Q. Is bariatric surgery advisable for the second time?

Answered by

and medically reviewed by Dr. Sneha Kannan

Published on Dec 25, 2015 and last reviewed on: Mar 11, 2019

Patient's Query

Hi doctor,

I am 41 years old. I am suffering from hypothyroidism and for which I am taking Thyroxine 175 mcg daily. My height is 5'10" and my current weight is 127 kg. Two years ago, I had sleeve gastrectomy and lost only 20 kg. The surgeon now advised me to get gastric bypass surgery. But I am not comfortable with that. I have attached my recent testosterone report. I feel as if I have low testosterone. How to increase my testosterone levels? I have a history of nasopharynx non-Hodgkin's lymphoma and it got treated successfully by radiation.

Answer

Dr. Divakara P

Diabetology Endocrinology General Medicine Internal Medicine Pain Medicine Pulmonology (Asthma Doctors)

Hi,

Welcome to icliniq.com.

I went through your query and the reports (attachment removed to protect identity).

Your testosterone level is normal. Though on the lower side of the normal range, there is nothing needs to be done to increase testosterone. There are medications to increase testosterone levels but it is not needed in your case. You can try some natural methods like doing aerobic exercise, eating more of citrus fruits, eating more of onion and garlic and also wear loose undergarments.

While going through your reports, I noticed that your insulin levels and C-peptide levels are elevated. This suggests that you are having insulin resistance which may lead to diabetes in the future. So, kindly start doing aerobic exercise which will reduce insulin resistance.

Patient's Query

Hi doctor,

Thank you for your response. Since the past six months, my weight has neither increased nor stagnant. My appetite is reduced due to bariatric surgery. I am going the gym at least five times a week for about an hour and religiously use the cross trainer particularly for about 45 minutes at a stretch. It is only the past two weeks that I have been away from the gym due to constant headache, body ache and some infection as the WBC count is high. Is it fine to get second bariatric surgery again? Awaiting for your response.

Answer

Dr. Divakara P

Diabetology Endocrinology General Medicine Internal Medicine Pain Medicine Pulmonology (Asthma Doctors)

Hi,

Welcome back to icliniq.com.

Well, I sincerely believe there is no need to repeat bariatric surgery. But, you need to increase your exercise intensity more. I need to know your daily calorie intake and the kind of food you eat.

I hope you have consulted a dietitian for low-calorie diet and if not kindly do it. Wait for few more months and increase your intake of fruits and vegetables and reduce the intake of non-vegetarian food, cheese, butter, sweets, and carbonated drinks.

Despite good diet and more physical exercise you gain weight, then consider bariatric surgery. If you are maintaining the same weight or losing a little then no need of surgery but continue the diet and exercise.