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Why is bariatric surgery useful for people with joint pains and osteoarthritis?

Bariatric surgery is a metabolic surgery which results in reduction of the excess weight of the person significantly and thereby contributes to resolution of obesity related diseases. Obese people often complain of pain in the weight bearing joints namely the lower back, knees and hips and also sometimes their ankles and feet. This is because of the increased mechanical load which causes damage to the cartilage and leads to reduction of the joint space. This leads to friction of bones against each other during movement which causes wear and tear of the joint. Though this process happens in every individual with increasing age, it is accelerated in obese people and they can have advanced stages of joint destruction even at a young age.

Once joint destruction has progressed beyond a certain point, medications are no longer useful and the person has to undergo a joint replacement surgery if they want to enjoy continued mobility and an active lifestyle. Joint replacement surgery is a major operation with chances of complications. Also, with increased weight of the person, the chances of long term success of the procedure decrease significantly because of the accelerated destruction of the replaced joint. Hence, it is recommended that people reduce their weight to near normal level before undergoing this procedure. This is where bariatric surgery plays a very important role as it helps to reduce weight significantly thus increasing the chances for long term successful result.

Bariatric surgery also has role in the prevention of osteoarthritis. If the surgery is undertaken timely before significant joint destruction has taken place, most of the changes can be reversed with weight loss and the person can be pain free and enjoy a normal function of the joints.

How does bariatric surgery help to overcome the problem of infertility?

Obesity is a leading cause for infertility in both men as well as women. Fat cells have an enzyme which converts the male hormone testosterone into the female hormone estrogen. Thus, obese men who have a high fat cell mass usually have decreased levels of testosterone and increased estrogen levels in their bloodstream. This causes them to have a lower sperm count with decreased sperm quality. It also leads to a decreased sex drive. Besides, morbidly obese people, because of their heavy body structure and impaired mobility have mechanical restrictions while performing sexual activity which can lead to frustration and depression. This is often coupled with the low self esteem and poor body image and contributes to a overall decreased interest in sex.

Obese women, on the other hand, generally have increased levels of female sex hormones due to their increased fat mass. This leads to hyperstimulation of the ovaries leading to condition known as polycystic ovarian disease. The menstrual cycles of such ladies become irregular with other features such as weight gain and unwanted hair growth. This contributes to a hormonal imbalance within the body and an overall decreased rate of conception. Besides, obesity also increases the risk of miscarriage during a normal pregnancy because of the increased risk of both maternal and fetal complications.

Bariatric surgery leads to excess weight loss and reduction in body fat percentage which normalises the hormonal milieu within the body. This leads to increased levels of male hormones in men leading to normalisation of their sex drive and sperm counts. For women, once the hormone levels are controlled, the symptoms of PCOD disappear which increases the chances of normal conception.

Also, reduced body weight decreases the chances for complications once conception is achieved and increases the chances for successful delivery of a healthy baby.

It a safe for a woman to conceive after one year of undergoing bariatric surgery and once their weight has stabilised. There is no risk of malnutrition or decreased birth weight of the baby if pregnancy is conceived after the above mentioned period.