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Bariatric Surgery Resistance: Using Preoperative Lifestyle Medicine and/or Pharmacology for Metabolic Responsiveness

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Abstract

Bariatric surgery is an effective and durable treatment for individuals with obesity and its associated comorbidities. However, not all patients meet weight loss and/or cardiometabolic goals following bariatric surgery, suggesting that some people are bariatric surgery resistant. The reason for this resistance is unclear, but potential factors, such as adiposity-derived inflammation, insulin resistance, hyperglycemia, and aerobic fitness prior to surgery, have been related to blunted surgery responsiveness. Exercise, diet, and/or pharmacology are effective at reducing inflammation and improving insulin action as well as physical function. Herein, we present data that supports the novel hypothesis that intervening prior to surgery can enhance disease resolution in people who are resistant to bariatric surgery.

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Acknowledgements

We thank the members of the Applied Metabolism and Physiology Laboratory for the helpful discussion on the manuscript.

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Authors and Affiliations

  1. Department of Kinesiology, University of Virginia, 210 Emmet St. S | Memorial Gymnasium, Charlottesville, VA, 22904, USA

    Nicole M. Gilbertson, Andrew S. Paisley, Sibylle Kranz, Arthur Weltman & Steven K. Malin

  2. Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia, Charlottesville, VA, USA

    Arthur Weltman, Jennifer L. Kirby & Steven K. Malin

  3. Department of Surgery, University of Virginia, Charlottesville, VA, USA

    Peter T. Hallowell

  4. Robert M. Berne Cardiovascular Research Center, University of Virginia, Charlottesville, VA, USA

    Steven K. Malin

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  1. Nicole M. Gilbertson
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  2. Andrew S. Paisley
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  3. Sibylle Kranz
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  4. Arthur Weltman
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  5. Jennifer L. Kirby
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  6. Peter T. Hallowell
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  7. Steven K. Malin
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Contributions

N.G. and S.K.M. were primarily responsible for the writing of the manuscript. A.P., S.K., A.W., J.K., and P.H. reviewed and edited the manuscript.

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Correspondence to Steven K. Malin.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Gilbertson, N.M., Paisley, A.S., Kranz, S. et al. Bariatric Surgery Resistance: Using Preoperative Lifestyle Medicine and/or Pharmacology for Metabolic Responsiveness. OBES SURG 27, 3281–3291 (2017). https://doi.org/10.1007/s11695-017-2966-1

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