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Alabama Bariatrics & Minimally Invasive Surgery

Bariatric Diet Orbera Gastric Band Sleeve Gastrectomy Gastric Bypass

W. Jay Suggs, MD, FACS, FASMBS
Huntsville & Decatur
Phone: (256) 274-4523
Fax: (256) 203-8791

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W. Jay Suggs, MD, FACS, FASMBS
Huntsville & Decatur
Phone: (256) 274-4523
Fax: (256) 203-8791
EMail: drsuggs@alabariatrics.com

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human-internal-organs-dummy-on-green-background-2021-04-05-12-33-30-utcPeople have a habit of compartmentalizing ideas. Our brains can only process so much stimuli while running our bodies. So, when we learn something new about our environment, or try to gain an understanding of the world around them, it takes shortcuts and stores certain stimuli into categories. That is most likely why, when we talk about weight loss surgery, we only think about the stomach. 

But our body parts do not work in a vacuum. Just like our environment, the food chain, and any other complex system that makes the world function, our bodies are an interconnected complex network. Our brain does not work at a different time than our nerves, our limbs do not work at a different time than our heart and our ears do not work at a different time than our eyes. No part of the body is an island. 

Instead of working in a vacuum, these systems all depend on each other to make the entire body function. So why is it, in medicine, that we treat our bodies like a series of separate parts? Why do we assume that if one organ, like our stomach, changes that the rest of us will not follow suit? It goes back to our tendency to assume that things work in categories.

 Luckily, this type of thinking can be overcome. Anyone can do it, despite how impossible it might seem. The only way to correct preconceived notions about how things work is to observe the effects of how something changes. That is what scientists do. They observe, check for consistency, and record the results. That is why there should be little shock that the effects of weight loss surgery does more than just change the stomach. In fact, it affects the way our blood flows. 

How Our Heart and Blood Vessels Work

The cardiovascular system, or what most people know as the circulatory system, is a combination of the heart, red and blue blood vessels, and the blood cells plus liquid it houses. The heart pumps blood around a closed circuit of vessels that deposits oxygen and other important elements to muscles and other functioning parts of the body.

This system is so important to our physical function even embryos rely on a rudimentary form of it to remain in a state of homeostasis as it grows. 

Our blood vessels or veins, are connected to microscopic capillaries which transport blood, nutrients, and other important fluids to every cell in the body. They also serve the function of removing waste from our bodies. 

“Many control mechanisms help to regulate and integrate the diverse functions and parts of the cardiovascular system in order to supply blood to specific body areas according to need. These mechanisms ensure a constant internal environment surrounding each body cell regardless of differing demands for nutrients or production of waste products.” - National Cancer Institute

Now that you know how the cardiovascular system works, you are most likely forming a few questions. How is the cardiovascular system relevant to weight loss surgery? How does losing a portion of your stomach translate to better heart health? It seems almost like an entirely distinct part of your body. Which brings me back to my beginning statement about compartmentalization. 

Blood Flow Changes After Weight Loss Surgery

I stated before that the capillaries are connected to every cell in your body. This does not mean just muscles or bone. This is also true for organs, including the stomach. Every part of our body requires a steady supply of blood flow to distribute oxygen and remove waste. So when that flow is interrupted, or harder to achieve, your body is not getting enough oxygen or nutrients, and is most likely not removing enough waste either. 

Doctors can measure how the blood flows in your cardiovascular system by measuring something called  Flow- mediated dilation, or FMD. It is a non-invasive way to determine blood vessel health and is a way to find an early indicator of cardiovascular diseases.  Your FMD can improve or deteriorate depending on several factors and it can be difficult to measure. However, it is a valuable tool for doctors to determine long-term health based on habit. 

The Boston Medical Center of Massachusetts measured a pool of 300 adults with obesity that had undergone weight loss surgery. Noyan Gokce MD and his colleagues spearheaded this study based on measured data in both macrovascular and microvascular function. According to them, vascular function improved 6 months after the weight loss surgery. This means that their blood could achieve balance and the cardiovascular systems of patients on average were more likely to achieve and maintain normal blood pressure. Sometimes, these patients had to discontinue blood pressure medication because it had already stabilized months after their weight loss surgery. 

Even patients with obesity that did not disrupt their metabolism saw a marked improvement in their cardiovascular system. In fact, these patients saw less inflammation after their weight loss surgery. 

But what makes this information valuable compared to other studies? How credible is the information?

The Study Pool for the Latest Weight Loss Surgery Discovery

What makes this study so groundbreaking if not outright fascinating for weight loss surgery experts is that the data pool, or the people who took part in the study, came from multiple backgrounds.

 According to the doctors who published the results, “This population-based longitudinal cohort study sought to identify variables associated with vascular improvement after bariatric surgery and examine the effects of sex, race, and metabolic status on postsurgical microvascular and macrovascular outcomes.”

In layperson's terms, it means that they chose people with different sexes, races, and types of obesity to be included in the study. The sheer variety involved in the study leads to more accurate data regarding weight loss surgery, because any good scientific observation would reflect the entire population, not just one group of people. 

Not only that but they, in good faith, pointed out any potential limitations that their study could bring. This type of self reporting is a gold standard for any scientific study and is often a sign of good faith by the people reporting. 

“A limitation of this study was that most study participants were women. Although this accurately reflects the general clinical practice and known sex differences in populations that seek weight loss interventions, it limits the generalizability of the study.”

They were using population data that is typical for weight loss surgery, but are also aware that there is a possibility that the lack of men in the original data population makes the study less easy to apply the results to everyone. 

Not even the person who invented the BMI showed this much attention to detail and good faith. 

Conclusion

There is a sound argument to be made that weight loss surgery is beneficial to our heart health, as well as the rest of our circulatory systems. While it may take more testing before this is a scientific fact, this could be a key factor with insurance claims, destigmatizing weight loss surgery and could encourage more people to get help.