Obesity can come with a whole host of other health issues. A co-morbidity is the presence of two or more chronic conditions in a patient. For those who are obese, comorbidities could include type 2 diabetes, heart disease, hypertension, gout, osteoarthritis and more.
Dr. Michael Bilof discusses comorbidities that can be impacted by obesity, plus how those comorbidities can improve after surgery.
Co-morbidities Associated with Obesity and Post-Surgical Health Improvements
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Learn more about Michael Bilof, MD
Michael Bilof, MD
Dr. Michael Bilof began his career as a vascular surgeon where he continuously saw chronically ill patients suffering from type 2 diabetes. Dr. Bilof was frustrated by the overwhelming acceptance of maintaining the comorbidities (e.g., obesity) associated with type 2 diabetes and believed there had to be something more doctors could do to help. In 2003, upon the urging of his wife, Dr. Bilof left his successful vascular practice and retrained in general surgery, specializing in bariatrics. In April 2007, he founded Garden State Bariatrics and began offering lifesaving solutions for individuals with obesity and related diseases.Learn more about Michael Bilof, MD
Transcription:
Bill Klaproth (Host): Comorbidities; what are they, what impact do they have and how does post-surgery improve them? Here to talk with us about comorbidities is Dr. Michael Bilof, a bariatric surgeon. He is also the founder of Garden State Bariatrics and Wellness Center. Dr. Biloff, thank you so much for your time. So, what is a comorbidity?
Dr. Michael Bilof (Guest): So, basically a comorbidity in very simple terms is a medical problem. A medical problem associated with some other condition. So, in this case, medical problems associated with being overweight or obese.
Bill: So, does obesity cause comorbidity?
Dr. Bilof: Absolutely. There is really a long list of medical problems, that is, comorbidities associated with obesity and overweight. The big four if you will are diabetes, high blood pressure, something called sleep apnea and heart disease coronary artery disease. Those are the main four ones that affect the overweight population. And then there is a whole host of sort of secondary ones. High cholesterol, elevated triglycerides, infertility, joint pains, arthritis, there is actually a number of cancers that are more likely in the overweight population, endometrial, prostate, esophageal. So, there is really a long laundry list of medical problems associated with being overweight and obese.
Bill: So, do most obese people have comorbidities?
Dr. Bilof: Most do. Although we do see the occasional patient who actually really has no medical problems just that they are overweight. But most of our patients do have some medical problems. And some may not even be aware. For instance, sleep apnea is one that many patients are not even aware that they have. And it’s interesting, usually when I interview a patient for the first time, if they are there with their spouse or significant other, I will ask the significant other or spouse if the patient snores or that sort of thing and oftentimes the person they sleep with is more aware of the sleep apnea than the patient themselves. So, or for instance not all patients know they are diabetic. That is another medical problem that sometimes patients are unaware of. So, most patients will have some medical problems associated with being overweight, even if they are not necessarily aware of the problem themselves.
Bill: So, being overweight, can severely impact the person’s daily life, but these comorbidities, are these things often what drive them to see someone like you to have the weight taken off because this is really a serious medical condition now?
Dr. Bilof: Many times, that is the thing that prompts patients to come in. they were recently diagnosed with sleep apnea or diabetes or a woman who is having trouble getting pregnant meet with her OB and is informed that the infertility or difficulty getting pregnant could be related to their weight or a patient in informed that they will need a new knee replacement at a rather early age and if they lose some weight, they may not need that knee replacement or can delay the need for the knee replacement five or ten years by losing 50 or 100 pounds. So, oftentimes, a diagnosis or some sort of intervention by another doctor kind of prompts the patient to seek out our services yes.
Bill: So, how does bariatric surgery improve or even cure these comorbidities?
Dr. Bilof: Well actually that’s really the most exciting thing. So, mostly when we think of surgical procedures or surgical interventions, they are usually for one specific problem. So, for instance if someone has appendicitis, we take out their appendix or if they have an irritated or inflamed gall bladder, we take out their gallbladder. So, there’s the surgical procedure so to speak just deals with one discreet problem. Bariatrics is interestingly – bariatric surgery is really I think the only surgical procedure/intervention that will improve and, in many cases, resolve a whole host of medical problems. So, for instance, we do an operation on the stomach and the patient’s diabetes gets better, or their sleep apnea gets better or their blood pressure is dramatically improved, or a woman can suddenly get pregnant. So, it handles or improves a whole host of medical problems and to my knowledge, it’s really the only surgical procedure that that’s true of. Many issues, many problems either completely resolve or dramatically improve. Their back pain goes away. Joint pain goes away. So, yes, the short answer is yes, it absolutely improves these medical problems and often many of them.
