I am obese despite Phentermine. Can bariatric surgery help?

Question

Hello doctor,

I am 32 and have struggled with obesity my entire adult life, but it has become dangerous now. I weigh 340 pounds at 5 feet 6 inches, with a BMI over 55, and I was just diagnosed as prediabetic with an A1C of 6.2.

My blood pressure is 180/100 despite being on two medications, and my cholesterol levels are extremely high.

I have tried every diet program, Weight Watchers, Jenny Craig, keto, intermittent fasting, and while I lost weight temporarily, I always regained more than I lost. My PCOS makes everything harder due to insulin resistance and hormonal imbalances.

I tried Phentermine and lost 25 pounds, but my doctor would not prescribe it for more than three months. I also tried Contrave, but it caused such severe nausea that I could not keep any food down.

My obesity is affecting every part of my life. I have sleep apnea, fatty liver disease, stress incontinence, and knee pain that makes exercise almost impossible. My periods are irregular, and my gynecologist says obesity is making it difficult to conceive. I have been trying to get pregnant for four years with no success.

My insurance has approved bariatric surgery, but I am terrified of the potential complications. I am worried that surgery might be the only way to lose enough weight to be able to have a baby.

What type of bariatric surgery is best for obesity with PCOS?

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I truly recognize how difficult it can be to live with lifestyle disorders that are chronic and can eventually become life-threatening.

Bariatric surgeries are weight-loss surgeries, and in your case, this appears to be one of the last options to help get things back on track.

These are metabolic surgeries designed to create changes in the digestive system, leading to weight loss and, ultimately, improvement in overall health outcomes.

They help with weight reduction, better blood sugar control, management of dyslipidemia, and lowering blood pressure.

These procedures work either by restricting stomach size or by rerouting the digestive tract. This results in reduced hunger, decreased food intake, and earlier satiety. Generally, individuals with a BMI (body mass index) of 40 or higher are considered candidates for bariatric surgery.

Some known common concerns include the risks related to anesthesia, which are present with most surgeries. Other possible complications include

Malabsorption of important nutrients.
Bowel obstruction.
Abdominal pain.
Diarrhea.
Infection.
In some cases, stricture formation occurs in the digestive tract.

These surgeries may also lead to symptoms of stress, anxiety, or depression. However, outcomes can also be very positive when everything goes well.

Most side effects are manageable, and there is often significant overall improvement in health. You can discuss with your doctor the type of surgery they recommend and specialize in to determine the best option for you.

I hope this helps.

Thank you.