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Weight Loss Surgery May Lead to a Healthier Heart, Says NJ Surgeon

A comprehensive review of about 20,000 patients who have had bariatric surgery has shown that weight loss surgery also improved the structure and function of the heart while reducing several risk factors for cardiovascular disease.

“Obesity is very bad for the heart,” Dr. Alexander Abkin, director of the Bariatric Services at JFK Medical Center said in a statement. “It’s not just a cosmetic concern. Bariatric surgery has very serious effects on heart disease as well as other metabolic diseases such as hypertension, high cholesterol and diabetes.”

More than one-third of the U.S. adult population is obese, according to the Centers for Disease Control and Prevention, and the World Health Organization reports approximately 2.8 million adults die every year due to being overweight or obese.

“It’s probably our country’s biggest public health concern,” Abkin admitted.

Bariatric surgery, known as weight loss surgery or metabolic surgery, refers to a range of procedures to help limit the amount of food you can consume. It usually is reserved for people who are severely obese, meaning they have a BMI — a ratio calculation that takes height and weight in account — over 35. Typically, it includes men who are 100 pounds or more overweight from normal ranges and women who are at least 80 pounds overweight. The most common bariatric procedures include gastric bypass surgery, gastric banding and sleeve gastronomy.

But, Abkin said studies like this show the benefits of weight loss on other areas of health may change patient criteria in the future. The International Diabetes Federation had recommended lowering the BMI criteria to 30 for bariatric surgery — which means the person is approximately 20 to 30 pounds overweight — if the patients have Type 2 diabetes, especially if it cannot be controlled with conventional medical therapy.

For the review, which was published online on Oct. 17, researchers looked at 73 bariatric surgery and cardiovascular risk-factor studies. Seventy-five percent of the patients were women, and the average age was 41. On average, patients lost about 54 percent of the extra weight they had after having the procedures done.

Before their surgery, around 44 percent of the patients had hypertension, 24 percent had diabetes and approximately 44 percent had high cholesterol.

About five years after surgery, 63 percent of patients saw their hypertension improve, 73 percent had improved their diabetes and 65 percent had lower cholesterol.

Another 18 studies including an additional 713 subjects and showed that those who underwent bariatric surgery had a significant decline in left ventricular mass, or thickness of the heart muscle considered to be a risk factor for heart failure. Diastolic function, or heart function at relaxation, also improved after the procedures. The time between the closing of the aortic valve and opening of the mitral valve — isovolumic relaxation time — improved from 84 to 72.9 milliseconds. This time is normally one of the most common diastolic problems in obese individuals.

The review did not consider which kind of weight-loss surgery the patient had undergone, and the studies had different ways of measuring improvements for their patients. Some had a long period of no contact before resuming recording statistics on the subject.

Abkin points out that there are some risks for surgery, which including infections, hernias and blood clots.

Bariatric surgery patients may also be at a higher risk for alcohol abuse in years following surgery, recent research suggests.

In general, Abkin said that if people can successfully lose weight without going under general anesthesia and having surgery can be a good thing. On average, people can only lose 10 to 12 pounds with conventional weight management.

“Losing weight is important to improving your heart health and mechanisms to lose weight such as diet and exercise can be really helpful, but for patients who are having struggles with their weight and have severe obesity should really think about a bariatric surgery,” he said.

Abkin said that the mortality rate of weight loss surgery is low, typically around 0.1 to 0.2 percent, with a 5 to 10 percent risk of complications. In comparison, coronary bypass surgery carries a mortality rate of 2 to 3 percent, he said. The American Heart Association added in a statement in March that the benefits of weight loss surgery often outweigh the risks involved.

Call 973.410.9700 or visit http://www.bariatricsurgeonnj.com to learn more about weight loss surgery in New Jersey.