Can Malnutrition cause obesity?

How Malnutrition Can Cause Obesity: Insights from Top Bariatric Surgeons

Obesity is a multi-factorial disease; it simply means that, no single cause which can be solely attributed to it. It is also well known that scientists do not know exactly what exactly causes weight gain.  Often, we all see people who can eat whatever comes their way and they still remain thin. With the exception of these lucky few, we are programmed to gain weight with age.

According to top bariatric surgeons, it is a matter of the balance between what you eat, and how much you spend. If we consume calorie-dense food regularly and don’t burn those extra calories, we are likely to gain weight. But can malnutrition cause obesity?

 Surprisingly yes.

Obesity Surgeons who treat obese teens know that children who were underweight at birth are prone to gain too much weight in their childhood and adolescence. Children who faced food shortages during famines later on developed abdominal obesity, the classic Indian Subcontinent profile of thin people with paunch, the so-called thin- obese in medical jargon. As we know that the tummy fat or abdominal obesity is the medically worst. This fat is the harmfully active type that leads to diabetes, heart disease, and cholesterol disorders, the so-called metabolic syndrome.

Malnutrition means not eating right; right food at the right time. People who starve for too long to lose weight are initially successful in losing some weight, but complex hormonal reactions result in weight regain, overshooting the earlier weight. This is known Yo-Yo dieting. Secondly, prolonged fasting slows down our metabolism and stops losing further weight, and starts regaining on the same diet. We tend to lose more muscle mass than fat during the starvation phase and fail to regain our muscle back. So with each dieting cycle of malnutrition, we lose more and more muscle mass and gain more fat.

Starvation or fasts followed by eating calorie-rich low protein food ultimately results in further weight gain and obesity. The best bariatric surgeons know well from their experience that protein-deficient diets after bariatric surgery are counterproductive in the long run and patients may end up regaining all their weight.

Malnutrition can really make us obese.

Still confused that malnutrition can cause obesity? Visit us at Smart Cliniqs and learn more about obesity.

Bariatric Surgery Hospital in Delhi

Choosing the Best Bariatric Surgery Hospital in Delhi for Effective Weight Loss

Delhi is the popular destination for medical tourism. Patients from every corner of the world come to Delhi, India for bariatric surgery. Many hospitals in Delhi are currently performing the surgery. Bariatric surgery hospitals in Delhi are specialized centers with trained and expert surgeons and specialized paramedic staff. In Delhi, both private and government hospitals are performing bariatric surgery. To name a few, private hospitals like Indraprastha Apollo hospitals, Max Healthcare, BLK super specialty, Fortis, Medanta hospital are performing bariatric surgery in Delhi. Premier government hospitals like All India Institute of Medical Sciences (AIIMS), Ram Manohar Lohia (RML), Lok Nayak Hospital (LNJP) are also performing bariatric surgeries.

Roux-en-y- gastric bypass surgery is the “gold standard” procedure. It refers to a type of bariatric surgical procedure in which the stomach is divided into a small pouch and then the small intestine is rearranged and connected to the newly created pouch. Roux-en-y- gastric bypass surgery is used to promote weight loss and also improve weight related issues like type 2 diabetes, hypertension, high cholesterol, arthritis, sleep apnea, infertility, hypothyroid, joint pain, backache etc.

Obese patients have a compromised vitamin and mineral intake due to excess energy consumption. Drastic weight loss post roux-en-y-gastric bypass surgery compounds the already present vitamin and mineral deficiencies. Patients who undergo Roux-en-y-gastric bypass surgery should attend regular follow-up sessions with a registered dietician so that deficiencies could be identified and treated at an early stage.

Obesity in Children and Adolescents

Addressing Obesity in Children and Adolescents: Causes, Risks, and Effective Interventions

The prevalence of obesity is increasing in both children and adolescents, in both sexes and in various ethnic and racial groups.

