Surgery for obesity & metabolic diseases
Making state of the art surgery affordable
This question is one of the most frequently received. We realize that people limit themselves since they believe that being diabetic or having a particular disease is a contraindication for obesity surgery.
The reality is that it is quite the opposite since there is no better candidate for weight loss surgery than a diabetic patient (ideally less than five years after diagnosis); whether it is a patient with an easy or difficult disease to control, people with diabetes will significantly benefit from the gastric sleeve or gastric bypass surgery.
The metabolic effects of weight loss surgery on a patient's organism even allow us to think of the possibility of "curing" the disease; we say it in quotation marks because it is not considered that the patient is really cured within the medical field.
Those patients with a history of type 2 diabetes mellitus who, after surgery, have normal blood glucose levels are considered to be in remission; that is, there is no evidence of the disease, but it is known that the risk of its recurrence is latent. Despite this, it is the only medical/surgical treatment that has achieved such favorable results for the quality of life and health of patients with diabetes.
Diabetic patients planning to undergo weight loss surgery should be in close contact with their surgeon and internist to achieve adequate control of their blood sugar levels. Before and after surgery situations will arise, leading to an even more significant imbalance of these levels.
We mean the need for the patient to undergo a preoperative diet before surgery, which also causes hormonal changes, and a postoperative diet, which could cause significant rises or falls in blood glucose levels. It is even more essential to avoid a sudden and drastic decline in them, so it is vital to maintain close contact with your doctors. After surgery, treatment should not be stopped until your doctor tells you to.
We always recommend that our patients have already planned a visit with their family doctor or internist for the days after surgery. Since it is likely that within a few weeks or months of the bariatric procedure, there will be a need to adjust the dose of medication for blood pressure, and even at some point, it may reach the point where treatment is stopped.
The preoperative tests are practically the same for all types of patients; however, in long-term diabetic patients, emphasis should be placed on aspects such as kidney function and the health of their cardiovascular system to ensure that they are in the right conditions to undergo a gastric sleeve surgery.
Postoperative care of diabetics
The care that the diabetic patient should have after a weight loss surgery is the same as any other patient; however, it is necessary to observe the aforementioned: check glucose levels more closely than usual, which will allow its appropriate control, which in turn will prevent problems such as infections or changes in the healing capacity of your wounds and internal organs.
As with diabetes, many patients with high blood pressure or hypertension often rule out considering weight loss surgery because they think their condition contraindicates surgery.
In reality, it is the opposite. A patient with hypertension and moderate or severe obesity will benefit greatly from weight loss surgery. The only thing to consider before surgery is to achieve the best possible control of your blood pressure levels to be in optimal conditions for the surgery.
Medications to control blood pressure before weight loss surgery should be continued until the day before surgery unless your surgeon or internist tells you otherwise.
As we explained, it is essential to seek the best possible control, so treatment must continue. After surgery, treatment should not be stopped until your doctor tells you to.
We always recommend that our patients have already planned a visit with their family doctor or internist for the days after surgery. Since it is likely that within a few weeks or months of the bariatric procedure, there will be a need to adjust the dose of medication for blood pressure, and even at some point, it may reach the point where treatment is stopped.
As with diabetic patients, the studies are practically the same, only emphasizing adequate metabolic control and adequate renal function.
In this case, the care would be exactly the same as in a patient without high blood pressure.
Just be careful that the foods you will eat in the postoperative phase are not high in sodium to avoid spikes in blood pressure.
Patients with thyroid disease are also good candidates for weight loss surgery. The first thing to determine is what type of thyroid disease they suffer from since suffering from hyperthyroidism or hypothyroidism, as their terms indicate, are opposite poles.
The first is a thyroid gland disease in which said gland has an exaggerated function and produces excess thyroid hormone, while in the case of hypothyroidism, it is the opposite, with insufficient thyroid hormone production. Patients with either of these two thyroid diseases can usually be controlled within a few months of medical treatment and can lead a practically normal life.
It is crucial that, regardless of the thyroid disease in question, there is excellent control of the function/production or administration/suppression of thyroid hormone since undergoing surgery with a significant lack of control of this hormone can have serious consequences.
Medications that affect thyroid hormone production or function are not usually used before, during, or after surgery. What is sought is optimal control of its levels during all phases of planning and after surgery.
A thyroid hormone profile is required, a very specific and reliable study to determine the functioning of the thyroid gland.
Ensure to continue with adequate control of thyroid function; otherwise, the care is the same as in the rest of the patients.
As well as these previous diseases, many other disorders can be suffered by people who are candidates for weight loss surgery; it is more common to see this situation in people 50 years of age or older; however, there are considerably younger patients who can suffer from other diseases that may make them think that they cannot undergo obesity surgery when in reality there are very few contraindications.
We share some examples of the diseases with which it is entirely possible to think about weight loss surgery.
Of course, as in all cases, the situation must be individualized and reviewed in detail to determine the risk/benefit. But in most cases, and when things are done well by both parties (doctors/patient), the benefit is much higher than the risk.
Examples of diseases that you can suffer from and do not necessarily contraindicate obesity surgery
The tests to be carried out in these cases would be individualized and adapted to each patient and the modifications in medications such as postoperative care.
The most important thing to highlight in this topic is that you should not stop investigating; I always tell my patients that there is no worse question than the one that is not asked. So instead of thinking that because of your current situation, you are condemned to not being able to solve your obesity problem, better contact the bariatric surgeon of your choice; they will have the ability to guide you and give you the best possible recommendation.
If you want to know if weight loss surgery is feasible in your case, do not hesitate to contact us through one of our communication channels.
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