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

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

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