What is Bariatric Surgery?

Such surgeries are performed when a person’s weight significantly impacts their health and when diet and exercise strategies haven’t been successful. The most popular bariatric procedure is gastric bypass, which most surgeons prefer because it frequently results in fewer complications than other weight-loss procedures.

Various obesity-related metabolic conditions, including diabetes and fatty liver disease, can be managed and prevented through these approaches. However, weight-loss surgery is not a quick or easy solution. Its success requires careful preparation beforehand and lasting lifestyle changes afterward.

For Whom is Bariatric Surgery Appropriate?

Morbidly obese patients (BMI over 40 kg/m² or 35 kg/m² with related health conditions) who have not succeeded with diet and exercise, are motivated, and do not have severe psychological disorders may be considered for treatment.

Procedures

For long-term management of class III obesity, bariatric surgery is the most effective treatment. It is almost impossible for patients with class III obesity to maintain weight loss by diet and exercise alone, according to National Institutes of Health (NIH). Your body will keep trying to get back to your original weight if it recognizes your increased weight as “normal.” Bariatric surgery helps facilitate lasting weight loss and improved health by changing how your body handles food, enabling sustainable dietary and lifestyle adjustments.

Types of Bariatric Surgeries

• Biliopancreatic diversion with duodenal switch (BPD/DS).
• Endoscopic sleeve gastroplasty.
• Gastric bypass (Roux-en-Y)
• Intragastric balloon
• Sleeve gastrectomy

There are two main steps in this supposedly less prevalent weight loss treatment or process.

Eighty per cent of the patient’s stomach will be removed in the first step, also known as a sleeve gastrectomy, leaving a significantly smaller tube-shaped stomach. A small piece of the small intestine that links with the stomach is still present, along with the pyloric valve that discharges food into the small intestine. Most of the intestine is bypassed to reach the duodenum, located close to the stomach, in the second and final phases.

Once the surgery is complete, you eat less and can only absorb nutrients, including fats and proteins. When two major procedures are combined into one, as is the case with the intestinal bypass, it is completed when weight loss has begun. Even if the results are compelling, this treatment involves higher risks. This surgery is suggested for individuals with a BMI greater than 50.

Endoscopic Sleeve Gastroplasty

Endoscopic sleeve gastroplasty is one of the newest procedures for weight loss. The endoscopic suturing tool is used in this surgery to reduce the patient’s stomach size. This surgery is suggested when a person’s body mass index is 30 or more. Endoscopic sleeve gastroplasty allows for a large loss of weight due to the surgery’s restriction of food intake, as well as its reduced invasiveness and low risk of complications.

Gastric Bypass (Roux-en-Y)

Roux-en-Y gastric bypass, often called gastric bypass surgery, involves forming a small stomach pouch and linking it directly to the small intestine. So, after being swallowed, food moves directly from the tiny pouch of the stomach to the small intestine, skipping much of the stomach and the first few inches of the small intestine in the process.

The most popular weight-loss treatment performed globally, this one is also carried out when a patient’s diet and exercise regimen don’t produce the desired results.

Intragastric Balloon

In this weight loss procedure, a silicone balloon filled with saline is implanted inside the stomach. The patient’s decreased food intake aids in weight loss. Moreover, even in small servings, it makes one feel full.

Sleeve Gastrectomy

Vertical sleeve gastrectomy, often called sleeve gastrectomy, is a surgical method for weight loss. Small devices are used to make many incisions on the upper stomach during this laparoscopic operation. During this treatment, the stomach is removed to about 80%. However, a little stomach resembling a tube and around the size and shape of a banana is still present. This technique causes hormonal changes to aid with weight loss. These hormones aid with weight loss and illnesses like high blood pressure or common heart disease linked to weight problems.

Is Bariatric Surgery the Right Option For You?

Due to the possibility that they may not be suited for everyone, bariatric procedures are only carried out when the patient’s excessive weight poses a major threat to their health. In addition, it is not recommended as a cosmetic operation due to the significant risks and potential complications.

Biliopancreatic Diversion with Duodenal Switch

When a person is at significant risk of developing potentially fatal health conditions as a result of weight increase, such as the following:

• Heart condition
• Low BP
• High cholesterol
• Severe sleep apnea
• diabetes type 2
• Stroke infertility

Not all obese people should undergo this treatment. As a result, screening procedures are conducted to assess your eligibility for this surgery.

