Surgical Polypharmacy



Photo by M Clock

Polypharmacy isn't usually a good thing.

The very term connotes severe or resistant disease processes, or even worse, possibly some type of negligence on the part of the prescriber(s) of those medicines as to the true necessity of each one for its intended purpose, etc.

What if the polypharmacy was a good thing?  How about a 'super drug' that could effect a broad range of similar conditions, and be effective via a mechanism of action that was multimodal?

I know, you probably saw it coming, but Bariatric Surgery is such a "drug". It really helps to think of it that way, or even describe it that way to a patient.

And as we have been discussing, the metabolic surgeries (notably Sleeves and Bypasses) do have powerful metabolic effects, by targeting many different sites to achieve that benefit.

Take Diabetes for example.  What medicine can you utilize as monotherapy that will effect body weight, food intake / portions, energy expenditure, insulin sensitivity, Glucose tolerance, and insulin secretion?

That's right, there is none.

Both Sleeve Gastrectomy and Gastric Bypass effect all of these parameters through their GI manipulation as a means to their metabolic effects.

Again, keep that in mind as you reach for that Rx pad to increase a medicine, add insulin, or consider an Endo referral for your overweight Diabetic patient.  Maybe it's time to initiate 'The Talk' about trading some medicines off for a surgical referral for weight loss surgery!