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I Have a Chronic Disease. Can I Get Weight-Loss Surgery?

If you’re obese and have a chronic disorder, such as Parkinson’s disease, multiple sclerosis, heart disease or epilepsy, you may think it’s too risky to have weight-loss surgery.

In most cases, just the opposite is true. You can benefit from having bariatric surgery to lose weight when you have a chronic disease. You’ll have to be extra careful about which weight-loss procedure to choose and about monitoring nutrients afterward, but that shouldn’t stop you. Being thinner will be a boon to your health.

Take Precautions

We know for sure that major weight loss will help patients who have diabetes, hypertension, hyperlipidemia (a high level of fat particles in your blood), fatty liver and metabolic syndrome.

Other chronic diseases offer more challenges and might complicate your journey. You’ll need your team of specialists to consult with one another beforehand so they can consider issues unique to your situation.

In addition, three general areas of concern might dictate which type of bariatric procedure you have. Be sure to discuss these issues with your surgeon before making a final decision.

  • Reflux. If you have acid reflux regularly, some weight-loss surgeries, such as sleeve gastrectomy, will be wrong for you.
  • Barrett’s Esophagus. If you have changes in the lining of your esophagus, known as Barrett’s esophagus, gastric bypass will be a better choice for you than a sleeve gastrectomy.
  • Nutrients. You’ll need to take extra steps to keep some nutrient levels high with certain medical diagnoses. For example, multiple sclerosis patients need to watch their vitamin D numbers carefully. In such cases, you’ll likely be advised to choose a sleeve gastrectomy because you’ll continue absorbing all the nutrients you ingest; that is not the case with some other bariatric options.

Weighing Less Can Help You

Chronic diseases don’t go away, but being thinner will enable you to move around more easily, which is a healthier, and more enjoyable, way to live.

Here are some examples of how weight loss might help, depending on your medical situation:

  • Chronic kidney disease. According to statistics, you’re likely to live longer after losing weight. A recent study shows that the five-year mortality rate plummets nearly 80 percent for those who’ve thinned down. Once you’re slimmer, your blood sugar level and kidney function are likely to improve.
  • Blood sugar issues. If you have Type 2 diabetes and a high BMI, your diabetes might go into remission for as many as seven years if you have bariatric surgery and then lose weight. This outcome isn’t guaranteed, of course, but then again, your experience might be even better: Research shows greatly reduced weight might lead to fewer eye, nerve and kidney complications as well as a reduced risk of stroke and heart attack.
  • Heart disease. It takes more work for your heart to pump when you’re severely overweight than when you’re not. As a result, your heart will be less strained, and therefore less at risk, following major weight loss.
  • Parkinson’s disease. If you’ve put on pounds from being less physically active due to Parkinson’s, sleeve gastrectomy might help you lose then stabilize weight, according to limited studies. That in turn can lead to a healthier heart and the need for 25 percent less levodopa medication.
  • Chronic liver disease. If you have cirrhosis or another liver issue, your medical team will have to consider a broad range of factors before recommending bariatric surgery. Bariatric surgery is not recommended if you have severe portal hypertension. However, for patients with cirrhosis who do not have severe portal hypertension, a sleeve gastrectomy is often the preferred surgical option. The weight you’ll lose in the long term might help you live longer, but you will need to give up alcohol. Studies have shown that when people with non-alcohol fatty liver disease have weight-loss surgery, the liver improves in most cases. This includes reductions in fat buildup in liver cells, liver cell swelling, inflammation in the liver and the formation of scar tissue (fibrosis).

How To Proceed

While everyone prepares for weight-loss surgery by switching to a liquid diet beforehand, you might need to take more actions. If you’re on blood thinners, for example, you will need to wean off beforehand. Your care team might cut your other medication doses before or after, too.

Afterward, like all bariatric patients, you’ll be required to take specific doses of vitamins and minerals after surgery. That edict might remain the new norm for the rest of your life, depending on your situation. If you have some chronic diseases, expect regular blood tests to check for nutrient levels to make sure your numbers are at their peak.

Do the math. Dealing with supplements and blood tests is worth the price to weigh less, be more mobile and put less strain on your heart and other organs. You can make your life much better even if you have a chronic disease.

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