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Excess Skin After Bariatric Surgery

>> Saturday, May 4, 2013









On the second day of the Canadian Obesity Summit, I had the honor of being asked to act as a judge for a number of excellent research presentations during the poster session.  First, a heartfelt congratulations to all of the presenters - I was truly impressed by all of your efforts and studies, and I enjoyed each of our stimulating conversations!

A study that really struck a chord with me, and which I feel is really important to share, was a study looking at the impact of excess skin on physical activity in women who have had bariatric surgery.  The reason for doing this study is that over 70% of patients who have bariatric (obesity) surgery are left with excess skin that interferes with physical and social functioning. The research, conducted by A Baillot and colleagues at the University of Sherbrooke in Quebec, administered questionnaires to 26 women who had had bariatric (obesity) surgery at least 2 years prior, asking women about how their excess skin impacted them physically, psychologically, and socially.

They found that 77% of patients reported that their excess skin was making mobility during physical activity difficult, and that almost half were avoiding physical activity because of their excess skin.  What really hurt my heart was that when these women were asked why the excess skin caused them to avoid physical activity, the most common reason cited was that they were concerned about people staring at them (other reasons were hygiene concerns, weightiness of the excess skin, and a feeling of 'sloshing' of the skin).

My take home message from this study is that the likely development of excess skin after obesity surgery is something that needs to be discussed in detail with patients prior to having surgery, such that they are prepared for the physical, psychological, and social challenges that they may perceive or encounter.

And, as always, it is my hope that with education of our society, that any obesity related stigma that may exist out there will continue to decrease until it disappears entirely.  I was asked a lot at the summit as to why I blog - this reason would be amongst the highest.

Dr Sue Pedersen www.drsue.ca © 2013 

Follow me on Twitter for daily tips! @drsuepedersen

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Nutritional Support After Bariatric Surgery





Today, I would like to kowtow to my friend and colleague Dr Priya Manjoo, endocrinologist at the University of Victoria, who gave a fantastic talk about nutritional support of the bariatric patient at the Canadian Obesity Summit


I'll highlight a few of the key points here: 

1.  Prior to obesity surgery, many patients are already often deficient in nutrients; for example, one study showed that 65% of patients were deficient in vitamin D before surgery, and 27% were deficient in iron.  Therefore, it is imperative that these levels be checked and corrected before surgery is undertaken. 

2.   Following obesity surgery, there are a number of reasons why nutritional deficiencies can occur,  including insufficient intake due to dietary restrictions and food intolerances, anatomical causes due to changes made in the intestinal anatomy, and a disconnect between the timing of release of digestive enzymes and entry of food into the intestine. 

3.  Dr Manjoo then went through a fabulous review of the various vitamins and nutrients that we need to be on the watch for after bariatric surgery.  Adequate protein intake, and monitoring and supplementation (depending on the type of surgery) of calcium, vitamin D, iron, vitamin B12, folate, thiamine, zinc, copper, and selenium are all things that we need to think about.

Finally, as previously blogged, she pointed us towards the 2013 American Bariatric Guidelines for some guidance on this complex topic. 

Thanks Priya for a fabulous session!

Dr Sue Pedersen www.drsue.ca © 2013 

Follow me on Twitter for daily tips! @drsuepedersen

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