Many factors, including genetics, environment, metabolism, lifestyle, and eating habits, are believed to play a role in the development of obesity. However, more than 90% of cases are idiopathic; less than 10% are associated with hormonal or genetic causes.

Defining Obesity in Childhood and Adolescence

There is no single definition of obesity in childhood and adolescence.

Consensus committees all over the world have concluded that children and adolescents be considered overweight or obese if the BMI exceeds the 85th or 95th percentiles, on curves generated from the 1963-1965 and 1966-1970 NHANES, or exceeds 30 kg/m2 at any age.

Energy Intake and Sedentary Lifestyle

During childhood and adolescence, excess fat accumulates when total energy intake exceeds total energy expenditure. Reduced energy expenditure is attributed to modern-day sedentary lifestyles. This is particularly associated with excessive television viewing, excessive computer use, and insufficient physical activity. Also, this is often seen when feedings are supplemented with additives such as carbohydrates or fat.

Hormonal Dysfunction and Familial Obesity

Some hormonal dysfunction like that in ghrelin leptin hormonal axis may be the causative factor in as many as 10% of obese children, particularly in those who appear to manifest familial morbid obesity.

Race and ethnicity are also associated with increased rates of obesity in children and adolescents.

Childhood Obesity as a Predictor of Adult Obesity

Childhood obesity is predictive of adult obesity such as with 80% of teenagers who are obese continue to be obese as adults.

This is associated with an increased incidence of type 2 diabetes, hypertension, gallstones, and hypercholesterolemia.

Chest Conditions Associated with Childhood Obesity

There are serious chest conditions associated with childhood obesity like reactive airways, poor exercise tolerance, increased work of breathing, and increased oxygen consumption.

They might develop obesity-hypoventilation syndrome and experience right-sided heart failure with right ventricular hypertrophy.

Acute Complications of Childhood Obesity

Acute complications of childhood obesity include hyperlipidemia, accelerated growth and bone maturation, ovarian hyperandrogenism and gynecomastia, cholecystitis, pancreatitis, and pseudotumor cerebri.

  • There is an increased incidence of fatty liver and they might develop liver cirrhosis and kidney disease.
  • Obstructive Sleep apnea and sleep-disordered breathing are common in children and adolescents with obesity which might lead to neurocognitive dysfunction.
  • Excess weight in children can cause numerous orthopedic disorders, including genu valgum, slipped capital femoral epiphysis, with bowing of the long bones.
  • Emotional and psychosocial sequelae are also widespread in obese children.
  • Social isolation, peer problems, and lower self-esteem are frequently observed.
  • Gout and colorectal cancer rates are found to be increased among men who had obesity as adolescents as well as arthritis.

Therapeutic Interventions for Childhood Obesity

Any therapeutic intervention in the child with obesity in aimed to achieve control of weight gain and reduction in body mass index (BMI) safely and effectively and to prevent the long-term complications of obesity in childhood and adulthood.

These might also require psychiatric assistance for unusual eating disorders or severe depression. It involves a team involving nurse educators, nutritionists, exercise physiologists, and counsellors.

Parental Involvement and Lifestyle Changes

Parents must advice children to walk at least 20 to 30 min daily. Limit their television timings and must indulge in vigorous exercise with children. Low-calorie balanced diet, in association with patient and parent education, behavioral modification, and exercise can limit weight gain in many patients with mild or moderate obesity. Reductions in total and saturated fat may be particularly useful in adolescents who consume large quantities of high-fat, snack, and packaged fast foods, including french fries, pizza, chips, and crackers. Also, they might sometimes require and care if evidence of psychopathology or dysfunction is present.

Bariatric Surgery for Childhood Obesity

According to Dr. Atul NC Peters, one of the pioneers of weight loss treatment in Delhi and among the top 10 obesity surgeons in India, various bariatric surgical procedures have been performed in “carefully selected” patients with a body mass index (BMI) >40 kg/m 2 who have severe comorbidities such as nonalcoholic fatty liver disease. It is important to consider several other factors before deciding whether a child or adolescent should undergo bariatric surgery like previous attempts at weight loss, and ability to adhere to follow-up care. Laparoscopic sleeve gastrectomy is the most widely performed procedure in childhood obesity nowadays.

