Is gastric sleeve safe after I stop nursing?

Question

Hello doctor,

My obesity has worsened significantly since having my third baby eight months ago. I was 180 pounds before pregnancy, and now I am stuck at 245 pounds, no matter what I try. My periods have completely stopped, and my endocrinologist says my insulin resistance is severe- my A1C is 7.8, and my fasting glucose consistently stays around 180. The bariatric surgeon wants me to lose 30 pounds before considering surgery, but I cannot seem to lose even five. My knees hurt constantly from carrying the extra weight, and I can barely keep up with my toddlers. I tried Metformin, but it caused terrible diarrhea. Although my thyroid levels are normal, my testosterone is elevated at 85 ng/dL. I feel like my obesity is taking over my life and negatively affecting my marriage. What are my options for managing my weight while breastfeeding? Could I still be eligible for gastric sleeve surgery if I stop nursing?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I am sorry to hear about your struggles. Managing obesity after pregnancy can be challenging, especially with insulin resistance and hormonal imbalances. Here are some options for weight management while breastfeeding:

Diet and exercise: Focus on a balanced diet and regular physical activity. Working with a dietitian who specializes in postpartum weight management can provide tailored advice.
Medications: Since Metformin causes diarrhea, discuss alternative medications with your endocrinologist. Options like GLP-1(glucagon-like peptide-1) agonists (e.g., Liraglutide) might be considered.
Hormonal treatments: Addressing elevated testosterone levels and potential PCOS (polycystic ovarian syndrome) with appropriate treatments can help.
Behavioral therapy: Psychological support, such as cognitive-behavioral therapy (CBT), can be beneficial for emotional distress and weight management.
Surgical options: Gastric sleeve surgery can be considered after you stop breastfeeding. Discuss this with your bariatric surgeon for a comprehensive evaluation.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.