What is the usefulness of metabolic surgery?

Question

Hello doctor,

I am 44 years old, had a minor stroke last year, and am dealing with stubborn hypertension. My BMI (body mass index) is stuck around 35, and despite dieticians and meds, nothing's changing. My cardiologist mentioned bariatric surgery might be an option now, even though I am not massively obese. I am not sure if it is too extreme or if it is the best move considering my stroke history and blood pressure. I have read that metabolic surgery could reduce hypertension risks, but what about stroke recurrence? Is this route safer long-term than staying on all these meds? I'm also on blood thinners — does that complicate surgery?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

I understand that you are highly motivated to take care of your resistant hypertension and are worried about the stroke you had earlier. Given that your current medications have not yielded significant results, bariatric surgery is certainly an option worth considering. While there are inherent risks associated with this type of surgery, they are generally uncommon. I recommend consulting with a qualified surgeon to discuss this matter in detail. I advise my patients that while they can expect positive short-term outcomes from bariatric surgery, achieving lasting results requires sustained motivation, a disciplined exercise regimen, and a healthy diet post-surgery. Ultimately, bariatric surgery presents a valuable opportunity for individuals like you who have been struggling with obesity and its related health issues, such as hypertension and stroke. Additionally, GLP-1 (glucagon-like peptide-1) analogues may be considered, but it is essential to have a thorough discussion with your surgeon to determine the best course of action for you. Typically, blood thinners are paused for a few days before surgery and then resumed afterward.

I hope this information helps you.

Feel free to ask further queries.

Thank you.