Evidence suggests that bariatric surgery can decrease the grade of steatosis, hepatic inflammation, and fibrosis in Non-Alcoholic Fatty Liver Disease. With more and more people opting for various bariatric surgical procedures, weight loss surgery cost in Delhi has been such that it is becoming affordable day by day and several finance and loan schemes are also available in special circumstances.

Bariatric Surgery in Delhi

The Rise of Bariatric Surgery in Delhi: A Comprehensive Solution for Obesity and Type 2 Diabetes

Increasing Prevalence of Obesity

There is a dramatic increase in prevalence of obesity. The traditional approaches like dietary and lifestyle modification, physical activity, and pharmacotherapy fail to facilitate weight loss and treat obesity. So, bariatric surgery is the most sustainable treatment option. Bariatric surgery also promises improvement in obesity-related comorbidities like type 2 diabetes, hypertension, dyslipidemia, arthritis, etc. so, the term bariatric surgery is now replaced with bariatric and metabolic surgery. These days metabolic surgery for diabetes has emerged as a proven tool for the resolution or control of type 2 diabetes. This weight loss treatment in Delhi is being done only at specialized centers, by adequately trained and expert surgeons. Thus it gives a permanent cure to this traditionally regarded as a progressive, unrelenting disease called type 2 diabetes.

Bariatric Surgery in Delhi

In the last few years, there has been an increase in weight loss treatment in Delhi. Many centers are currently performing bariatric surgery. Patients from every corner of India prefer to come to Delhi for bariatric surgery owing to the availability of the best medical facilities, trained and experienced bariatric surgeons, and specialized paramedic staff. Even International patients prefer Delhi, India for bariatric surgery.
Sleeve gastrectomy and roux-en-Y gastric bypass are the most commonly performed weight loss procedures. Metabolic surgery for type 2 diabetes targets patients with uncontrolled diabetes who are currently on oral drugs and insulin. Scientific literature reports that bariatric and metabolic surgery results in weight loss, improvement/ normalization of blood sugar levels, reduction/ withdrawal of diabetes medications, and decrease in cardiovascular disease risk factors. It is a simple procedure and the patients may be able to leave the hospital in one day or even the same day in selected cases.

Comparing Surgical Procedures

In patients with reflux disease and type 2 diabetes, the results of sleeve gastrectomy may be inferior to the roux-en-Y gastric bypass but the excess weight loss of both the procedures may be comparable in a select subgroup of patients.

Nutritional Considerations Post-Surgery

Nutritional deficiencies are present in obese patients as consumption of a high-energy diet compromises on protein, vitamin, and mineral intake. As Sleeve gastrectomy and roux-en-Y gastric bypass involve removal or bypassing of some parts of the stomach and /or small intestine, so, macronutrient (protein) and micronutrient deficiencies (calcium, iron, B12, vitamin D, folate, etc.) are very likely to occur post-operatively in the patients. Nutritional assessment remains the key component pre-operatively and post-operatively to identify, prevent, and treat nutritional deficiencies at an early stage. Nutritional assessment involves taking physical measurements of the body (height, weight, etc.), analyzing blood and urine samples, identifying deficiency signs and symptoms, and performing a comprehensive dietary assessment.

Ensuring Surgical Success

Consuming a well-balanced energy-restricted diet with vitamin and mineral supplements and timely follow-up with the bariatric team promises success of the surgery.

Weight loss surgery in India

Why India is Emerging as a Top Destination for Weight Loss Surgery

Rising Obesity Rates in India

With the persisting need to address the problem of malnutrition, India has developed another nutritional problem, obesity. According to the National Family Health Survey 4, the number of obese people in the country has doubled in the last decade.

