‘Obesity metabolic surgery’ that restricts food intake and absorption through stomach reduction and intestinal bypass. Excellent for weight loss and blood sugar control
Seoul National University Bundang Hospital, Professor Young-Seok Park’s team, study on the state of nutrient deficiency in patients before obesity metabolic surgery, the first in Korea
[헤럴드경제(성남)=박정규 기자]Professor Young-Seok Park of Surgery at Seoul National University Bundang Hospital announced on the 6th that patients with vitamin D deficiency appear the most before undergoing obesity metabolic surgery. Vitamin B1, folic acid, and iron were followed. The research team said that the nutrients should be thoroughly tested and managed before surgery.
Obesity was recognized as a disease, unlike in the past when it was simply defined as’a state of accumulation of fat’. Various treatment strategies are being developed.
The most notable treatment is’obesity metabolism surgery’, which reduces the amount of food and restricts absorption of nutrients such as sugars through gastric sleeve resection. It is also called’diabetes surgery’ because it is effective in controlling blood sugar as well as losing weight. In Korea, it was recognized as an official treatment for obesity in 2019, and national health insurance benefits were applied.
These obesity metabolic surgery are ▷’gastric sleeve resection’ that reduces the size of the stomach ▷’Louis gastric bypass grafting’, which directly connects the small intestine with a little bit of the stomach left near the esophagus ▷’duodenal duct surgery and duodenal bypass It can be categorized as’replacement surgery (biliary pancreatic diversion)’. If weight loss is the main goal, reducing the amount of meals with gastric sleeve resection can have a great effect. In the case of obesity accompanied by severe diabetes, etc., it is recommended to perform Ruwai gastric bypass surgery or cholangiopancreatic diversion. By bypassing the intestine and shortening the length of the small intestine through which food passes, it is the principle that even if you eat the same amount, it is absorbed less.
Since the intake and absorption of nutrients as a whole decreases after surgery, care must be taken not to deplete essential micronutrients such as vitamins and iron.
In particular, the lack of nutrients before surgery can become more severe after surgery, so it is important to identify them in advance and prevent them through management. However, there have been difficulties in preparing standard guidelines since there have been no studies in Korea that have investigated the nutritional status of patients before and after obesity metabolic surgery in Korea.
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| Professor Young-Seok Park |
Prof. Young-Seok Park’s team conducted a study to investigate the state of nutrient deficiency in patients before surgery using data from 215 people who underwent obesity metabolic surgery at Seoul National University Bundang Hospital in 2019.
As a result, it was confirmed that the most common nutrient deficiency before obesity metabolic surgery is vitamin D, and 80% of all patients are’deficient’ and 14% are’insufficient’.
Vitamin D is related to calcium metabolism and bone mineral density. If the body weight and muscle mass are decreased after surgery and at the same time, the bone density decreases due to vitamin D deficiency are accompanied, the risk of fracture may increase. Care should be taken because it can affect the onset of chronic cardiovascular diseases, including myocardial infarction.
After vitamin D, vitamin B1 (18.3%), folic acid (14.2%), iron (11.8%), and zinc (7.6%) were in the order of high deficiency. All four are essential nutrients for our body, and if they are deficient, symptoms such as beriberi disease, anemia, and reduced immunity may appear, so they must be managed continuously.
In particular, because folic acid deficiency is also related to the onset of congenital neurological diseases in children, women of childbearing age must check and supplement the deficiency before surgery.
The results of this study are expected to serve as an important basis for establishing standard preoperative and postoperative nutritional management guidelines for Koreans amid the gradual expansion of obesity metabolic surgery in Korea.
Professor Park Young-seok said, “Although obese patients are perceived to be overnutrition, there are many deficient nutrients because they are less physically active and their diet is inclined to one side.”
He added, “If you identify and supplement the deficient areas, centering on the major deficient nutrients identified through research, you can achieve the goal of losing weight and reducing blood sugar in a healthy way while minimizing nutritional deficiencies after obesity metabolic surgery.”
The results of this study were published in the SCI-level international academic journal’Obesity Surgery’ of the World Federation of Obesity Metabolism Surgery.