For today I want to share an article entitled “Lipedema in patients after Bariatric Surgery” which was published in the journal Surgery for Obesity and Related Diseases in 2016. It’s a case study report from several surgeons at hospitals in New York, including Drs. John Bast, Leaque Ahmed, and Ryan Engdahl.
The authors observed two women who underwent weight-loss surgery. The first woman had a gastric bypass and the second had a gastric sleeve.
The authors reported that both women lost a significant amount of weight after their surgery. The first woman went from a body mass index of 69 down to almost 41, while the second woman’s BMI went from almost 60 down to 42.5. Unfortunately, even after the tremendous amount of weight they lost, both women still had a substantial amount of excess fat on the lower half of their bodies. The conclusion of the authors was that more surgery, including debulking or liposuction, is needed.
The authors’ recommendation for further surgery is not surprising, as the authors are surgeons. However, the pros and cons of having weight-loss surgery when there is a co-occurring condition of lipedema need to be carefully considered by each patient and her medical team. These case studies show that bariatric surgery outcomes may not always be as expected in the presence of lipedema. Because most weight-loss surgeries are a surgical equivalent to a starvation diet, women with lipedema may find that most of the fat and even some muscle loss will occur only on the trunk.
Some clinicians in Germany are suggesting that any woman with lipedema and a BMI over 40 should have bariatric surgery. By this case study report, it seems that this is not the answer. Still, for some women, it may be that lipedema is first diagnosed after bariatric surgery because this disproportionate appearance between the upper and lower body may not be seen until weight is only lost on the trunk in response to the bariatric procedure.
For those of you who are aware of the work we are doing at the Lipedema Project and Lipedema Simplified, you will know that a ketogenic way of eating is being used by women with lipedema, even if they have already had weight loss surgery. Many women in our social media groups have already had weight loss surgery and have found that they are able to enjoy even better success by changing their diet in a way that is both satisfying and pleasurable.
Reference article: https://pubmed.ncbi.nlm.nih.gov/27317598/
Listen to our mini-podcast: https://lipedema-simplified.org/flash_briefings/episode-269/