barclay L (2012) Bariatric Surgery Beats Standard Therapy in Obese Diabetics, http://www.medscape.com/viewarticle/760883, accessed 30/12/13
  2. Australian Medical Association (2009) Obesity position statement, https://ama.com.au/position-statement/obesity-2009, accessed 30/12/13
  3. Rachel Reilly (2013) Obese mothers who have weight-loss surgery before giving birth have thinner children, say researchers, http://www.dailymail.co.uk/health/article-2332088/Should-obese-women-weight-loss-surgery-pregnancy-prevent-children-fat.html, accessed 30/12/13

Disclaimer: this information is of a general nature only. Please consult your health professional before acting on information contained herein.

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Posted in Blog by Douglas Fahlbusch