Health Education

Sleep apnea

Sleep apnea is a dangerous and growing problem in the U.S. and is closely related to the epidemic of obesity. Simply stated, sleep apnea is a disorder when a person’s airway becomes obstructed while asleep, causing problems ranging from loud snoring to a complete cessation of breathing, cardiac arrhythmias and low blood oxygen levels at its worst. The repeated episodes of apnea (lack of breathing) cause frequent nighttime awakening (thought the patient is often unaware) and hence broken, choppy, non restorative sleep. Sleep apnea was eliminated in 85.7 percent of bariatric surgery patients who participated in a landmark study published by the Journal of the American Medical Association (JAMA) in 2004.

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Diabetes

Type 2 diabetes is the form of the disease most closely linked to obesity. Approximately 90 percent of all diabetics in the United States are type 2 diabetics. The obesity rate has been climbing over the last several years. People carrying extra weight increases the chances of developing serious health problems like heart disease, stroke, as well as diabetes.

A recent study in the Journal of the American Medical Association (JAMA) found that 73 percent of people with diabetes who received gastric banding combined with conventional therapy achieved remission, which is defined as normal blood sugar levels and no need for diabetes medication. By contrast, just 13 percent of those who received only conventional therapy went into remission.

Additionally, within days of surgery and long before significant weight loss, many patients with type 2 diabetes experience complete remission. To learn more visit Ministry Health Care's Diabetes Services.

Hypertension

Being overweight, especially being defined as obese or morbidly obese, can have many negative impacts on your health. Among the health attributes that can be impacted is hypertension, or in other terms high blood pressure. Hypertension is the term used to describe high blood pressure. Blood pressure is a measurement of the force against the walls of your arteries as your heart pumps blood through your body. Blood pressure readings are usually given as two numbers -- for example, 120 over 80 (written as 120/80 mmHg). One or both of these numbers can be too high. The top number is called the systolic blood pressure, and the bottom number is called the diastolic blood pressure.

• Normal blood pressure is when your blood pressure is lower than 120/80 mmHg most of the time.
• High blood pressure (hypertension) is when your blood pressure is 140/90 mmHg or above most of the time.
• If your blood pressure numbers are 120/80 or higher, but below 140/90, it is called pre-hypertension.

Acid Reflux / GERD

Obese people who undergo minimally invasive gastric bypass surgery to lose weight may also experience a reduction in their symptoms of gastroesophageal reflux disease (GERD). From a high level, GERD occurs when stomach acid spills into the esophagus because of a faulty valve at the bottom of the esophagus. The result is chronic heartburn. For example, when you eat, food passes from the throat to the stomach through the esophagus (also called the food pipe or swallowing tube). Once food is in the stomach, a ring of muscle fibers prevents food from moving backward into the esophagus. If this sphincter muscle doesn't close well, food, liquid, and stomach acid can leak back into the esophagus. This is called reflux or gastroesophageal reflux. Reflux may cause symptoms, or it can even damage the esophagus.

The risk factors for reflux include:

• Alcohol (possibly)
• Hiatal hernia (a condition in which part of the stomach moves above the diaphragm, which is the muscle that separates the chest and abdominal cavities)
• Obesity
• Pregnancy
• Scleroderma
• Smoking

Joint Disease / Arthritis

Osteoarthritis is a degenerative condition that affects the joints in the knees, hips, and lower back. Over time, the cartilage (padding that helps cushion joints), and bones in joints wear away. This causes chronic pain.  Obesity leads to an increase risk of arthritis. The symptoms of osteoarthritis include pain and stiffness. These symptoms are worse in the obese population as joints are put under greater stress and pressure. Therefore, musculoskeletal problems like osteoarthritis are much more prevalent in the obese population than among normal weight individuals. Health studies show that obesity is a strong predictor of arthritis, especially in the knees. After bariatric surgery and the subsequent weight loss, the symptoms of osteoarthritis can be dramatically improved, avoided or completely resolved.

Pregnancy Issues Related to Obesity

Research has shown that women who are overweight or obese have a hard time getting pregnant. Studies have also shown that the more overweight the woman is, the lower her chances of pregnancy.  “Obesity during pregnancy is now a common condition affecting approximately 1 of 5 pregnant women”. (source: http://www.cdc.gov/reproductivehealth/maternalinfanthealth/PregComplications.htm)

Being overweight or obese during pregnancy can cause complications for you and your baby. If you’re overweight or obese, you’re more likely than pregnant women at a healthy weight to have certain medical problems during pregnancy. The more overweight you are, the higher your risk for problems. These problems include:

• Infertility, not being able to get pregnant
• Miscarriage, when a baby dies in the womb before 20 weeks of pregnancy
• Stillbirth, when a baby dies in the womb before birth but after 20 weeks of pregnancy
• High blood pressure and preeclampsia, a form of high blood pressure that only pregnant women get. It can cause serious problems for mom and baby.
• Gestational diabetes, diabetes that some women get during pregnancy
• Complications during labor and birth, including having a really big baby (called large-for-gestational-age) or needing a cesarean section (c-section)

Weight loss surgery may reduce your chances of pregnancy complications.  More than 50,000 women each year in the United States have weight loss surgery. It is recommended to wait 2 years after having weight loss surgery before you try to get pregnant. You may lose a lot of weight quickly during the first year after surgery. If you’re pregnant, this rapid weight loss could cause problems with the baby. Further discussion with your doctor about your pregnancy plans and how weight-loss surgery may affect them is recommended.