Gastric Bypass

The gastric bypass procedure is typically an excellent choice for people who:

A body mass index (BMI) of at least 40 or a BMI between 35 and 39 accompanied by medical conditions like type 2 diabetes, high blood pressure, or severe sleep apnea qualifies for surgery. In certain situations, people with a BMI of 30 to 34 might also qualify if they suffer from serious health conditions.

Intragastric Balloon

In general, this technique is advised for those who:

Have a BMI of 30 to 40

Are prepared to engage in behavioral therapy and establish a healthy lifestyle

have never had esophageal or stomach surgery before

Stomach Sleeve Surgery

The following individuals should generally avoid this procedure:

• Have a BMI of at least 40 (classified as extreme obesity).
• A BMI ranging from 35 to 39.9 is often associated with health issues such as type 2 diabetes, hypertension, or severe sleep apnea.
• Even if you have serious health difficulties and your BMI is between thirty and thirty-four, surgery may be performed in some rare circumstances.

Risks Factors

It’s critical to examine the procedure’s risks and any potential postoperative side effects while weighing the benefits and drawbacks of bariatric surgery.

Complications After Surgery

Every surgical procedure carries some risk. Operations that are longer and more difficult may entail more. Risks consist of:

• Bleeding
• Infection
• Clots of blood
• Hernia
• Blockage of the small bowel
• Leaked anastomosis

After Surgery, How Do I Keep the Weight Off?

The patient’s behavior and lifestyle choices following the surgery significantly impact the success of bariatric surgery. Patients must adhere strictly to the diet plan recommended by the dietitian and attend behavioral therapy sessions to improve their attitudes toward food and activity.

Diet Before Surgery

Before having surgery, your bariatric surgeon may set a weight loss goal and a plan for you to follow. This weight reduction helps to reduce the excess fat in the area around the liver and the belly, which lowers the risk of problems. However, the doctor can postpone the treatment if you don’t reach the target weight.

Dietary Advice Following Surgery

You will need to modify your lifestyle and adhere to a number of lifelong rules after your surgery. For example, prevent unhealthy binge eating, it is advisable to prepare your meals at home and keep them with you at all times.

Following the procedure, you must adhere to the following rules for the rest of your life.

• Eat and drink slowly, taking your time to pace yourself during each meal.
• Portion management is crucial.
• If your body exhibits any indicators of discomfort, pay attention to it.
• Eat less food that is high in saturated fats.
• Don’t drink anything during meals, especially something sugary.
• Stay hydrated all day long.
• Chew your food well and cut it into tiny pieces.

Benefits

Beyond helping people lose weight, bariatric surgery has other advantages:

• Long-Term Remission of Type 2 Diabetes: Research suggests that bariatric surgery can lead to prolonged remission of type 2 diabetes. Findings indicate that the procedure effectively manages both obesity and diabetes, allowing nearly all patients to discontinue insulin and related medications for at least three years post-surgery.
• Obstructive Sleep Apnea is Resolved: Achieving and maintaining a healthy weight often allows individuals with sleep apnea to stop using a CPAP machine at night. Within a year after surgery, 80 to 85% of patients report a resolution of their sleep apnea.
• Relief from Joint Pain: Excess weight places significant strain on weight-bearing joints, often leading to chronic pain and joint damage. After bariatric surgery, substantial and long-lasting weight loss reduces joint strain, often allowing individuals to stop using pain medication and experience significantly improved mobility.
• Boost Fertility: Weight loss surgery can enhance fertility before pregnancy. Research suggests that bariatric surgery may improve menstrual cycles in women who do not ovulate and lower the risk of miscarriage.
• Relief from Depression: A lot of obese people experience depression due to their negative self-perception and societal stigma. Even young individuals with significant excess weight may struggle to participate in activities they enjoy, potentially leading to social isolation and depression.

Disadvantages

Risks associated with bariatric surgery include

• The risks of anesthesia.
• Persistent diarrhea and vomiting
• Oesophageal dilation
• Being unable to consume certain foods.
• Gastrointestinal obstruction
• Putting on weight or failing to lose weight

Who to Consult for Bariatric Surgery?

Consult with a Bariatric Surgeon regarding the surgery.

Frequently Asked Questions