Metabolic Syndrome

What Is Metabolic Syndrome?

Metabolic Syndrome, Hypertension, Cancer, Heart Disease, Bariatric Surgery


Metabolic syndrome is a serious health condition. It is made up of a group of five conditions which include increased blood pressure, high blood sugar, high cholesterol or triglyceride levels, and excess abdominal fat occurring together at the same time. 


Metabolic syndrome increases your risk of suffering from heart disease, stroke and diabetes, as opposed to having only one of the above conditions.


Having just one of these conditions does not mean that you have metabolic syndrome. However, any of these conditions may increase your risk of developing severe health problems if left untreated. Experiencing more than one of these conditions may further increase the risk of developing long term health issues.


If you have metabolic syndrome or any of its conditions, you are recommended to make significant changes in your lifestyle and habits to avoid developing serious health problems in the long run.


Why Is Metabolic Syndrome a Cause of Concern?


Metabolic syndrome significantly increases your risk of suffering from cardiovascular diseases. High cholesterol and high blood pressure may lead to blockages in your arteries. Plaque that forms narrows and hardens your arteries which may lead to a stroke or heart attack.


Metabolic syndrome also poses the risk of developing Type-2 Diabetes. It is linked to insulin resistance in diabetics, where cells do not respond normally to insulin and glucose is not broken down as quickly, causing the blood glucose levels to remain high.


What Causes Metabolic Syndrome?


Metabolic syndrome is a severe health condition that is primarily affected by an individual’s lifestyle. The underlying causes of metabolic syndrome include leading a sedentary lifestyle, being overweight or obese, and physical inactivity.


The risk factors of an individual developing metabolic syndrome may include:


  • Age – the risk of developing metabolic syndrome increases with age.
  • Race – a more significant proportion of metabolic syndrome cases are reported among Indians and Malays community (according to Healthhub).
  • Being overweight or obese
  • Family history of diabetes
  • Other medical conditions – individuals with high blood pressure, lipid disorders, or polycystic ovarian syndrome have a higher chance of developing metabolic syndrome.


A combination of the risk factors above may increase your chances of getting heart disease. On top of that, a patient is six times more likely to be diagnosed with heart disease if they suffer from all of the risk factors stated above. 


Patients who have a family history of diabetes or currently are diagnosed with Type-2 Diabetes are also more likely to develop metabolic syndrome.


How Is Metabolic Syndrome Diagnosed?


During a consultation session with our doctor, metabolic syndrome is diagnosed against a criterion if you have at least three of the following:


  • Central obesity (defined as a waist circumference of more than 40 inches in men and more than 35 inches in women)
  • High triglyceride level of 150 milligrams per deciliter of blood (mg/dL) or more, or being on medications for high triglycerides
  • Low HDL cholesterol of less than 40 mg/dL in men or less than 50 mg/dL in women, or being on low HDL cholesterol medications
  • Elevated blood pressure of 130/85 mm Hg or higher, or being on medications for high blood pressure
  • Fasting glucose of 100 mg/dL or greater, or being on medication for high blood glucose


When Should Bariatric Surgery Be Considered for Metabolic Syndrome? 


Although metabolic syndrome is a serious health condition, you can significantly reduce your risks by losing weight. This means increasing your physical activity and eating a healthy and balanced diet rich in whole grains, fruits, vegetables, and fish.


However, for severely overweight individuals (BMI<40) who have repeatedly been on diets or exercised without much success, bariatric surgery is recommended. 


It has a high success rate, with over 80% of patients losing and maintaining their initial weight loss. It is proven to improve or cure Type-2 Diabetes dramatically, lower insulin levels and normalise blood glucose levels to help a patient wean off therapy and medication in the long run. 

Another key indicator of the success of bariatric surgery is the low risks and complications associated with the procedure.


It should be noted that while the success of bariatric surgery depends most importantly on choosing an experienced surgeon, you will have to play a part by changing your diet and exercise routines to maintain sustainable weight loss.


Why Bariatric Surgery for Metabolic Syndrome?


Weight loss is the most effective way to manage metabolic syndrome as it benefits the health of the individual through keeping active and making better choices when selecting food. 


