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

  • Nicole M. Gilbertson
  • Andrew S. Paisley
  • Sibylle Kranz
  • Arthur Weltman
  • Jennifer L. Kirby
  • Peter T. Hallowell
  • Steven K. Malin
Review Article

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.

Keywords

Bariatric surgery Insulin resistance Diet Exercise Pharmacology Weight loss surgery 

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Nicole M. Gilbertson
    • 1
  • Andrew S. Paisley
    • 1
  • Sibylle Kranz
    • 1
  • Arthur Weltman
    • 1
    • 2
  • Jennifer L. Kirby
    • 2
  • Peter T. Hallowell
    • 3
  • Steven K. Malin
    • 1
    • 2
    • 4
  1. 1.Department of KinesiologyUniversity of VirginiaCharlottesvilleUSA
  2. 2.Division of Endocrinology and Metabolism, Department of MedicineUniversity of VirginiaCharlottesvilleUSA
  3. 3.Department of SurgeryUniversity of VirginiaCharlottesvilleUSA
  4. 4.Robert M. Berne Cardiovascular Research CenterUniversity of VirginiaCharlottesvilleUSA

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