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Effect of Weight Loss Surgery on Metabolic Disorders in the Obese and Non-Obese


Over the last 60 years there has been an impressive change in the human environment, behaviors and lifestyle. These changes have resulted in an increase in both, Type 2 Diabetes and macrovascular disease (heart attack and stroke). These rises must be attributed to the greater prevalence of obesity and consequent pathophysiologic condition, the so-called metabolic syndrome.

It is estimated that 190 million people worldwide have diabetes and it is likely that this will increase to 324 million by 2025. This epidemic is taking place both in developed and developing countries and the combination of obesity, diabetes and metabolic syndrome is now recognized as one of the major threats of human health in the twenty-first century.

The logic dictates that it will always be easier and cost-effective to prevent diseases rather than treating them, even more so if these diseases are chronic and life threatening such as in the case of diabetes, high blood pressure and the rest of the diseases that accompany the metabolic syndrome.


The International Diabetes Federation has proposed a new practical definition, which includes the following:

  • Central Obesity
  • Waist Circumference above 94 cm for males and 80 cm for females in Caucasians (Europe and North America)
  • Plus any two of the following:
  • Raised tryglicerides
  • Raised HDL-C
  • Raised blood pressure
  • Raised fasting plasma glucose or previously type 2 diabetes

The prevention, improvement and reversion of type 2 diabetes, high blood pressure and several other diseases associated with obesity are observed after all the Weight Loss Procedures. This statement has a scientific proven basis supported by several well planned studies, in articles such as Brethauer’s published in 2009 it was shown that Sleeve Gastrectomy achieved a very high percentage of remission or at least a high rate percentage of improvement of this disease that affects obese patients.

Another study by Himpens in 2007 demonstrated an Excess Weight Loss percentage of 66 after 3 years  in patients who got the Gastric Sleeve or VSG.

The results and benefits from Weight Loss Surgery on such diseases have even encouraged some investigators and patients to enroll on studies that involve Type 2 Diabetes patients with BMI’s as low as <35

There are several surgical options that have been developed through the last five decades, and one of the newest ones and most promising of these is the Gastric Sleeve. Even if in the USA the FDA “recently” approved this procedure many other countries in the world have been performing it for almost a decade with excellent results.

The Gastric Sleeve or Vertical Sleeve Gastrectomy (VSG) has the following advantages over other procedures:

  • It is a much less invasive bariatric procedure and therefore has a lower morbidity rate.
  • It does not involve the placement of a foreign device as in the gastric band.
  • It does not involve any risky stomach or intestinal re-routing.
  • Since there is no re-routing, there is no dumping syndrome.
  • It is the only procedure that involves the removal of the portion of stomach that produces the hunger hormone “ghrelin” so it will effectively reduce hunger strikes.
  • Fullness and satisfaction is achieved with just small portions of food.
  • It does not limit or restrict the type of food you are able to eat. You will be able to eat anything, but in small healthy portions.
  • The reduced intake of food because of the restriction and lack of hunger strikes results in dramatic weight loss!
  • Weight loss won’t be drastic in a very short period of time, letting your body and skin to more easily adapt to a constant and healthier weight loss pattern.
  • It adjusts to every person’s needs. Even if “adjustments” are neither possible nor necessary, the sleeve is considered a “smart” procedure that leads patients close to their goal weight and just after this, the weight loss stalls.
  • Requires no periodic and costly testing and measuring levels of vitamins, minerals, etc. It is practically maintenance free.
  • No need for uncomfortable preoperative intestinal or colon cleansing.

According to this article up to now, it might seem that Weight Loss Surgery is or should be reserved only for severely ill patients or very obese patients, and this is very far from the truth, even though a patient for Weight Loss Surgery should be studied and should comply several criteria in order to be a real candidate, the benefits from Weight Loss Surgery can be obtained by many people.

Here are some of the main criteria that a patient would need to meet in order to be considered a good candidate:

Criteria for laparoscopic weight loss surgery:

According to the National Institutes of Health (NIH) consensus on gastrointestinal surgery for severe obesity, patients are candidates if they are morbidly obese (BMI > 40 kg/m2 or BMI ≥ 35 kg/m2 with co-morbidities), have failed attempts at diet and exercise, are motivated and prepared to make substantial changes in their eating habits, have no dependency on alcohol or drugs, well informed, free of significant psychological disease and have acceptable operative risks.

As mentioned previously, numerous therapeutic approaches to this problem have been advocated, including low calorie diets, medication, behavioral modification and exercise therapy. However, the only treatment proven to be effective in long-term management of morbid obesity is surgical intervention.

Surgically induced weight loss is associated with resolution or substantial improvement of co-morbid diseases in 75–100% of patients and reduced mortality compared with medically treated patients.

About the Author

Dr. Gabriel Rosales and his team are highly skilled surgeons, board certified and in continuous training. They are in constant pursuit of learning the latest innovations in minimal invasive surgery in order to offer patients the best care possible.

Even though Dr. Rosales likes performing general surgery procedures, in the last 5 years he has focused mainly on performing weight loss surgery since these kinds of procedures, specifically the laparoscopic Gastric Sleeve and Gastric Band have demonstrated to him that it is possible to offer patients a life changing experience.

After dedicating most of his practice in recent years to bariatric surgery, Dr. Rosales has a combined experience of performing and assisting in more than 1500 bariatric procedures. Website:

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