Description: Professor Davidson of the Exercise Science Department is compiling extensive data to see if there is correlation between severe obesity and bone weakening. This is even in the case of patients losing weight via Roux-en-Y Gastric Bypass Surgery, who might be in greater danger of injury.
Start: April 26, 2014
End: March 31, 2016
- Sponsor: National Institutes of Health
- Principal Investigator: Lance Davidson
Roux-en-Y Gastric Bypass Surgery, concisely put, is a procedure to close off part of the patient’s stomach so that the person eats less food and still feels full. This weight-loss technique is prescribed for those who suffer from morbid obesity—meaning that their body mass index is greater than 40— and subsequently are at a much higher risk for fatal health conditions. Such an operation is only employed after dieting, exercising, and behavior reevaluation fail to shed the large amount of weight. There are a few nuances within gastric bypass surgeries, the most-used version in the United States being the Roux-en-Y (RYGB). Procedurally, the doctor begins the biopsy by sealing off the majority of the lower stomach so that the person physically cannot eat large portions; food is still able to enter the top of the stomach. Next, the doctor divides the small intestine to redirect the lower part, called the jejunum, to the “new” or top portion of the stomach. This allows the body to still absorb some nutrients, and for the food to travel through the rest of the digestive tract.
In the past, specialists believed obese individuals to be protected from bone fragility, osteoporosis— a condition where the skeleton becomes brittle due to tissue and nutrient deficiencies— and consequential fractures. New research, however, suggests that perhaps there is only minimal protection, and that these individuals are actually at a higher risk for disease-related fractures. Though the RYGB surgery is consistently successful in producing the needed weight loss and keeping it off, there is simultaneous muscle loss which contributes to strength and balance problems. Furthermore, this procedure excludes the beginning portion of the small intestine—the duodenum. This intestinal region is where nutrients, like calcium and iron, are largely absorbed, the other being the stomach which has also been bypassed. Minimizing the body’s intake of vitamins will exacerbate preexisting bone and muscle weakness, or cause enough bone mineral density (BMD) reduction as to lead to osteoporosis.
Specialists still do not know the full risk relationship between obesity and fractures. Professor Davidson, in conjunction with Utah’s Intermountain Healthcare, Inc. and Cornell University’s Medical College, will be investigating these correlations within existing patient databases. The study will include tens of thousands of gastric bypass cases, many with decades of doctoral notes and injury reports. With such extensive access to case studies, this will be the first long-term, wide-spread assessment of bone fracture rates within the severely obese population (with and without RYGB surgery). If there does prove to be a strong correlation between corpulence and skeletal damage, the next course of action will be to prescribe longer follow-up with physicians, and conduct further research of related BMD, bone structure, vitamin deficiency, and accidental injury.
Gastric bypass surgeries are often last-resort treatments for obese individuals to initiate substantial weight loss. Despite concerns of bone fracture, RYGB surgery continues to reduce the problems onset by diabetes, hypertension, sleep apnea, dyslipidemia, and other heart diseases. As doctors become more aware of potential and unintended side effects of this procedure, they can strategize new ways to improve the longevity and quality of patients’ lives.