Obesity and Type 2 Diabetes

It is a known fact now that obesity is the major reason for developing Type 2 Diabetes. Several studies have revealed that obesity accounts for 80-85% risk of developing type 2 Diabetes. Moreover, most of the world’s population lives in countries where overweight and obesity kill more people than underweight.

Bariatric Surgery as an Effective Solution

Bariatric surgery is now more efficacious than lifestyle changes or medical treatment for sustained weight loss and remission of Type 2 Diabetes.

Cost-Effectiveness of Bariatric Surgery

The cost of weight loss surgery versus the cost of medicines and lifestyle changes has been debated extensively. Similarly, not only savings but also cost-effectiveness of weight loss surgery have also been discussed. Various studies have demonstrated cost-effectiveness and cost savings for bariatric procedures compared with usual medical care or intensive lifestyle interventions. All of these studies have been carried out in setups where weight loss surgery has been expensive as compared to the eastern world.

Delhi: A Hub for Medical Tourism

New Delhi, the capital city of India has now become a popular destination for medical tourism. Millions of foreign tourists visit India annually for their medical needs.  There are many world-class and reputed hospitals in Delhi, which provide exemplary services in the field of medical care. The presence of highly qualified and experienced weight loss surgeons along with institutions of international repute have made Delhi a prime city for weight loss surgeries in India.

Reasons to Choose India for Bariatric & Metabolic Surgery

According to Dr. Atul NC Peters, Senior Consultant and Head of Apollo Institute of Bariatric and Metabolic Surgery, Indraprastha Apollo Hospitals, New Delhi, more and more patients are flying from the Western world for bariatric surgery in India. Not only for weight loss surgery, but people have also started travelling for metabolic surgery for Diabetes in India. Reasons for choosing India as a favorite destination for Bariatric & Metabolic Surgery are innumerate, a few of them being:

  • Bariatric Surgery cost in India is approx. half to one-third of the cost of the Western world.
  • There are no long waiting lists, as patients seeking weight loss surgery in Delhi are given almost immediate treatment.
  • International accredited hospitals and surgeons.
  • Dedicated bariatric surgical program which includes a team of expert surgeons, nurses, dieticians, and bariatric care specialists.
  • Fully equipped operation theaters with trained anesthetist.
  • Dedicated intensivist with exposure to more than a thousand operated bariatric surgical patients.
  • Safe and effective results.
  • Long-term follow-up schedules.
  • Options for single incision surgery.
  • Options of Robotic Surgery.

Hence India is now a preferred destination for weight loss surgery as well as metabolic surgery.

How Does Bariatric Surgery Reverse Diabetes?

How Bariatric Surgery Can Reverse Diabetes and Improve Overall Health

Obesity is the root cause of diverse diseases such as Asthma, sleep apnea, cardiovascular problems, Type 2 Diabetes Mellitus, joint pains and most important some forms of cancers.

Obesity increases insulin resistance in the body leading to Type 2 Diabetes Mellitus, and also results in Metabolic Syndrome.

There are various ways to deal with these problems which include changes in lifestyle and modification in the eating habits and use of certain drugs. But almost all of the studies conducted have come to the conclusion that these therapies are not effective in providing sustained weight loss. Bariatric surgery has been the most effective treatment option till date which results in effective and sustained weight loss along with resolution of the other problems associated with obesity.

There are various bariatric and metabolic surgical procedures available which can be done by Laparoscopic Techniques as well as with Robotic assistance. They include Sleeve gastrectomy, Roux-en-Y gastric bypass, Mini Gastric Bypass, Ileal Interposition, Duodeno-Jejunal Bypass, and so on.

Mechanism of resolution of Diabetes Mellitus:

The intestine is now considered as a metabolic organ and this new insight can be utilized for the treatment of Diabetes. Bariatric and metabolic surgery leads to changes in the anatomy of the gastrointestinal tract resulting in the treatment of obesity and diabetes mellitus.

Reason Behind How Bariatric Surgery Reverse Diabetes?

