Health Brief

OBESITY SURGERY CAN LEAD TO ANOTHER SERIOUS CONDITION

Full Library

A serious neurological condition linked to a lack of vitamin B 1, also known as thiamine, with symptoms of confusion and poor coordination, has been found in a significant number of patients in the months following obesity surgery.

The condition, called “Wernicke encephalopathy”, is caused by a thiamine deficiency and is normally associated with severe alcoholism or chronic malnutrition. Patients with it suffer from confusion, a lack of coordination, rapid rhythmic eye movement, weakness, seizures, deafness and limb numbness.

But a new study published in the journal Neurology says it also occurs within a few months of obesity surgery; particularly if patients stop taking prescribed vitamin supplements or if they vomit frequently, preventing vitamins from being absorbed.

Patients who show symptoms “need to seek help immediately and get injections of thiamine as early as possible,” said study author Sonal Singh, an instructor in internal medicine at Wake Forest University School of Medicine. “For doctors, the message is that they should keep this in their minds when they see these patients.”

Incidents of Wernicke encephalopathy are expected to increase because the number of bariatric surgeries performed in the United States continues to grow. About 170,000 obesity surgeries were done in 2005, up from 120,000 the year before and 16,000 in 1992. Most recovered completely after getting thiamine intravenously, though a few continued to have problems with memory, coordination and vision.

Operations for obesity, commonly known as gastric bypass surgery, are technically called “bariatric surgery”. The word “bariatric” comes from the Greek words for “weight” and “treatment”.

According to the National Institutes of Health (NIH), a person is considered “obese” when he or she weighs 20 percent or more than his or her ideal body weight. At that point, the person’s weight poses a real health risk. Obesity becomes “morbid” when it significantly increases the risk of one or more obesity related health conditions or serious diseases (also known as comorbidities). Morbid obesity—sometimes called “clinically severe obesity”—is defined as being 100 lbs. or more over ideal body weight or having a Body Mass Index (BMI) of 40 or higher.

According to the NIH Consensus Report, morbid obesity is a serious chronic disease, meaning that its symptoms build slowly over an extended period of time. Today 97 million Americans, more than one-third of the adult population, are overweight or obese. An estimated 510 million of those are considered morbidly obese. The cost of lost productivity related to obesity among Americans age 17 to 64 is $3.9 billion.

Full Library

SOURCE: The journal “Neurology”, March 13, 2007; http://www.neurology.org/cgi/content/abstract/68/11/807; National Institutes of Health, http://win.niddk.nih.gov/statistics/index.htm