Our Summary

This research paper discusses a study done in Germany from 2005 to 2013 to find the best methods to prevent deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing weight loss surgery. DVT is a blood clot that forms in a deep vein in your body, and PE is a blockage in one of the arteries in your lungs, often due to a blood clot that has traveled from your legs. Both of these conditions can be life-threatening.

The researchers studied over 31,000 weight-loss operations and collected data on the use of drugs to prevent blood clots, the type of surgery, and patient characteristics. They found that the type of surgery, use of drugs to prevent blood clots, and the patient’s gender had no significant impact on the occurrence of DVT.

However, they found that a patient’s Body Mass Index (BMI) and the duration of use of drugs to prevent blood clots did influence the chance of getting DVT. The researchers also found that being older, having a higher BMI, being male, and having a history of blood clots were the biggest risk factors for developing DVT or PE.

They conclude that the best drug to prevent blood clots is heparin, and specifically low molecular weight heparin (LMWH), which has better properties than other types of heparin. However, they also note that there is a lack of evidence in this area, and more research is needed to determine the best ways to prevent blood clots in patients undergoing weight loss surgery.

FAQs

  1. What factors did the German study from 2005 to 2013 identify as the biggest risk factors for developing deep vein thrombosis (DVT) or pulmonary embolism (PE) in weight loss surgery patients?
  2. According to the study, what drug is considered the best for preventing blood clots during weight loss surgery?
  3. Does the type of weight loss surgery or the patient’s gender have a significant impact on the occurrence of DVT, as per the study’s findings?

Doctor’s Tip

A doctor might tell a patient undergoing obesity surgery to make sure to follow their prescribed medication regimen, especially in regards to blood thinners like heparin, to prevent the risk of blood clots. Additionally, they may advise the patient to maintain a healthy BMI and to stay active as much as possible to reduce the risk of developing DVT or PE post-surgery. It’s important for patients to discuss any concerns or questions they may have with their healthcare provider to ensure the best possible outcome after surgery.

Suitable For

Patients who are typically recommended for obesity surgery are those who have a 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 methods of weight loss such as diet and exercise without success, and are at risk for serious health complications due to their obesity.

In addition, patients who have a history of blood clots or are at a higher risk for developing DVT and PE may also be recommended for obesity surgery. These patients may benefit from weight loss surgery to reduce their risk of developing blood clots and other complications related to obesity.

Overall, the decision to recommend obesity surgery to a patient is based on a thorough evaluation of their individual health conditions, risk factors, and likelihood of success with weight loss surgery. It is important for patients to discuss their options with their healthcare provider and make an informed decision about whether weight loss surgery is the right choice for them.

Timeline

Before obesity surgery:

  • Patient consults with healthcare provider to discuss options for weight loss surgery
  • Patient undergoes medical evaluation to determine if they are a candidate for surgery
  • Patient attends education sessions to learn about the procedure and post-operative care
  • Patient may be required to lose a certain amount of weight before surgery
  • Patient undergoes pre-operative testing and preparation for surgery

After obesity surgery:

  • Patient undergoes surgery, which may vary depending on the type of procedure chosen
  • Patient stays in the hospital for a few days for recovery and monitoring
  • Patient follows a strict post-operative diet and exercise regimen to aid in weight loss
  • Patient attends follow-up appointments with healthcare provider to monitor progress and address any concerns
  • Patient may experience changes in their body, such as rapid weight loss or changes in appetite
  • Patient may also experience psychological changes, such as improved self-esteem or body image
  • Patient may need to take medications or supplements to support their weight loss journey
  • Patient may need to make long-term lifestyle changes to maintain their weight loss and prevent complications.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with obesity surgery, specifically in relation to blood clots like DVT and PE?

  2. How will my BMI and other health factors influence my risk of developing blood clots after surgery?

  3. What measures will be taken to prevent blood clots during and after surgery?

  4. What type of blood clot prevention medication will be used, and for how long will I need to take it?

  5. How will my medical history, including any previous blood clot issues, impact my risk of developing DVT or PE after surgery?

  6. What signs and symptoms should I watch out for that may indicate a blood clot post-surgery?

  7. How often will I need to follow up with a healthcare provider after surgery to monitor for any potential complications, including blood clots?

  8. Are there any lifestyle changes or additional steps I can take to reduce my risk of blood clots post-surgery?

  9. What is the success rate of using heparin, specifically low molecular weight heparin, in preventing blood clots in patients undergoing weight loss surgery?

  10. Are there any ongoing research studies or advancements in this area that may impact the prevention of blood clots in patients undergoing weight loss surgery in the future?

Reference

Authors: Stroh C, Michel N, Luderer D, Wolff S, Lange V, Köckerling F, Knoll C, Manger T; Obesity Surgery Working; Group, Competence Network Obesity. Journal: Obes Surg. 2016 Nov;26(11):2562-2571. doi: 10.1007/s11695-016-2182-4. PMID: 27112588