The quick lowering of blood sugar after bariatric surgery is due to hormonal changes after re-routing of the small intestine and not purely do the restriction of the calorie intake. It has been proposed and proved that after bariatric surgery there is an augmented release of certain hormones like GLP-1 and PYY from the small intestine that leads to improvement in the high blood sugar levels. These hormones not only decrease the cellular resistance to insulin, they also increase the efficiency of insulin. There is also decreased production of glucose from the liver due to their effects.

After surgery, long-term follow-up for the best results is a must. It’s a complete lifestyle change. One must follow instructions carefully for optimum results.There are absolute guidelines decided by the international diabetes federation for the selection of patients who can be benefitted from surgery.

These surgeries must be done at the best bariatric and metabolic surgical centers doing these surgeries routinely and under expert care and experienced hands. Although hospital stay remains from 2 to 3 days, a strict and regular follow-up is a must.

Obesity Discrimination and Gastric Bypass Surgery

Understanding Obesity Discrimination: Types, Impact, and Effective Solutions

Definition: Obesity Discrimination

Obesity discrimination can be defined in either of several ways, including:
1. The unjust treatment of an overweight or obese person based on bias, or misconception.
2. Ill-treatment of obese people purely because of their weight as compared to non-obese people.

There are mostly four types of discrimination prominently described: Employment, Health Care, Education, and Relationships

Employment Discrimination:

Several studies have shown that obese people find more difficulty in finding a job, are paid lower wages, are discriminated against in promotions, and have more likelihood of early termination.

Healthcare Discrimination:

It is unfortunate that even, doctors and healthcare workers are not immune from obesity discrimination. It is a place where caring, trust, and unbiased treatment should be guaranteed. The problem is, that most of the doctors do not have a sound knowledge of obesity or its treatment.

Physicians spend less time discussing health with obese patients. They are more biased towards technical issues rather than discussing nutrition to patient’s obesity.

Discrimination at Schools:

At schools, discrimination is a bigger concern. It causes emotional distress, as children who are obese are less likely to succeed. It appeared in various studies that young men had a much lower chance of attaining higher education than their normal-weight counterparts. Obesity was also associated with lower educational attainments than normal-weight students.

Discrimination in relationships:

When it comes to finding a romantic partner, obesity appears to play a big role, especially for women. When studied among people, it was found that boys were less interested in looking for obese women.

Effectively Addressing Obesity Discrimination: Tips For All 4 Types Of Discrimination

The ideal solution is obvious: weight loss treatment.

Finding the medically supervised weight loss treatment program composed of the right diet and exercise is the most appropriate first step.

Research has shown diet and exercise programs supervised by a medical professional to be much more effective than doing it alone.

If your body mass index is over 35 which means that you are morbidly obese and attempts at sufficient weight loss, even under a medically supervised program, have yielded no results, you may be a candidate for weight loss surgery or laparoscopic gastric bypass surgery.

It has been proved time and again that bariatric surgery results in sustained weight loss in morbidly obese people. In other words, Bariatric surgery may improve occupational outcomes in morbidly obese individuals by reducing levels of unemployment and absenteeism. The evidence regarding this is limited and studies are needed before any conclusions could be drawn on this aspect. Similarly, there could also be economic, social, and psychological benefits of bariatric surgery which might help in improving relationships among individuals after weight loss.

It is advisable to visit a well-experienced bariatric surgeon as they usually have more knowledge about caring for obese patients, and they also work with doctors who are empathetic toward the difficulties of being obese.
Similarly, the research suggests that an obese child, especially an obese girl, is more likely to succeed in schools where obesity is more common.
If you find that your weight is getting in the way of your romantic relationships, several options may help:

First and foremost: weight loss treatment
• Consider dating partners who are also overweight or obese
• Choose partners who are willing to get to know you as a person before judging you only by your appearance

Consider Laparoscopic Gastric Bypass Surgery if you are morbidly obese.
There are certain non-surgical options also available like endoscopic intra-gastric balloons which are available these days to lose weight for overweight people.

