Weight Loss Surgery and Fractures
Severely obese patients undergoing weight reduction surgery usually tend to have accelerated fracture risks both earlier than and after the surgical procedure in comparison with obese and non-obese individuals who don’t need surgery, finds a study published in BMJ recently.
Weight problems is probably not as protective for fracture as what was initially thought, say the authors, and so they suggest that fracture risk evaluation and management must be part of weight reduction care.
Guidelines will have to be followed on patient adherence to dietary supplements and bodily activity, and patients should be brought to bone specialists if fracture chance is considerably high. Advantages and risks of surgery must be viewed individually to suggest the form of surgical process that is suitable to the patient because the efficacy of weight reduction surgeries differs in terms of resolution of long term conditions, they add.
This study was done by researchers in Canada and examined the incidence and sites of fracture in severely obese patients who had gone through weight reduction surgical procedure, and compared the results to obese and non-obese control subjects matched for age and sex.
Obesity and Fracture Risk
Data was gathered and analysed from Quebec Integrated Chronic Diseases Surveillance System (QICDSS) which studied 12,676 patients and 38,028 obese and 126,760 non-obese people in the control groups between the years 2001 to 2014.
Prior to the surgical procedure, 10.5% sufferers in the weight reduction surgical procedure group had a minimum of one fracture when compared with 8.1% obese and 6.6% non-obese people in the control groups.
After a median follow-up of 4.4 years, 4.1% of the weight loss surgery patients had at least one fracture in comparison with 2.7% of obese and a pair of.4% of non-chubby groups. The median time to first fracture was once 3.9 years.
These expanded fracture risks remained high even after adjusting for fracture history, quantity of comorbidities, material and social deprivation, and area of residence.
The fracture risk after the procedure transformed from a sample related to obesity within the distal lower limb fracture, to a pattern which is suggestive of osteoporosis in the upper limb, spine, pelvis, hip and femur.
The authors think that the extended fracture dangers are due to falls and obesity associated conditions, such as Type 2 diabetes, along with anatomical alterations, and dietary deficiencies induced by weight reduction surgery.
This is an observational study so conclusions will be made about rationale and outcome, and the authors noticed a few limitations, such as being unable to match members on body mass index, and lack of consideration to other motives that may have precipitated fractures, such as vitamin intake and drug use.
They conclude that by calling for more studies on preventative and therapeutic tactics the bad effects of weight reduction surgical procedures on the bone will decrease, due to the paucity of evidence and guidelines on this area.
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Reference: Science Daily
Written By: Dr. Marie Gabrielle Laguna Bedia