Weight Loss Surgery May Reduce Stroke Risk

Weight loss surgery, also known as bariatric surgery, is one of the medically recommended treatment options for people who are fighting obesity. This type of surgery is not about a shortcut to weight loss or about getting an attractive body. Bariatric surgery is a surgical operation that is done with the main objective of reversing and preventing the health complications of obesity.

Complications of obesity include diabetes, heart disease, hypertension, and stroke.

Most of these health-related side effects are known to lead to stroke. In fact, a stroke is the most life altering complication of obesity. About 12-18 percent of people who experience a stroke do not survive while those who do survive experience a shortened lifespan. It is estimated that stroke survivors experience an average of 12 1/2 years earlier death. Living as a stroke survivor often means years of disability as well as a surprisingly huge financial cost of stroke.

Nevertheless, bariatric surgery is a major surgical procedure. If you have considered bariatric surgery or if your doctor has recommended that you look into it, you should know some of these basics about its relationship with stroke risk. 

What Is Bariatric Surgery?

Bariatric surgery and weight loss surgery are surgical operations that are deliberately designed to cause weight loss and to prevent weight gain. There are several types of weight loss surgery.

For example, a gastric bypass is a procedure that reroutes the connection between the small intestine and the stomach, ultimately leading to fewer calories absorbed into the body. After a gastric bypass procedure, the food that a person eats enters the small intestine shortly after entering the stomach.

The stomach is where most food is prepared to be absorbed in the small intestine, so shorter time in the stomach results in fewer calories absorbed from food into the body. 

Gastric resection and gastric sleeve procedures are types of weight loss surgery that involve removing a portion of the stomach to make it smaller. After a gastric bypass, the stomach is literally reduced in size and therefore it is uncomfortable to overeat. Overeating after a gastric bypass procedure may even result in vomiting. Less eating means fewer calories, which leads to weight loss.

One of the other common types of bariatric surgery is gastric banding. Gastric banding involves surgically placing a band on a region of the stomach to create a sensation of fullness — as if the stomach was smaller. This sensation of fullness that results after eating small amounts of food prevents overeating. All of these methods are effective means of calorie restriction and result in both losing weight and preventing weight gain.

Procedures such as 'tummy tucks' and liposuction are not the types of surgeries that are considered weight loss surgery or bariatric surgery. These types of procedures remove fat or skin from the body to ‘sculpt’ the shape and size of the body. They do not have an impact on the amount of calories a person can eat and they do not have the same health benefits as bariatric surgery. 

How Does Bariatric Surgery Help Prevent Stroke?

Obesity is associated with a higher incidence of stroke. The healthy way to lose weight is generally  through an overarching lifestyle modification plan that includes diet and exercise. Healthy dieting for weight loss is focused on getting the necessary nutrients by eating nutritious food while gradually losing weight through calorie restriction.

Exercise for weight loss is focused on regularly participating in physical activities that use calories, such as walking, or aerobic exercises such as running or biking. Some individuals, however, are unable to lose all of the excess weight through lifestyle alone. And, when a person is extremely overweight, it may be difficult to reach a healthy weight solely through diet and exercise. The exact weight or body mass index (BMI) that is enough to cause health problems may differ for different people. In some cases, your doctor may prescribe weight loss so that you can avoid complications of obesity like stroke, and, depending on your situation, bariatric surgery might be recommended as an option for you. 

Does Bariatric Surgery Really Help Prevent a Stroke?

A research group that includes the Cardiovascular Institute from the University of Manchester in the UK compiled the results of 14 separate studies on the outcome of bariatric surgery. The data showed that  there was a 50 percent lower death rate among participants who had bariatric surgery and a significantly reduced risk of stroke and heart attack among participants who had bariatric surgery.

Another group of researchers made up of a team from several universities in the United States, including The University of Utah, The University of Alabama at Birmingham, Brigham Young University and Weill Cornell College of Medicine, reviewed the effect of bariatric surgery on medical illnesses. The results showed that obese patients who had bariatric surgery had a significantly lower chance of stroke death when compared to people who were comparably obese who had not had weight loss surgery. 

One of the results of bariatric surgery was a decline in the development of type 2 diabetes mellitus and even the reversal of type 2 diabetes among those who already had it. According to The Journal of the American College of Surgeons, patients with type 2 diabetes mellitus who had bariatric surgery experienced a 60-80 percent reduction in vascular events such as stroke and heart attacks. 

Is the Cost/Benefit Worth It?

Of course, weight loss surgery is a major procedure, so it is important to consider whether the benefits are worth the risk. There are side effects and complications of bariatric surgery, including malnutrition, anemia and hormonal irregularities. Overall, weight loss surgery has been shown to prevent death, and prevention of stroke is a major reason for that benefit. In fact, according to news released by the American Heart Association, health insurance companies are expanding the criteria they use when it comes to paying for bariatric surgery.

For some people, the risks of weight loss surgery are too significant while for others the risks are more tolerable in light of the potential health benefits. Whether or not you would be better off with weight loss surgery or with a non-surgical approach to weight loss depends on a number of factors that you need to discuss with your team of doctors.

Sources:

All-Cause and Cause-Specific Mortality Associated with Bariatric Surgery: A Review, Adams TD, Mehta TS, Davidson LE, Hunt SC, Current Atherosclerosis Reports, December 2015

Bariatric surgery and its impact on cardiovascular disease and mortality: a systematic review and meta-analysis, Kwok CS, Pradhan A, Khan MA, Anderson SG, Keavney BD, Myint PK, Mamas MA, Loke YK, International Journal of Cardiology, April 2014

Bariatric surgery is associated with a reduction in major macrovascular and microvascular complications in moderately to severely obese patients with type 2 diabetes mellitus, Johnson BL, Blackhurst DW, Latham BB, Cull DL, Bour ES, Oliver TL, Williams B, Taylor SM, Scott JD, The Journal of the American College of Surgeons, April 2013

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