These methods are temporary but might result in good outcomes for people who are serious and motivated.

Importance of Protein Post-Bariatric Surgery

The Power of Protein: Essential Post-Bariatric Surgery Nutrition for Optimal Weight Loss

Protein is practically a component in each cell of our body. It is known for their ability to build and repair our tissues. Along with carbohydrates and fats, protein is also called a MACRONUTRIENT, which means the body needs a large amount of it for daily wear-and-tear activities. In your first consult with Team Bariatric, you are made familiar with the diet post-weight loss surgery, and the importance of protein is explained as a top priority.
A meal rich in protein and low in carbohydrates will help you lose weight faster, as protein makes the digestive system work harder to metabolise and digest the food. In simple words, you will burn more calories when you consume proteins.

What is your protein requirement?

Generally as per the RDA, an adult needs 50-60 grams of protein per day, but these recommendations change post your surgery. ASMBS recommends 60- 90g of protein daily, depending on their medical conditions, type of surgery, and activity level.

5 Best Sources of Protein Post-Bariatric Surgery

Meat and Poultry

This group is one of the most generous sources of proteins for you. 1 serving of 30 grams would give you approximately 7 grams of high biological value protein, which is easy to absorb by the body, and good news it is nearly free from carbohydrates. Choose only lean meats and don’t forget to remove the skin and fat.

Fish

Fish has been known to be the best source of not just protein, but also omega-3 fatty acids. 30 grams of fish would give you roughly 7 grams of protein and a good dose of healthy fats. Try flaky fish, including tuna, tilapia, or salmon.

Egg

Egg is my favorite and most versatile ingredient. One serving equals one egg or two egg whites, which gives you roughly 7 grams of proteins. Prepare eggs without added fat by using a nonstick pan. Make an omelet or scrambled eggs of whole eggs or egg whites with spinach, onions, cheese, or chicken for added nutrition.

Legumes

Dried pulses and peas, provide about 7 grams of protein in one cup. Add kidney beans (Rajmah) or chickpeas (white channa) or Black Channa to your salad or mix brown rice with peas. A mixture of rice and pulses becomes a source of complete protein. Soy and its products are another great source of protein for you.

Milk and Its Product

Dairy provides you with both calcium and protein, but choose the nonfat or low-fat options to avoid consuming too many calories. One cup of skim milk gives 8 grams of protein. Low-fat plain yogurt or curd is very good for maintaining the healthy bacteria’s in the gut and drinks made using it can be great to meet your protein and water requirements of the day. Buttermilk is your best bet. Paneer or low-fat cottage cheese can be used very flexibly.

Along with the above food items it is always recommended to include a high-quality low-calorie protein powder in your daily diet to help you meet your protein requirement.

Conclusion

It is best to discuss your protein requirements and options with your bariatric dietitian. They will help you plan your meals so that you can get the best result from your weight loss surgery. It is a very vital step towards a “new you”.

Good Luck

Home Care After Bariatric Surgery

Essential Care After Bariatric Surgery: Tips for a Smooth Recovery at Home

Now that you have been discharged from the hospital and have reached home, you might feel relieved but also apprehensive about home care after bariatric surgery. You might worry about whether stitches could break, experience pain at home, or have questions about how much to walk and whether or not to take a bath. These are some helpful points for your guidance.

Wound Care

  • Change the dressings every day, if your doctor tells you to do so. Be sure to change your dressing always whenever it gets dirty or wet.
  • You may have bruising around your wound or redness around the incisions, do not panic, this is normal.
  • Avoid wearing tight clothing to prevent rubbing against your incisions.
  • Stitches or staples are usually removed within 7 to 10 days after surgery. some stitches dissolve on their own. Your doctor will tell you if you have them.
  • You can have a shower when advised by your doctor, let the water run over your incision, and do not scrub over the incisions.

