Obese mothers who underwent weight-loss surgery prior to pregnancy had a lower prevalence of obese children than siblings born before the same obese mothers had the bariatric surgery.

"Our study confirms previous research showing that the intrauterine environment may be more important than genes and the post-natal environment when it comes to the association between maternal obesity and childhood obesity," says John Kral, M.D., Ph.D., of SUNY Downstate Medical Center in Brooklyn, NY.

Weight-loss surgery limits the amount of food a person can consume and digest. Dr. Kral's study focused on women who had a type of surgery known as biliopancreatic diversion (BPD) prior to becoming pregnant. BPD changes the normal process of digestion by making the stomach smaller and directing food to bypass part of the small intestine, resulting in reduced caloric absorption.

Dr. Kral and colleagues studied 49 mothers who had undergone BPD surgery and their 111 children (between the ages of 2.5 and 25 years). All mothers in this study had children born before and then after their weight-loss surgery.

The research found that children who were born after their mother underwent weight-loss surgery had reduced birth weight and waist circumference and were three times less likely to become severely obese.

Furthermore, children born after their mother's weight-loss surgery had improved cardiovascular markers including reduced insulin resistance and lower cholesterol.

Dr. Kral tells DOTmed News that because obesity can lead to insulin resistance, heart disease and pregnancy complications, obesity during pregnancy "must be prevented."

He believes that if women can't lose weight with lesser efforts [such as diet and exercise] they should not hesitate to undergo bariatric surgery before deciding to have a child.

"Preventing obesity and treating it effectively in young women could prevent further transmission to future generations," he says. He adds, "I think clinical medicine is evolving and I hope people will respond to our research the way the editors of JCEM did."

Dr. Kral's paper, "Effects of Maternal Surgical Weight Loss on Intergenerational Transmission of Obesity", will appear in the November 2009 issue of the Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).

Dr. Kral says he will continue to follow women and their offspring in what will be an ongoing effort to show that intrauterine conditions may determine "whether a child at birth is destined to become obese."

Source: SUNY and The Endocrine Society

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