Weight Loss Surgery Increases The Risk Of Broken Bones

By Margarita Nahapetyan

It has not been a secret that bariatric surgery for the purposes of losing weight, may be a life-saving move for many individuals. However, the scientists say that the procedure doubles the risk of suffering from broken bones.

It has been known that the lost of bone density after operation is a natural consequence of the fast and significant weight loss that happens in patients, as well as the difficulty some individuals experience digesting enough vitamins and essential nutrients. But what was not known before, is how that loss of bone density results in broken bones after surgery.

"We have shown that risk of fractures after this type of weight-loss surgery is clinically significant," said a principal investigator of a new study, Dr. Elizabeth Haglind. She added that according to the results of their study, patients who have had bariatric surgery, showed two times more risk in developing a fracture or sustaining a fracture, when compared to individuals who did not undergo the operation.

The study on the matter, which is still ongoing, involves a review of the records of nearly 300 patients who had bariatric surgeries over twenty years at the Minnesota facility. All patients had either stapling of the stomach (gastric bypass) or banding of the stomach (gastric band surgery). The procedures are performed to limit or reduce the consumption of food and nutrients into the body.

In their own, smaller study, the investigators from the Mayo Clinic included the records from 97 surgical patients. The majority of the patients were female, with the average age of 44 years. All of them had had bariatric surgery for medically complicated obesity between 1985 and 2004. The experts revealed that within an average of 7 years after their weight loss or bariatric surgery, 21 patients developed 31 fractures.

When researchers compared those injuries with a similar group of people, the bariatric surgery patients appeared to be 1.8 times more likely to have a first fracture anywhere on the body. And while most breaks were in the hands and feet, fractures of the hip, spine and upper arm bone - the humerus - were also reported. Risk of hand fractures were 3 times greater and foot fractures 4 times greater than average.

"We knew there was a dramatic and extensive bone turnover and loss of bone density after bariatric surgery," said a co-author of the study, Dr. Jackie Clowes, a Mayo rheumatologist."But we did not know what that meant in terms of fractures."

Chronic deficiency in vitamin D as well as inadequate calcium intake are common with obesity, and bariatric surgery poses a risk owing to malabsorption and decreased oral intake. Although the experts believe that calcium and vitamin D supplements at post-surgery period may help, they are not quite sure if they will significantly reduce the risk of fractures.

Dr. David Haslam, of the National Obesity Forum, said that in spite of the fact that bariatric surgery might increase future risk of having fractures, this risk is likely to be far outweighed by the health benefits of the surgery when it comes to the weight reduction and obesity-related issues, such as heart disease and diabetes. For these reasons, the increase in risk is probably not worth worrying about, he said and added that more studies are needed in order to support the findings of the new study.

The new findings were presented recently at the annual meeting of the Endocrine Society in Washington, D.C.