Obesity surgery’s benefits extending to next generation

Pregnancies after the operation yield healthier children.

Children born to women who have achieved drastic weight loss through stomach surgery are healthier than children born to severely obese moms, a new study shows. The findings suggest that obesity creates an unhealthy environment for a fetus that has ramifications later on.

"This is very important work," says Dana Dabelea, a physician and epidemiologist at the University of Colorado-Denver and the Colorado School of Public Health in Aurora. "This is the first proof that exposure to obesity in utero is associated with long-term effects," she says.

Severely obese women should be encouraged to lose weight before becoming pregnant, asserts study coauthor John Kral, a surgeon at the State University of New York Downstate Medical Center in Brooklyn.

Kral collaborated with researchers at University of Laval in Quebec City in contacting 49 women who had given birth and had also undergone a specific type of obesity surgery. About half of the women had one child before surgery and another child after.

All the women who had undergone biliopancreatic diversion bariatric surgery, in which a portion of the stomach is removed and food and digestive enzymes are shunted past part of the small intestine, limiting the amount of nutrients absorbed. On average, the women lost more than one-third of their body weight after surgery, and they kept it off.

The surgeries took place between 1984 and 2005. During that time, these women had a combined total of 111 children-54 born before obesity surgery and 57 afterward. When the children were examined in 2007 and 2008, they ranged in age from 2 to 25 years.

The researchers found that 19 children born before their moms underwent surgery were severely obese, compared with six children born after surgery.

As a group, the children born after surgery scored better on a host of medical tests. Blood tests revealed that those born after surgery had healthier levels of leptin and ghrelin, hormones that regulate appetite

Measurements of overall HDL cholesterol, the good kind, were higher in children born after surgery, and their total-cholesterol-to-HDL ratio was lower.

Children born after mom had obesity surgery also had lower blood levels of C-reactive protein.

The new data suggest that a fetus can undergo epigenetic changes in the womb brought on by maternal obesity.

Meanwhile, the cause of obesity itself is unclear.

In a departure from past generations' medical dogma doctors are starting to counsel women to maintain only modest weight gain during pregnancy and should ask obese women to lose weight while pregnant.

Original report was modified by Jakub Málek
Source: www.sciencenews.org, www.wikipedia.org