Bill: So, there are many health benefits associated with bariatric surgery and in many cases, this surgery can be a life saver for many people.
Dr. Bilof: Indeed. For instance, a patient who is diabetic and is taking pills or insulin has bariatric surgery and, in many cases, their diabetes goes away completely. That is, they no longer need insulin, they no longer need pills. Their blood sugar is normal and that has a dramatic effect on a person’s overall health and even how long they live, their longevity. Going from a diabetic who needs insulin to a nondiabetic will add years to a person’s life.
Bill: And post-surgery, if they change their lifestyle and watch what they eat and exercise; these comorbidities then theoretically should stay away. Is that right?
Dr. Bilof: Correct. Assuming the patient does not regain the weight; the comorbidities are for the most part resolved pretty much forever. Yeah.
Bill: And I know at Garden State, you do wonderful follow up. Can you talk about how you are a partner with that patient on their journey post-surgery, checking up on them and helping them make those lifestyle changes?
Dr. Bilof: Sure. Once – we often say we are kind of joined at the hip for life once you have had surgery with us. So, there is obviously a lot of follow up in the immediate post-operative period but once someone gets out two, three, six months; then we basically see them every several months to kind of keep them on the right track if you will. And then after the first year, it’s several visits in the second year and then usually somewhere between the first and second year, the weight loss will stop. They kind of bottom out and hit their target weight so to speak and then following the second year; it’s basically once a year follow-up to make sure number one that they have maintained their weight loss and number two to make sure that they don’t develop any types of vitamin or nutritional deficiencies that can develop several years after surgery.
Bill: So, it sounds like the overall message then is these comorbidities can be managed and erased with bariatric surgery and proper post-operative care and lifestyle changes.
Dr. Bilof: Absolutely. So, if you are person who has been diagnosed with diabetes or sleep apnea or had some heart issue or heart attack this is a procedure that can radically improve those medical problems and, in many cases, actually make them disappear completely. And that’s very exciting. Most people don’t think of these medical conditions as having a surgical cure, but in fact, many of them do.
Bill: Well that is exciting and really good news. Dr. Bilof, thank you so much for your time. For more information, please visit the Garden State Bariatrics and Wellness Center website at www.gsbwc.com, that’s www.gsbwc.com. This is Winning Through Losing a Weight Loss Surgery podcast with Garden State Bariatrics and Wellness Center. I’m Bill Klaproth. Thanks for listening.
Bill Klaproth (Host): Comorbidities; what are they, what impact do they have and how does post-surgery improve them? Here to talk with us about comorbidities is Dr. Michael Bilof, a bariatric surgeon. He is also the founder of Garden State Bariatrics and Wellness Center. Dr. Biloff, thank you so much for your time. So, what is a comorbidity?
Dr. Michael Bilof (Guest): So, basically a comorbidity in very simple terms is a medical problem. A medical problem associated with some other condition. So, in this case, medical problems associated with being overweight or obese.
Bill: So, does obesity cause comorbidity?
Dr. Bilof: Absolutely. There is really a long list of medical problems, that is, comorbidities associated with obesity and overweight. The big four if you will are diabetes, high blood pressure, something called sleep apnea and heart disease coronary artery disease. Those are the main four ones that affect the overweight population. And then there is a whole host of sort of secondary ones. High cholesterol, elevated triglycerides, infertility, joint pains, arthritis, there is actually a number of cancers that are more likely in the overweight population, endometrial, prostate, esophageal. So, there is really a long laundry list of medical problems associated with being overweight and obese.
Bill: So, do most obese people have comorbidities?
Dr. Bilof: Most do. Although we do see the occasional patient who actually really has no medical problems just that they are overweight. But most of our patients do have some medical problems. And some may not even be aware. For instance, sleep apnea is one that many patients are not even aware that they have. And it’s interesting, usually when I interview a patient for the first time, if they are there with their spouse or significant other, I will ask the significant other or spouse if the patient snores or that sort of thing and oftentimes the person they sleep with is more aware of the sleep apnea than the patient themselves. So, or for instance not all patients know they are diabetic. That is another medical problem that sometimes patients are unaware of. So, most patients will have some medical problems associated with being overweight, even if they are not necessarily aware of the problem themselves.
