An unintended consequence of weight-loss surgery: unplanned pregnancy

[MsJacquiiC]

Obesity is one of the most important health epidemics in the United States - an estimated two-thirds of the population is over-weight. Five percent of the population is morbidly obese, 100 lbs over their ideal body weight or a body mass index (BMI) of 40 or higher.

Gastric bypass can affect the body?s ability to absorb medications, including oral contraceptives.

Weight loss is difficult, especially when the goal is one hundred pounds or more. Many people turn to bariatric surgery, procedures that either restrict how much food the stomach can hold and/or shorten a portion of the bowel so fewer calories are absorbed. More than 100,000 of these procedures are performed every year in the United States and 80% of people having this surgery are women.

In addition to affecting absorption of food, vitamins, and minerals gastric bypass can affect the body?s ability to absorb medications, including oral contraceptives, the most common form of contraception among young women. This is a very important point as 50% of women who have bariatric surgery are still in their reproductive years. Consequently, there is an increased risk of unplanned pregnancy after bariatric surgery. According to a statement released this month by the American College of OB/GYN adolescents who have bariatric surgery have double the rate of unplanned pregnancy as compared with their peers who do not have this surgery.

A non-oral route easily bypasses the absorption problem. Excellent choices include depo-provera (the shot) or an IUD. The birth control patch and the ring are other options, but these medications contain estrogen and should be discontinued four weeks before surgery and not re-started until four weeks after surgery (a back-up method should be used during this time). The reason? The combination of surgery and estrogen increases the risk of potentially fatal blood clots.

Women having bariatric surgery must pay special attention to their reproductive needs as most doctors recommend delaying pregnancy for 12-24 months after the surgery, when weight loss has stabilized. Obesity contributes to infertility so many women are more likely to conceive after bariatric surgery. As there is a growing trend of bariatric surgery among adolescents, the highest risk population for unplanned pregnancy, conversations about contraception are an essential part of the plan.



SF Sexual Health Examiner • Jennifer Gunter
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Body Mass Index BMI A statistical method of figuring out the degree of excess or insufficient weight based on one's height & weight. Though the controversial BMI does not actually measure the percentage of body fat, it is a useful tool to estimate a healthy body weight based on how tall a person is.

Morbid Obesity A condition in which the Body Mass Index is 40.0–49.9, which is roughly equal to 100 pounds or more over ideal body weight; a weight level that is life-threatening. A BMI greater than 50 is termed as "super obese." CLICK HERE TO OPEN THE JOURNEY BMI CALCULATOR!

Bariatrics The branch of medicine that deals with the causes, prevention, and treatment of obesity. The term bariatrics was created around 1965, from the Greek root baro ("weight," as in barometer), suffix -iatr ("treatment," as in pediatrics), and suffix -ic ("pertaining to"). Besides the pharmacotherapy of obesity, it is concerned with obesity surgery.

Roux-en-Y Gastric Bypass A type of gastric bypass procedure which combines restrictive and malabsorption techniques - meaning, it reduces the amount of food a patient can comfortably eat (restriction), and also reduces the amount of calories that can be digested in the small intestine (malabsorption). This combination of bariatric methods leads to greater weight loss and the roux-en-y procedure is seen as one of the best ways to treat clinically severe obesity. See WLS Videos for animated surgery technique.

Obesity Obesity results from the excessive accumulation of fat that exceeds the body's skeletal and physical standards. Obesity has been defined as a weight more than 20% above what is considered normal according to standard age, height, and weight tables, or by a complex formula known as the body mass index. According to the National Institutes of Health (NIH), an increase in 20 percent or more above your ideal body weight is the point at which excess weight becomes a health risk. CLICK HERE TO OPEN THE JOURNEY BMI CALCULATOR!