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Weight gain and weight loss resistance are one of the most common symptoms of both hypothyroidism and Hashimoto’s. As a result, most patients are looking for options that can finally help them “lose the thyroid weight.” While bariatric surgery has excellent benefits, there are also things to consider – especially for those with hypothyroidism.
Bariatric surgery is a procedure that involves making changes to your digestive system and is used as an effective treatment option for weight loss. Bariatric surgery is done as a last-measure option, after diet and exercise have been ineffective for obese patients.
While there are many benefits to having bariatric surgery, all forms of weight-loss surgery – while considered effective procedures – can pose severe risks and side effects. Throughout the preparation process, patients must make permanent, life-long health changes to their diet and implement regular exercise to ensure long-term success.
There are five types of bariatric surgery. The most common types are sleeve gastrectomy, gastric bypass, and adjustable gastric banding.
The Laparoscopic Sleeve Gastrectomy, often referred to as the "sleeve," removes approximately 80% of the stomach, leaving the remaining stomach the size and shape of a banana.
The procedure forces the patient’s new stomach to hold less food and liquid, reducing the intake (and calories) consumed. Since most of the stomach that produces the hunger hormone is removed, the patient’s metabolism directly decreases hunger and increases fullness. These effects have helped patients achieve a healthy weight and better blood sugar balance.
Gastric bypass is more complex than sleeve gastrectomy surgery and is more often recommended for patients who need significant weight loss. This procedure has been shown as one of the best operations to improve or resolve diabetes.
With a gastric bypass, patients are more likely to have problems with nutritional deficiencies, which will require patients to take multivitamins, calcium, and vitamin B-12 regularly. It is also common for patients to develop ulcers at the bottom of the stomach due to smoking or an intake of regular use of non-steroidal anti-inflammatory medicines. It is also worth noting that patients may experience “dumping syndrome,” severe abdominal cramping, and diarrhea due to poor food choices, including overconsumption of sugar and greasy foods.
Adjustable Gastric Banding
Also known as lap banding, in adjustable gastric banding, a silicone device is placed around the top part of the stomach, as a way to limit the patient’s food intake. Although it’s a simple surgery compared to gastric bypass or sleeve gastrectomy, the lap band can result in loss of 40-50% of body weight, with a low risk of serious complications after surgery.
Although this procedure is reversible, there is a high risk of re-operation, bandage movement (slippage), or damage to the stomach over time. Patients should also be aware that this procedure can cause chronic heartburn or reflux, and patients may require frequent visits to a healthcare provider to get band adjustments.
It is highly suggested that patients must meet the following requirements to be eligible for weight-loss surgery:
- Have a body mass index (BMI) of 40+, or a BMI between 35 and 40
- Have an obesity-related condition, such as heart disease, diabetes, high blood pressure, severe sleep apnea, or morbid obesity.
- Weigh less than 450 pounds, the maximum weight that hospital radiology equipment can accommodate. Patients who need to lose weight before bariatric surgery can work with a bariatric nutritionist to achieve their goals and qualify for surgery.
Although these are suggestions, your primary care physician can best judge if bariatric surgery is right for you.
Optimal thyroid hormone levels help regulate several body functions, including metabolic rate, brain development, digestive process, and bone maintenance.
When your thyroid hormone production drops (hypothyroidism), your body processes – including your metabolic rate – slow down and change. Too little thyroid hormone slows the body’s metabolism, and can cause weight gain and difficulty losing weight.
With the help of bariatric surgery, a patient's metabolism can improve and empower them to make healthier lifestyle choices, resulting in continued weight loss and a higher quality of life.
There is a complex interaction cycle between the thyroid, pituitary, adrenal glands, and the pancreas, insulin, and glucagon, which all play a role in obesity.
Due to this feedback loop and many changes made during weight loss surgery, the entire body can be affected. One of the most common side effects of gastric bypass is poor absorption, due to fluctuations in stomach acidity, slowed bowel movements, smaller stomach surfaces, and shorter intestines. This absorption problem is particularly important for hypothyroid patients who take thyroid medication after weight loss surgery. When absorption is impaired, hypothyroid patients may need slightly higher doses of thyroid medication, or may benefit from the liquid form of levothyroxine (Tirosint.)
Implementing a healthy lifestyle through a whole-food-based diet and regular exercise can help decrease inflammation, increase energy, and support your weight loss goals. It is important to seek medical advice about your risks with bariatric surgery and how it might affect your current treatment plan for conditions such as hypothyroidism and autoimmune diseases such as Hashimoto’s.
Schedule a visit with a Paloma doctor to monitor your thyroid levels and find if you have any nutritional deficiencies you may need to address.