Gastric bypass and other weight-loss surgeries (collectively known as bariatric surgery) are made to help people lose weight; to lose excess weight. It is usually done when diet and exercise have not worked. The goal is to reduce the risk of obesity-related health problems, such as heart disease. But new research shows that, in addition, it can also reduce other complications that we did not expect.
The study carried out by the Medical University of Michigan (United States) followed 127 patients underwent weight loss surgery over the two years after the intervention. In the course of the investigation, they verified that the surgical procedure improved all the metabolic factors that increase the risk of suffering from diabetes. In fact, there was a sustained drop in blood sugar (glucose) levels, which were previously high, as well as in the levels of certain lipids (fats).
But the most surprising thing was to discover that bariatric surgery also had markedly improved peripheral neuropathya disorder that affects the density of nerve fibers that run from the spinal cord to the feet, causing weakness, numbness, and pain in the feet, as well as the hands.
“Our findings suggest that bariatric surgery likely allows for peripheral nerve regeneration and therefore may be an effective treatment for millions of people with obesity who are at risk of developing diabetes and peripheral neuropathy,” said Brian Callaghan, MD. , study author and neurologist at the American University. Likewise, he adds that “The metabolic and neurological improvements were impressive after bariatric surgery.”
Callaghan noted that bariatric surgery is typically reserved for patients who “have tried and failed to lose weight, especially those with a very high body mass index (BMI),” a standard measure of obesity. This study opens the door to seriously consider this intervention when the patient has diabetes, because perhaps it can not only be controlled, but also refer.
Losses of more than 30 kilos
Patients in the study were 18 years or older and had a BMI of 35 or greater. Anyone with a BMI of 30 or more is classified as obese. All underwent bariatric surgery at some point between 2015 and 2018. To assess peripheral neuropathy status, skin biopsies were taken before surgery to measure the density of nerve fibers in the thigh and lower leg. Blood tests to measure blood sugar and lipid levels were also performed before the operation.
Two years after the intervention, just over 60% of patients underwent testing in-person follow-up, along with approximately 20% who undertook virtual follow-ups due to the onset of the Covid-19 pandemic.
On average, patients had lost more than 30 kg. The team found that almost all metabolic risk factors – including blood sugar and lipid levels – were “significantly improved”, although no improvements were seen for blood pressure or total cholesterol levels.
Improving metabolic profiles appeared to have a positive impact on both prediabetes and diabetes risk, with improvements observed in 54% of patients and stabilization in approximately 44% of them.
Reduced pain from previous nerve injuries
As for peripheral neuropathy, the researchers found that the surgery had resulted in improvements in nerve fiber density throughout the thigh, suggesting that the intervention had stimulated the regeneration of damaged nerves. Nerve fiber density in the leg stabilized.
Patients undergoing weight loss surgery also experienced a significant decrease in pain associated with previous nerve injuries. In addition, they reported significant improvements in general quality of life and that related to neurological problems in the feet.
Callaghan noted that more research is needed to better understand how weight loss surgery triggers these neurological benefits. “We think weight loss is an important factor, especially since diet also seems to improve peripheral neuropathy,” she said, adding: “It will be something very important to study in the future”. In fact, his team has already embarked on other research that will explore whether exercise, bariatric surgery, or both are more helpful for peripheral neuropathy.