Bill: So, being overweight, can severely impact the person’s daily life, but these comorbidities, are these things often what drive them to see someone like you to have the weight taken off because this is really a serious medical condition now?
Dr. Bilof: Many times, that is the thing that prompts patients to come in. they were recently diagnosed with sleep apnea or diabetes or a woman who is having trouble getting pregnant meet with her OB and is informed that the infertility or difficulty getting pregnant could be related to their weight or a patient in informed that they will need a new knee replacement at a rather early age and if they lose some weight, they may not need that knee replacement or can delay the need for the knee replacement five or ten years by losing 50 or 100 pounds. So, oftentimes, a diagnosis or some sort of intervention by another doctor kind of prompts the patient to seek out our services yes.
Bill: So, how does bariatric surgery improve or even cure these comorbidities?
Dr. Bilof: Well actually that’s really the most exciting thing. So, mostly when we think of surgical procedures or surgical interventions, they are usually for one specific problem. So, for instance if someone has appendicitis, we take out their appendix or if they have an irritated or inflamed gall bladder, we take out their gallbladder. So, there’s the surgical procedure so to speak just deals with one discreet problem. Bariatrics is interestingly – bariatric surgery is really I think the only surgical procedure/intervention that will improve and, in many cases, resolve a whole host of medical problems. So, for instance, we do an operation on the stomach and the patient’s diabetes gets better, or their sleep apnea gets better or their blood pressure is dramatically improved, or a woman can suddenly get pregnant. So, it handles or improves a whole host of medical problems and to my knowledge, it’s really the only surgical procedure that that’s true of. Many issues, many problems either completely resolve or dramatically improve. Their back pain goes away. Joint pain goes away. So, yes, the short answer is yes, it absolutely improves these medical problems and often many of them.
Bill: So, there are many health benefits associated with bariatric surgery and in many cases, this surgery can be a life saver for many people.
Dr. Bilof: Indeed. For instance, a patient who is diabetic and is taking pills or insulin has bariatric surgery and, in many cases, their diabetes goes away completely. That is, they no longer need insulin, they no longer need pills. Their blood sugar is normal and that has a dramatic effect on a person’s overall health and even how long they live, their longevity. Going from a diabetic who needs insulin to a nondiabetic will add years to a person’s life.
Bill: And post-surgery, if they change their lifestyle and watch what they eat and exercise; these comorbidities then theoretically should stay away. Is that right?
Dr. Bilof: Correct. Assuming the patient does not regain the weight; the comorbidities are for the most part resolved pretty much forever. Yeah.
Bill: And I know at Garden State, you do wonderful follow up. Can you talk about how you are a partner with that patient on their journey post-surgery, checking up on them and helping them make those lifestyle changes?
Dr. Bilof: Sure. Once – we often say we are kind of joined at the hip for life once you have had surgery with us. So, there is obviously a lot of follow up in the immediate post-operative period but once someone gets out two, three, six months; then we basically see them every several months to kind of keep them on the right track if you will. And then after the first year, it’s several visits in the second year and then usually somewhere between the first and second year, the weight loss will stop. They kind of bottom out and hit their target weight so to speak and then following the second year; it’s basically once a year follow-up to make sure number one that they have maintained their weight loss and number two to make sure that they don’t develop any types of vitamin or nutritional deficiencies that can develop several years after surgery.
Bill: So, it sounds like the overall message then is these comorbidities can be managed and erased with bariatric surgery and proper post-operative care and lifestyle changes.
Dr. Bilof: Absolutely. So, if you are person who has been diagnosed with diabetes or sleep apnea or had some heart issue or heart attack this is a procedure that can radically improve those medical problems and, in many cases, actually make them disappear completely. And that’s very exciting. Most people don’t think of these medical conditions as having a surgical cure, but in fact, many of them do.
Bill: Well that is exciting and really good news. Dr. Bilof, thank you so much for your time. For more information, please visit the Garden State Bariatrics and Wellness Center website at www.gsbwc.com, that’s www.gsbwc.com. This is Winning Through Losing a Weight Loss Surgery podcast with Garden State Bariatrics and Wellness Center. I’m Bill Klaproth. Thanks for listening.