However, many patients with metabolic syndrome fail to achieve significant and sustained weight loss through lifestyle changes. 


These include consuming a healthy, reduced-calorie diet and engaging in regular physical activity. As such, bariatric surgery, also known as metabolic surgery, may be the option to help patients who are severely obese achieve sustainable results. 


Laparoscopic roux en y gastric bypass and laparoscopic sleeve gastrectomy have proven to be effective and safe medical procedures in helping a patient recover from metabolic syndrome.


Sustained Weight Loss With Bariatric Surgery


For severely obese individuals with metabolic syndrome, bariatric surgery plays a significant role in helping them lose a substantial amount of weight and sustaining weight loss in the long run. 


Research has shown that in patients with metabolic syndrome, the average weight loss one year after surgery is 30% of the initial body weight and eventually 60%. 


Furthermore, patients were also observed to have more sustainable weight loss over a more extended period of time. More than 50% excess weight loss was maintained for patients that underwent Laparoscopic roux en y gastric bypass and laparoscopic sleeve gastrectomy at 8 and 10, and 14 years and 8 years after the procedure, respectively.


Reduced Components of Metabolic Syndrome


As a result of substantial weight loss, bariatric surgery has been shown to significantly reduce the components of metabolic syndrome one year after surgery. 


Weight loss surgery helps significantly lower blood pressure, triglycerides and total cholesterol levels, leading to a 95 per cent resolution or improvement of metabolic syndrome a year after surgery. This is especially significant in reducing stroke and heart disease risk, where HDL and triglycerides are critical indicators in these conditions.


Reduced Risk of Obesity-Related Medical Conditions


Many patients also resolve or improve their Type II Diabetes, hyperlipidemia, hypertension and obstructive sleep apnea after bariatric surgery. Type II Diabetes resolved in around 80 per cent, hyperlipidemia in more than 70 per cent, hypertension in 60 per cent and sleep apnea in 85 percent of patients.


As diabetes, hyperlipidemia and hypertension form the triad of metabolic components, and this resulted in a 95 per cent resolution or improvement rate in metabolic syndrome for severely obese patients one year following surgery.


How Can I Qualify for Bariatric Surgery for My Metabolic Syndrome?


Bariatric surgery is performed to help patients who are either severely or moderately overweight overcome their health conditions due to their excess weight. This is especially so if an individual has been unable to lose weight through conventional methods such as diet, exercise or medicine. 


According to health guidelines, you may be recommended to undergo weight loss surgery if you have a Body Mass Index (BMI) of:

  • 40 or higher
  • 35 or higher and display signs of diabetes or metabolic syndrome


How Does Bariatric Surgery Work for Metabolic Syndrome?


Weight loss surgery works in several ways and are all either malabsorptive, restrictive (Laparoscopic sleeve gastrectomy), or a combination of both (Laparoscopic roux en y gastric bypass).


Malabsorptive procedures alter the way your digestive system works. Restrictive procedures significantly reduce the size of your stomach, which helps to reduce your appetite.


More specifically, Laparoscopic roux en y gastric bypass is a surgery to change your gastrointestinal tract. It causes the food you consume to bypass most of the stomach and the upper part of your small intestine. This procedure helps you lose weight in two ways: you will feel full more quickly and consume smaller amounts of food with the reduced space in your stomach. It also restricts food it can hold and curbs your body’s absorption of calories and nutrients (malabsorptive). 


This surgery improves metabolic syndrome by helping you achieve rapid and significant weight loss.


Laparoscopic sleeve gastrectomy is a surgery that removes a large portion of your stomach. Doing so helps you reduce the space in your stomach, leading to a decrease in appetite, which leads to weight loss. You will only be able to consume smaller amounts of food after the surgery. 


Laparoscopic sleeve gastrectomy may also cause your appetite to decrease as it removes the upper part of your stomach called the fundus. The fundus is a part of your stomach that produces a hormone known as ghrelin, amongst others. Ghrelin is known as the ‘hunger hormone’, which controls an individual’s impulse for hunger. By reducing the levels of the ‘hunger’ hormone produced by your stomach, an individual has less urge to consume food, thereby reducing their overall intake of food, leading to weight loss.


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