Cardiovascular disorders are the leading causes of death and heart attack, with obesity as the leading risk factor. Obesity and overweight have already become a global and constantly growing problem. Weight reduction is an important though quite a tough task. Diet and exercise can work for some patients, while for the others it does not. Individuals, who are severely obese, with a body mass index over 30, usually need additional help for weight loss to be more effective. Gastric bypass, also called stomach-stapling is the most popular,effective and long lasting treatment for morbid obesity and many related conditions.
More than 340,000 stomach-reduction surgeries are performed each year in the world. During the surgery a surgeon makes the stomach smaller and attaches it to the lower part of the intestine creating a small opening for food to pass through. The part responsible for the basic steps of digestion and absorption is bypassed, which leads to reduced amount of food taken into the bloodstream. After gastric bypass surgery patients experience early satiety and, consequently, eat smaller meals. As a result, the formation of fat tissue decreases.
Based on weight alone, obese people have twice the risk of developing cardiovascular diseases and death compared to normal weight people. Cardiovascular risk factors develop progressively with an increase in weight. Moreover, it is known that obesity is often accompanied by metabolic syndrome, also known as the insulin resistance syndrome which constitutes a constellation of metabolic abnormalities including glucose intolerance, hyperinsulinemia, dyslipidemia and hypertension. Clearly, high amounts of cholesterol, triglycerides and abnormal concentrations of lipids and lipoproteins are closely associated with premature and accelerated coronary atherosclerosis that increase the risk of coronary heart disease and heart attack and abnormal concentrations occur more frequently in overweight individuals. Weight control is considered as one of the most important tasks aimed at reducing the overall incidence of cardiovascular disease in obese patients.
Treatment of obesity should be based on its severity and complaints of the patient. Gastric bypass surgery is a relatively safe procedure, even for patients who have cardiovascular disease. In fact, various studies have shown that gastric bypass significantly reduces the risk of having a heart attack in patients with heart disease during the first year after surgery.
As a person loses weight, blood pressure goes down as well as the risks of cardiovascular complications. The reduction of weight also improves fasting blood glucose concentrations and the action of insulinand reduced serum triglycerides, low density lipoprotein and total cholesterol concentrations.
Not only the surgery for obesity results in sustained weight loss but it also improves or often resolves underlying conditions, including diabetes mellitus, hypertension, sleep apnea, lower extremity venous stasis, gastroesophageal reflux disease, nephropathy, left ventricular hypertrophy, degenerative joint disease, and nonalcoholic steatohepatitis in the majority of morbidly obese patients. The net effect is an increase in the quality of life. Through these effects and possibly other independent mechanisms bariatric surgery appears to reduce cardiovascular morbidity and mortality.
Undoubtedly, obesity surgery is a serious surgical intervention which involves certain risks. Postoperative complications occur in approximately 10% of the cases. Most common complications are deep venous thrombosis, anastomotic leaks, internal hernias, gastrointestinal bleeding and others. Some cardiac problems might occur in patients with cardiovascular diseases, because their hearts are required to do more extra work during any surgery or stress.
These problems might occur within 2 days after the surgery, therefore close monitoring should be done for patients who are at a higher risk. However, all postoperative patients need constant monitoring by their doctor to check for other potential problems. However, postoperative complications are usually outweighed by the serious health complications caused by morbid obesity, especially considering the most modern and increasingly safe bariatric surgery.