Another Obesity Risk Identified: Leg Lymphedema

Carrying excess weight can increase the odds of developing lymphedema, a painful condition affecting the legs, found a new small study. Leg lymphedema occurs due to blockage of the lymph nodes in the groin area. Complications include functional disability, psychosocial disorders, infection, skin changes, and although rare, malignant transformation. Worldwide, millions of people are affected by lymphedema. The study involved 15 obese patients with swelling in both legs. Twelve of the 15 were women and the mean age was 58 years. The average body mass index (BMI) was about 51. (BMI of 30 or greater is considered obese.)  The average BMI of the five patients who were diagnosed with lymphedema was 70. The findings indicated that the individuals who had a BMI lower than 54 had normal lymphatic function. The researchers believe that obesity is a risk factor for lymphedema in patients with a BMI greater than 60. They explain that as the amount of fat tissue increases in the lower extremity, lymphatic vessels may become dysfunctional, possibly due to compression or inflammation, reducing proximal lymphatic flow. Alternatively, increased production of lymph from an enlarging limb may overwhelm the capacity of a normal lymphatic system to remove the fluid from the extremity. Although there is no cure for lymphedema, major weight loss, such as after bariatric surgery, may improve the condition in obese patients.

As the researchers suggest in this study, more and more evidence is showing that bariatric surgery can also be used to help reverse medical complications of obesity, not just eliminate obesity itself. At the annual meeting of the American Society of Metabolic & Bariatric Surgery (ASMBS) last month, several studies were presented showing that surgery can reduce the complications of metabolic disease.  In an interview with ABC News, Dr. Jaime Ponce, ASMBS President and expert bariatric surgeon in Chattanooga, explained that “We’re not just treating the weight; we’re actually treating the metabolic damage by doing this surgery. It changes their hormones and how their organs work in their body.”  In addition to improvements in metabolic disease, research at the conference described improvements in kidney disease and diabetes following weight loss surgery, as well as a reduced 10 year risk of heart attack.

Of course, surgery is never without risks and is not a quick fix. Dr. Ponce explained that “patients need to understand that there is a team and a practice and a hospital ready to take care of them following surgery. It’s not a one-time surgical procedure; there is constant follow up.” He concluded that successful patients commit themselves to the idea that this is a long-term lifestyle change they need to actively participate in.

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