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Los Angeles vascular surgeon Jackson Dyers, MD, has begun recommending that his patients living with obesity undergo above the knee amputations (AKAs) as a means of reducing their total body weight.
"Diets rarely work. Patients always gain back the weight once they stop the diet," explained Dr. Dyers. "And bariatric surgery has so many relative contraindications," he continued. "My amputation approach to weight management ensures that their weight stays down for good."
Dr. Dyers said he got the idea when chatting with a neighbor with morbid obesity at a backyard BBQ. "The guy was venting to me about being unable to keep the weight off despite trying a slew of different interventions. Then he jokingly said he'd give an arm and a leg for a solution to his weight issues," Dr. Dyers recounted. To which I responded, "'OK, yeah, actually let's do that.'
"I usually recommend a single unilateral AKA. Never bilateral AKA. I'm not a madman," he reassured. "But that's mainly just because if we remove both their legs, then technically their height decreases. Then, when we calculate their new post-op BMI, it doesn't drop as low as we'd like. Alternatively, if you just take off one leg, then their height stays the same, so their post-op BMI calculation looks a lot better," he expounded. "It's a lot of math, but don't overthink it. Trust me, the numbers don't lie."
Dr. Dyers also pointed out that his approach is a good preemptive measure for many of his patients as a common comorbidity of patients with obesity is diabetes. "Obesity and diabetes go hand in hand so chances are they have diabetes too and will need an amputation at some point down the line anyways," he explained.
"But above the knee amputations are just the beginning," Dr. Dyers added. "The real future of surgically managed weight loss is in decapitation."