Personal hygiene

  • Take a shower daily.do not rub the wounds. let only water run on your incisions
  • You can oil massage and wash your hair daily to feel fresh and active
  • Change your clothes daily
  • Clean your skin folds well with soap and water once a day and keep them dry, especially during the rainy season

Activity

  • Walk as much as you can, move around, and use stairs at home
  • Do not lift things heavier than 5 to 7 kgs in the initial months
  • Increase your exercise slowly
  • Take short walks
  • Get up and move around if you have some pain in your belly, it may help
  • Do not join the gym until recommended by your doctor.

Follow-up

  • To help recover from surgery and changes in your lifestyle, see your surgeon regularly and other health care providers.
  • The dietitian will teach you to eat correctly with your small stomach.
  • The psychologist can help you deal with the feelings or concerns you may have after surgery.
  • Blood tests are important as recommended by your surgeon, get them done timely to prevent vitamin and mineral deficiencies.

When to Call the Doctor

  • Temperature is above 100°F.
  • You have redness, pain, swelling, or bleeding around your incision
  • You have pain that your pain medicine is not helping
  • You have breathing difficulty
  • You cannot eat or drink
  • You are vomiting after eating

These simple precautions will help you tide over the initial difficult time at home after your bariatric surgery. Bariatric surgery is the best way to lose weight and regain health.

Infertility in Women and Bariatric Surgery

Improving Infertility in Women with PCOS: The Impact of Bariatric Surgery on Reproductive Health

The relationship between PCOS, obesity and infertility has been documented for many years. Anovulation, miscarriage, impairment in follicle formation and altered activity are the known effects of these. These women also face difficulty in managing diabetes, pre-eclampsia, growth disorders, higher rates of caesarean delivery, higher maternal mortality, and increased children’s risk for metabolic disease in the future.

A considerable weight loss can increase the chances of spontaneous ovulation, which is why the solution – bariatric surgery. This surgery is known to improve both fertility and pregnancy in women with reproductive concerns, polycystic ovarian syndrome (PCOS), along with metabolic syndrome (MS).

Bariatric Surgery’s Positive Effect on Women

Bariatric surgery in reproductive-age women has been shown to decrease menstrual irregularities. Women suffering from hormonal imbalance show considerable improvement postoperatively, and chances of conceiving increase after this surgery. Sensitivity to leptin levels increases post-surgery, reflecting improved reproductive metabolic status. Many women (about 10%-25%) with subclinical hypothyroidism, haven also shown a significant improvement following surgical weight loss.

Women already take pregnancy into consideration when electing for bariatric surgery. Nowadays women undergoing surgery are aware of their own reproductive risks and a significant number of these women are thinking ahead.

Studies on Infertility in Women and Bariatric Surgery

Bariatric surgery has attracted the interest of many scholars with more individuals showing improved fertility post-weight loss treatment. An older study implied that a BMI drop greater than 5 kg/m2 was a significant predictor of fertility within 2.5 years of follow-up after surgery. There was also a trend of a reduced need for fertility treatment in women conceiving within 3 years of weight loss surgery compared to their need for fertility treatment prior to surgery. Reports also show previously anovulatory women conceiving post-operatively without ovulation induction agents.

Comparing Pregnancy Outcomes in Women Pre and Post-Bariatric Surgery

A study comparing pregnancy outcomes in women before and after weight loss surgery showed improvements in pregnancy-related hypertension and diabetes mellitus, and a significant drop in caesarean delivery rate too. Moreover, bariatric surgery did not result in increased rates of post-partum haemorrhage, infection, shoulder dystocia or foetal demise.

The benefits of bariatric surgery in women suffering from PCOS with metabolic syndrome are discussed extensively on various platforms, leading in favour of surgery in such cases. Nutritional and vitamin deficiencies in these women during that time frame of rapid weight loss can be dealt with supervised supplementation and regular follow-ups with the surgeon and obstetrician. There were no differences in maternal complications, foetal outcomes or delivery complications, making bariatric surgery a highly recommended solution and one of the best ways to lose weight in morbidly obese people.