Our Summary

This research paper investigates how common Cushing’s syndrome (a hormonal disorder which can cause weight gain and obesity) is in extremely obese patients who are preparing to undergo weight loss surgery. The researchers looked at the medical records of 1037 severely obese patients who were assessed for hormonal issues before their surgery between 2012 and 2019. They used a specific test (the 1 milligram dexamethasone suppression test) to check for high cortisol levels, a sign of Cushing’s syndrome. The researchers found that a small number of patients (around 4%) had abnormal test results, and less than 1% were confirmed to have excessively high cortisol levels. The test used was found to be very accurate (96.8%). The conclusion is that Cushing’s syndrome is quite rare in this group of patients, and the test used is a good way to screen for it.

FAQs

  1. What percentage of extremely obese patients preparing for weight loss surgery were found to have Cushing’s syndrome in the research study?
  2. How was Cushing’s syndrome detected in the patients participating in the study?
  3. How accurate was the 1 milligram dexamethasone suppression test in detecting high cortisol levels indicative of Cushing’s syndrome?

Doctor’s Tip

A doctor may tell a patient considering obesity surgery that it is important to undergo hormonal testing, such as the 1 milligram dexamethasone suppression test, to check for conditions like Cushing’s syndrome that could impact their weight loss journey. By identifying and addressing any underlying hormonal issues before surgery, the patient can optimize their chances of successful weight loss and overall health improvement.

Suitable For

Patients who are typically recommended obesity surgery are those who have a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related health conditions such as type 2 diabetes, high blood pressure, or sleep apnea. These patients have often tried other weight loss methods without success and are at high risk for complications related to obesity.

In the case of this research paper, severely obese patients who were undergoing weight loss surgery were assessed for hormonal issues, specifically Cushing’s syndrome. Cushing’s syndrome is a rare hormonal disorder that can cause weight gain and obesity, among other symptoms. Patients with Cushing’s syndrome may have high cortisol levels, which can contribute to obesity and other health issues.

The researchers found that only a small number of patients had abnormal test results for high cortisol levels, and less than 1% were confirmed to have Cushing’s syndrome. This suggests that Cushing’s syndrome is not a common issue in severely obese patients undergoing weight loss surgery. However, screening for hormonal disorders such as Cushing’s syndrome is important in this patient population to ensure that any underlying medical issues are addressed before surgery.

Overall, patients who are recommended obesity surgery are those who have not been able to lose weight through other methods and are at high risk for obesity-related health complications. Screening for hormonal disorders such as Cushing’s syndrome is an important part of the pre-surgical evaluation process to ensure that patients receive appropriate care and treatment.

Timeline

Before obesity surgery:

  1. Patient is assessed for eligibility for weight loss surgery
  2. Patient undergoes various medical tests and evaluations to ensure they are healthy enough for the procedure
  3. Hormonal issues, such as Cushing’s syndrome, are checked for using specific tests like the 1 milligram dexamethasone suppression test

After obesity surgery:

  1. Patient undergoes the surgical procedure for weight loss
  2. Patient receives post-operative care and instructions for recovery
  3. Patient begins the process of adjusting to their new lifestyle, including changes in diet and exercise habits
  4. Patient may experience weight loss and improvements in overall health and quality of life
  5. Patient continues to follow-up with healthcare providers for long-term monitoring and support.

What to Ask Your Doctor

  1. What are the potential risks and benefits of obesity surgery for me personally?
  2. How will obesity surgery impact my overall health and well-being in the long term?
  3. Are there any alternative treatments or lifestyle changes that I should consider before opting for surgery?
  4. How will my diet and exercise routine need to change after obesity surgery?
  5. What are the potential complications or side effects of obesity surgery that I should be aware of?
  6. How long is the recovery process after obesity surgery, and what kind of support will I need during this time?
  7. Will I need to take any medications or supplements after obesity surgery to maintain my health?
  8. What kind of follow-up care will I need after obesity surgery, and how often will I need to see my doctor?
  9. Are there any specific tests or screenings that I should undergo before undergoing obesity surgery to ensure my safety?
  10. How will obesity surgery impact my ability to lose weight and maintain a healthy lifestyle in the long term?

Reference

Authors: Yavuz DG, Apaydin T, Gunhan HG, Uygur MM. Journal: Obes Surg. 2020 Dec;30(12):4981-4985. doi: 10.1007/s11695-020-04865-x. Epub 2020 Aug 15. PMID: 32803707