Question of the Month

Q:  My two sisters and I have all have PCOS. My oldest sister is slim and in great health. My second oldest sister is severely obese, diabetic and has a host of other troubles. In the past four years, after I went off the pill, I have gained 125 lbs. My sister's doctor has her scheduled for gastric bypass surgery. My doctor wants me to have the surgery. I just don't see the surgery as a solution. I cannot figure out how making a stomach smaller will take away all the hormone issues we are plagued with. Please explain why doctor's are considering this drastic surgery for PCOS.

A: I have had a program for people with significant weight problems for more than 20 years. It uses an extremely low carbohydrate diet - essentially no carb at all-- which has some similarities to Atkins but better for people with a large amount of weight to lose.

My point here is not to advocate my, or any other particular approach but to explain that I have been working as a physician in this area for quite some time. I have seen many fad treatments come and go. When I refused to prescribe Redux because the history of diet pills had been so unfortunate, some of my patients were unhappy. But then they thanked me when it turned out to cause heart damage.

Obesity surgery is another treatment which comes and goes. I have not been impressed that it provides long term benefits and so do not recommend it.

I can't say what is best for a particular individual but do advise people to think very carefully before undergoing any such surgery.

As to whether the surgery helps PCOS, weight loss usually does improve the condition, even a modest amount such as 20 to 30 lbs. I have not seen any study however documenting how obesity surgery affects PCOS.

Hope this is helpful.

Geoffrey Redmond, MD

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