Our Summary

This research paper looks at how fat in the body changes after weight loss surgery. The fat in our body isn’t just for storing energy, it also helps control how much we eat and use energy, and can cause low-level inflammation. The research focuses on two types of fat - epicardial and ectopic fat, and how they interact with white and brown fat in our body.

After weight loss surgery, the size and makeup of the ectopic and epicardial fat improve, which helps the body’s metabolism get better and reduces the risk of heart disease. The surgery also increases the size and activity of brown fat, which is good at burning calories. This might be because of changes in hormones produced in the gut after surgery, which can help with weight loss and keeping the weight off after surgery.

FAQs

  1. What changes occur in the adipose tissue after bariatric surgery?
  2. How does the decrease in ectopic fat and epicardial fat size contribute to post-surgery recovery?
  3. What role does brown adipose tissue play in weight loss after bariatric surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about obesity surgery is to focus on making long-term lifestyle changes to support the success of the surgery. This can include following a healthy diet, engaging in regular physical activity, attending support groups, and attending regular follow-up appointments with healthcare providers. Making these changes can help optimize the benefits of the surgery and improve long-term outcomes.

Suitable For

Patients who are typically recommended obesity surgery are those who have a BMI of 40 or higher, or a BMI of 35 or higher with obesity-related comorbidities such as diabetes, hypertension, or sleep apnea. Patients who have been unable to lose weight through diet and exercise alone may also be candidates for obesity surgery. Additionally, patients who have a history of obesity-related health problems and are motivated to make lifestyle changes to support the surgery’s success may also be recommended for bariatric surgery.

Timeline

Before obesity surgery:

  • Patient undergoes consultation with a bariatric surgeon to discuss the different surgical options available
  • Patient may be required to undergo pre-operative testing and evaluations to ensure they are a suitable candidate for surgery
  • Patient may be required to follow a specific diet and exercise regimen prior to surgery to help prepare their body for the procedure

After obesity surgery:

  • Immediately post-surgery, patient may experience pain, discomfort, and nausea as they recover from the procedure
  • Patient will be placed on a strict liquid diet for a period of time before gradually transitioning to solid foods
  • Patient will need to make significant lifestyle changes, including adopting a healthier diet and regular exercise routine, to support the weight loss and maintain long-term success
  • Over time, patient will experience significant weight loss and improvements in metabolic health, including reductions in ectopic fat and epicardial fat size and composition
  • Patient may also experience an increase in the size and activity of brown adipose tissue, which can help promote continued weight loss and metabolic improvements
  • Patient will continue to follow up with their bariatric surgeon and healthcare team for monitoring and support in maintaining their weight loss and overall health.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with obesity surgery?
  2. What is the expected weight loss and health improvement outcomes following the surgery?
  3. Will I need to make lifestyle changes, such as diet and exercise, after the surgery?
  4. How long is the recovery period and what is the follow-up care plan?
  5. Will I need to take any medications or supplements after the surgery?
  6. How will the surgery affect my metabolism and hormone levels?
  7. Are there any long-term effects or risks associated with the surgery?
  8. How will the surgery impact my ability to absorb nutrients from food?
  9. Are there any specific dietary restrictions I will need to follow after the surgery?
  10. What support resources are available for post-operative care and maintenance?

Reference

Authors: Adami GF, Carbone F, Montecucco F, Camerini G, Cordera R. Journal: Obes Surg. 2019 Sep;29(9):3030-3038. doi: 10.1007/s11695-019-04030-z. PMID: 31190263