Lara Pizzorno is the author of “Your Bones: How You Can Prevent Osteoporosis and Have Strong Bones for Life – Naturally” and a member of the American Medical Writers Association with 29 years of experience specializing in bone health.
Recently we asked Lara if she would help us provide a series of short, ongoing videos to help you (our customers and readers) stay up to date on the latest facts and science related to bone health.
In this latest video, Lara discusses recent research on the long-term effects of gastric bypass surgery. Watch the video below (or read the transcript provided) and let us know what you think in the comments. 🙂
Hello, my name is Lara Pizzorno. I am the author of “Your Bones” and I am here today to share some information with you that I hope will help you to have healthier bones. The topic of this view and the next several videos to follow is the latest research findings on the long-term effects of gastric bypass surgery and other forms of bariatric surgery, which simply means surgery to treat obesity on the health of our bones. After seeing two very recently published papers in the February and March 2015 issues of the Journal of Clinical Endocrinology and Metabolism, both of them confirming that bariatric surgeries cause relentless bone loss.
I have spent the past several weeks reading up on numerous papers on this adverse effect of bariatric surgery because these surgeries are increasing astronomically. I also Googled bariatric surgery to check the websites of numerous hospitals offering these procedures and also looked at the official website of the American Society for Metabolic and Bariatric Surgery and at the Weight Control Information Network, which is a part of our National Institutes of Health Information Services, whose mission is to “provide the general public, help professionals, the media and congress with up-to-date, science-based information on weight control, obesity, physical activity, and related nutritional issues.”
None of these resources, not a single one, even mentions that,
bariatric surgeries cause significant unstopping bone loss.
Only Wikipedia notes, “Metabolic bone disease osteopenia and increase risk of fracture are common side effects of bariatric surgery”, but even Wikipedia attributes these bone destructive results simply to reduced calcium absorption, which most recent studies investigating changes in numerous hormones that are induced by bariatric surgery, now tell us that’s just the tip of a very large iceberg.
For this reason, I felt compelled to try and summarize for you what the few who are doing the research and those medical professionals who are reading it know, and that is we are talking about a lot of people who are affected here. Thirty-five percent of Americans, one out of every three of us now, are considered obese. If you have had or are considering gastric bypass surgery, I very much hope that this information and the references provided from the peer-reviewed medical literature, will help you and your doctor to work together to most effectively minimize the adverse effects of bariatric surgery on your bones and to protect your long-term health.
The obesity epidemic is not just happening in the United States. It is occurring worldwide.
The number of people affected continues to rise and so does the use of bariatric surgery as a solution to this problem. Even teenagers and children as young as five years of age are now being treated with bariatric surgery and the most commonly performed bariatric surgical procedures, the Roux-en-Y gastric bypass and the sleeve gastrectomy, are not reversible. So we are going to have to find ways to counter the bone destroying effects of these procedures and help their recipients, most whom are young adults in their thirties and forties, to keep their bones.
In this series of videos, I will be talking about what researchers are now thinking are the possible reasons why people who have the Roux-en-Y gastric bypass or sleeve gastrectomy procedure, which are the two most common popular forms of gastric surgery, quickly begin to lose bone and keep on losing it with no signs of slowing down, for how long? As long as the studies conducted so far have run and some have now collected data for seven to nine years. There are a number of reasons for this and encouragingly there is a great deal we can do to combat them some of which are now beginning to appear in the medical literature.
As with all my videos, these videos will be accompanied by a full listing of the PubMed references that I discuss so you or your doctor can easily find and read these medical journal articles. So, what is the latest research telling us? The most recently published studies, two papers were published, as I mentioned in the Journal of Clinical Endocrinology and Metabolism, one in February 2015 and the other in the March 2015 issue, continue to confirm that gastric bypass surgeries, both Roux-en-Y and the increasingly popular sleeve gastrectomy versions, cause significant ongoing bone loss.
Unlike weight loss which plateaus about six months after bariatric surgery, rapid bone loss does not, it continues and how long and whether it can be stopped, is anyone’s guess, but bone loss was still occurring at the end two years during which these two studies were conducted.
In other words, as long as they conducted data. And the same outcome has been seen in a number of other studies, including one published in 2004, in which subjects were followed for at least three years after gastric bypass surgery. Another published in 2009, in which subjects were followed up to five years and yet another published in 2014, in which subjects were followed an average of seven point seven years. Regardless of the length of time investigated, accelerated bone loss, unlike weight loss, did not subside.
These findings are not all that surprising given that both forms of bariatric surgery, the Roux-en-Y and the sleeve gastrectomy, greater reduce the size of the stomach and thus the amount of food we can consume, but the ability of our digestive tract to absorb nutrients. In our next video, we will talk about why these bariatric surgeries so greatly reduce our ability to absorb not just calcium but all the nutrients that are bones require. I hope you’ll tune in then. Thanks.
American Society for Metabolic and Bariatric Surgery, http://asmbs.org/patients/life-after-bariatric-surgery
Weight-Control Information Network, a part of our National Institutes of Health http://www.win.niddk.nih.gov/index.htm
Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg. 2013 Apr;23(4):427-36. doi: 10.1007/s11695-012-0864-0. PMID: 23338049
Yu EW, Bouxsein ML, Putman MS, et al. Two-year changes in bone density after Roux-en-Y gastric bypass surgery. J Clin Endocrinol Metab. 2015 Feb 3:jc20144341. [Epub ahead of print] PMID: 25646793
Muschitz C, Kocijan R, Marterer C, et al. Sclerostin levels and changes in bone metabolism after bariatric surgery. J Clin Endocrinol Metab. 2015 Mar;100(3):891-901. doi: 10.1210/jc.2014-3367. Epub 2014 Dec 9. PMID: 25490275
Goode LR, Brolin RE, Chowdhury HA, et al. Bone and gastric bypass surgery: effects of dietary calcium and vitamin D. Obes Res. 2004;12(1):40–7. PMID: 14742841
Valderas JP, Velasco S, Solari S, et al. Increase of bone resorption and the parathyroid hormone in postmenopausal women in the long term after Roux-en-Y gastric bypass. Obes Surg. 2009 Aug;19(8):1132-8. doi: 10.1007/s11695-009-9890-y. Epub 2009 Jun 11. PMID: 19517199
Nakamura KM, Haglind EG, Clowes JA, et al. Fracture risk following bariatric surgery: a population-based study. Osteoporos Int. 2014 Jan;25(1):151-8. doi: 10.1007/s00198-013-2463-x. Epub 2013 Aug 3. PMID: 23912559
Co-morbidities: Obesity facts, figures and guidelines. West Virginia Division of Health Statistics http://www.wvdhhr.org/bph/hsc/pubs/other/obesity/commor.htm