Navigation Links
When considering bariatric surgery think about bones
Date:11/2/2012

Bariatric surgery, which significantly curtails the amount of food a person can eat, is the most effective treatment against obesity and is being recognized as a potentially valuable tool in the fight against diabetes related to obesity. It is being performed on increasing numbers of people worldwide, including teenagers.

Unfortunately, some types of bariatric surgery may also cause bone loss, a cause for concern, particularly when carried out on young people who have not yet reached their peak bone mass, say endocrinologists from Sydney's Garvan Institute of Medical Research, who have just published a review of current literature in the journal Obesity Reviews, now online.

Authors, Dr Malgorzata Brzozowska and Associate Professor Jackie Center, say that skeletal examination and treatment should be considered part of patient care, before and after procedures.

In the United States, 'Roux-en-Y' gastric bypass surgery, one of the most invasive of the procedures, is the most common. Much of the stomach is removed and part of the small bowel bypassed. Less radical is the 'gastric sleeve', which involves removing a large part of the stomach leaving a narrowed smaller stomach, restricting food intake and at the same time speeding the passage of food to the gut. The least invasive, and only reversible measure, is the 'gastric band', which is an inflatable ring placed between the oesophagus and stomach, making it possible to eat only small amounts of food slowly.

"Even though we don't yet understand all the mechanisms, we can see that the more radical the procedure, the greater the bone loss long-term," said Dr Brzozowska, who undertook the review as part of her PhD.

Dr Brzozowska is the first person to do a widespread analysis of current research into the complex interrelationships between fat, bone and nutritional restriction.

"In many situations significant weight loss is associated with bone loss, with or without surgery. The more invasive types of surgery appear to heighten bone turnover and the associated bone loss. This is thought to be caused not only by rapid weight loss and absorption of fewer vital nutrients like vitamin D and calcium, but possibly also by changes in hormones released by fat and the gut, and their impact on the central nervous system," she said.

In particular, the review points out, we should be aware of surgery-induced changes in hormones that can affect the central regulation of appetite and bone strength. These include the fat-derived hormones leptin and adiponectin; gut-derived hormones such as peptide YY (PYY), glucagon-like peptide 1 (GLP-1) and ghrelin; and the hypothalamic regulator of energy balance, neuropeptide Y (NPY). However, although there is quite a lot of animal data concerning these hormones and their effects, human data are scanty.

Associate Professor Jackie Center believes that the findings are very important despite the widely held assumption that obese people are protected against bone fragility and fracture.

"It has always been assumed that the heavier someone is, the denser their bones will be, because bones become strong when they carry a load. While that is true up to a certain point, the bones may not continue to become stronger in the very obese, who can also have low bone density and fracture.

"Increasing evidence suggests that in very obese people, the relationship between bone density and weight fails and that the excess fat is detrimental to bone.

"While there are many studies looking at weight loss and improvement in insulin sensitivity after bariatric surgery, very few look at what happens in bone.

"We are certainly not arguing against bariatric surgery. There is no doubt that it is an effective weapon against obesity and obesity-related diabetes. We just ask that doctors and patients take bone health into account.

"Bone mineral densitometry scans can be done and adequate calcium and vitamin D intake advised. For those patients at particular risk, additional monitoring may be advised and protective drugs considered."


'/>"/>

Contact: Iris Hui
iris.hui@researchaustralia.org
61-292-958-545
Research Australia
Source:Eurekalert

Related medicine news :

1. Medical Tourism: Uncharted Territory for Patients James Goldberg, Author of the American Medical Money Machine, Is Offering a New Consulting Service to Medical Patients Considering “Medical Tourism” Treatment
2. Optimal care of bariatric surgery patients vital for long-term health and well-being
3. Rhode Island Hospital study: Bariatric patients with obstructive sleep apnea fail to show symptoms
4. Bariatric surgery substantially reduces the risk of diabetes
5. Esophageal Cancer Surgery Can Leave Lingering Health Problems, Study Says
6. Codeine After Surgery Could Endanger Certain Kids: Study
7. Surgery Rates Rising for Non-Melanoma Skin Cancer: Study
8. Study examines medicare use for Mohs micrographic surgery and surgical excision for skin cancer
9. Weight-Loss Surgery Beat Drugs for Cutting Diabetes in Very Obese
10. Brain Surgery Might Ease Tough-to-Treat OCD
11. Men More Prone to Complications After Brain, Spine Surgery
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... , ... June 25, 2016 , ... "With 30 hand-drawn ... specific project," said Christina Austin - CEO of Pixel Film Studios. , ProHand ... all within Final Cut Pro X . Simply select a ProHand generator and ...
(Date:6/25/2016)... Montreal, Canada (PRWEB) , ... June 25, 2016 , ... ... the pursuit of success. In terms of the latter, setting the bar too high ... low, risk more than just slow progress toward their goal. , Research from ...
(Date:6/24/2016)... Texas (PRWEB) , ... June 24, 2016 , ... ... International Conference and Scientific Sessions in Dallas that it will receive two significant ... of the grants came as PHA marked its 25th anniversary by recognizing patients, ...
(Date:6/24/2016)... , ... June 24, 2016 , ... People across the ... Genome magazine’s Code Talker Award, an essay contest in which patients and their families ... to be presented at the 2016 National Society of Genetic Counselors (NSGC) Annual Education ...
(Date:6/24/2016)... ... ... National recruitment firm Slone Partners is pleased to announce the ... as Vice President of North American Capital Sales at HTG Molecular . ... team in the commercialization of the HTG EdgeSeq system and associated reagents in North ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... 24, 2016   Bay Area Lyme Foundation ... Dean Center for Tick Borne Illness , Harvard ... MIT Hacking Medicine, University of California, Berkeley, and ... the five finalists of Lyme Innovation , ... than 100 scientists, clinicians, researchers, entrepreneurs, and investors ...
(Date:6/24/2016)... SAN CLEMENTE, Calif. , June 24, 2016  American Respiratory ... testing company, is now able to perform sophisticated lung assessments in ... Medical Technologies , Inc. Patients are no longer ... to ndd,s EasyOne PRO ® , ARL patients like Jeanne R. ... testing done in the comfort of her own home. ...
(Date:6/24/2016)... , June 24, 2016  Arkis BioSciences, ... less invasive and more durable cerebrospinal fluid treatments, ... funding.  The Series-A funding is led by Innova ... Fund, and other private investors.  Arkis, new financing ... instrumentation and the market release of its in-licensed ...
Breaking Medicine Technology: