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Improvements or Resolution of Comorbidities
Infertility
Some fertility issues associated with obesity include irregular or infrequent menstrual cycles, increased risk of miscarriage, increased risk during infertility surgery, decreased success with fertility treatments, and in men diagnosed with Diabetes Type 2, there is an increased risk of sperm DNA fragmentation.20,21
Being overweight or obese affects fertility in women by causing an imbalance of normal hormone levels and Diabetes Type 2 is associated with polycystic ovarian syndrome (PCOS), which also leads to hormonal imbalance and infertility. Pregnancy in severely obese women involves many complications including hypertension, preeclampsia, late fetal death and gestational diabetes.22,23
Sex hormone levels can return to normal in patients who have experienced weight loss after bariatric surgery. These patients also have restored menstrual regularity and improved fertility. Weight loss of 5-10% may dramatically improve ovulation and pregnancy rates while reducing the negative effects of diabetes.22,20
While obesity-related infertility often resolves with weight loss, the adjustability feature of Gastric Band procedure can help lower obstetric complications.16
Urinary Stress IncontinenceRelevant Links:
Physician Resources—InfertilityStandards of Care—Infertility
Resolution of co morbidities References:
1.Obesity in the U.S. American Obesity Assocation.http://www.obesity.org/subs/fastfacts/obesity_US.shtml.
2.Dixon JB, O’Brien PE. Health outcomes of severely obese type 2 diabetic subjects 1 year after laparoscopic adjustable gastric banding. Diabetes Care. 2002;25:2:358-363.Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142:547-559.
3.Ahroni JH, et al., Laparoscopic adjustable gastric banding: weight loss, co-morbidities, medication usage and quality of life at one year. Obes Surg. 2005;15:641-647.
4.Spivak H, et al., Weight loss and improvement of obesity-related illness in 500 U.S. patients following laparoscopic adjustable gastric banding procedure. Am J Surg. 2005;189:27-32.
5.Frigg A, Peterli R, Peters T, Ackerman C, Tondelli P. Reduction in co-morbidities 4 years after laparoscopic adjustable gastric banding. Obes Surg. 2004;14:216-223.
6.Canadian Diabetes Association 2008 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Management of Obesity in Diabetes, S77-80. Available at: http://www.diabetes.ca/files/cpg2008/cpg-2008.pdf.
7.Centers for Disease Control and Prevention Web site. National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2005. Available at: http://www.cdc.gov/diabetes/pubs/factsheet05.htm. Accessed June 20, 2007.
8.Dixon JB, et al., Adjustable Gastric Banding and Conventional Therapy for Diabetes Type 2: A Randomized Controlled Trial, JAMA 2008;299(3):316-323
9.Ponce J, Haynes B, Paynter S, et al. Effect of Lap-Band-induced weight loss on Diabetes Type 2 mellitus and hypertension. Obes Surg. 2004;14:1335-1342.
10.Littner M, Alessi C. Obstructive sleep apnea: asleep in our consciousness no more. Chest. 2002;121: 1729-1730.
11.Fritscher LG, et al., Obesity and obstructive sleep apnea-hypopnea syndrome: the impact of bariatric surgery. Obes Surg. 2007;17:95-99.
12.Morgenthaler TI, et al., Practice parameters for the medical therapy of obstructive sleep apnea. Sleep. 2006;29:1031-1035.
13.Dixon JB, et al., Sleep disturbance and obesity: changes following surgically induced weight loss. Arch Intern Med. 2001;161:102-106.
14.Ong KL, et al., Prevalence, awareness, treatment, and control of hypertension among United States adults 1999-2004. Hypertension. 2007;49:69-75.
15.Beuther DA, Sutherland ER. Overweight, obesity, and incident asthma: a meta-analysis of prospective epidemiologic studies. Am J Respir Crit Care Med. 2007;175:661-666.
16.Dixon JB, O’Brien PE. Gastroesophageal reflux in obesity: the effect of Lap-Band placement. Obes Surg. 1999;9:527-531.
17.Clearfield MB. The national cholesterol education program adult treatment panel III guidelines. J Am Osteopath Assoc. 2003;103:S1-S5.
18.Gordon C. McCarter GC. Wrestling the beast: obesity, metabolic syndrome, diabetes, and related disorders Medscape. 2006; http://www.medscape.com/viewprogram/5352
19.American Obesity Association Web site. Health effects of obesity. Available at: http://obesity1.tempdomainname.com/subs/fastfacts/Health_Effects.shtml. Accessed April 20, 2007.
20.American Society for Reproductive Medicine Web site. Patient’s fact sheet: weight and fertility. Available at: http://www.asrm.org/Patients/FactSheets/weightfertility.pdf.
Accessed June 20, 2007.
21.Agbaje IM, et al., Insulin dependant diabetes mellitus: implications for male reproductive function. Hum Reprod. 2007;1-7 [epub ahead of print].
22.Sugerman HJ. The pathophysiology of severe obesity and the effects of surgically induced weight loss. Surgery for Obesity and Related Diseases. 2005;109-119.
23.Dixon JB, et al., Pregnancy after Lap-Band surgery: management of the band to achieve healthy weight outcomes. Obes Surg. 2001;11:59-65.
24.The American Urogynecologic Society Web site. Female urinary stress incontinence: overview. Available at http://www.augs.org/i4a/pages/index.cfm?pageid=208. Accessed on May 16, 2007.
25.Carroll JF. Lap Band gastric bypass surgery improves insulin resistance. The American Physiological Society Web site. Available at: http://www.the-aps.org/press/journal/07/29.htm. Accessed June 20, 2007.