What is Bariatric Surgery

Overview

“Bariatric Surgery” is just the umbrella term for weight-loss procedures. To assist you in losing weight, these surgeries change your digestive system. They either restrict the amount of food you can eat, impede your ability to absorb nutrients, or sometimes both.

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.

Numerous obesity-related metabolic illnesses, such as diabetes and fatty liver disease, can be treated and prevented with these methods. Surgery for weight loss, however, is not a simple “quick fix”. To be successful, it necessitates planning prior and long-term lifestyle changes afterwards.

For whom is bariatric surgery appropriate?

Patients who are morbidly obese (BMI > 40 kg/m2 or 35 kg/m2 with comorbidities) have failed diet and exercise attempts, are motivated, and do not suffer from any severe psychological disorders.

Why do bariatric procedures?

The most effective long-term treatment for class III obesity is bariatric surgery. It is almost impossible for patients with class III obesity to maintain weight loss by diet and exercise alone, according to theNational Institutes of Health (NIH). Your body will keep trying to get back to your original weight if it recognises your increased weight as “normal.” With the help of bariatric surgery, you can make healthy dietary and lifestyle adjustments that will result in long-term weight loss and improved health by altering how your body processes food.

Types of Bariatric Surgeries

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

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 intestinal bypass is completed when weight loss has begun. Even if the results are compelling, this treatment involves higher risks. Individuals with a body mass index (BMI) of more than 50 are advised to have this procedure.

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)

A Roux-en-Y gastric bypass is another name for gastric bypass surgery. During this surgery, a tiny pouch in the stomach is directly linked 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 silicon balloon filled with saline is implanted inside the stomach. The patient’s decreased food intake this aids in weight loss. Moreover, even in small servings, it makes one feel full.

Sleeve Gastrectomy

Sleeve gastrectomy, commonly referred to as vertical sleeve gastrectomy, is a surgical weight loss technique. 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.

BPD/DS, or 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. Therefore, screening procedures are carried out to determine your suitability for this surgery.

Gastric Bypass

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

Body mass index of at least forty BMI of between thirty-five and thirty-nine with medical conditions such as type 2 diabetes, high blood pressure, or severe sleep apnea Occasionally, even if you have a BMI between thirty and thirty-four, surgery may still be performed if you have serious health problems.

Intragastric Balloon

In general, this technique is advised for those who:

Have a BMI of 30 to 40

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

have never had oesophagal or stomach surgery before

Stomach sleeve surgery

The following individuals should generally avoid this procedure:

Have at least 40 on the BMI scale (extreme obesity)

BMI range of 35 to 39.9 with health concerns such as type 2 diabetes, high blood pressure, 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.

What are the risks of having bariatric surgery?

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
• Hernias
• Blockage of the small bowel
• Leaked anastomosis

After bariatric surgery, how do I keep the weight off?

The patient’s behaviour and lifestyle choices following the surgery significantly impact the success of bariatric surgery. Patients must adhere strictly to the diet plan recommended by the dietician and attend behavioural 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 and pace yourself at 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 of bariatric surgery

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

• Long-term type 2 diabetes remission: According to a study, type 2 diabetes can go into long-term remission after bariatric surgery. According to the study’s findings, the procedure successfully treats type 2 diabetes and obesity, enabling almost all patients to avoid using insulin and other related medications for at least three years following surgery.
• Obstructive sleep apnea is resolved: Getting to and maintaining a healthy weight range frequently enables persons with sleep apnea to discontinue using a CPAP machine at night. One year following surgery, 80 to 85% of patients report that their sleep apnea has resolved.
• Relief from joint pain: Your weight-bearing joints experience great stress when you carry around excess weight, which frequently results in chronic pain and joint deterioration. Following bariatric surgery, significant and sustained weight loss lessens the strain on joints, frequently enabling people to cease taking painkillers and enjoy significantly greater mobility.
• Boost fertility: Before having children, weight loss surgery can also increase fertility. According to one study, bariatric surgery may reduce the chance of miscarriage and help women who don’t ovulate have better menstrual cycles.
• Relief from depression: A lot of obese people experience depression due to their negative self-perception and societal stigma. Even younger people who are significantly overweight find it challenging to engage in activities they might otherwise enjoy, which can cause social isolation and depression.

Who to consult for Bariatric Surgery?

Consult with a Bariatric Surgeon regarding the surgery.

FAQ

Who qualifies for bariatric surgery?

You must fulfil the following conditions to be a candidate for weight-loss surgery: a BMI of 40 or higher or a BMI between 35 and 40 with an obesity-related illness such as heart disease, diabetes, high blood pressure, or severe sleep apnea.

What are the disadvantages of bariatric surgery?

Risks associated with bariatric surgery include

• The risks of anaesthesia.
• Persistent diarrhoea and vomiting
• Oesophageal dilation
• Being unable to consume certain foods.
• Gastrointestinal obstruction
• Putting on weight or failing to shed weight

What are examples of bariatric surgery?

• Roux-en-Y gastric bypass: This treatment is the most popular method.
• Gastric sleeve surgery: About 80% of the stomach is removed during a sleeve gastrectomy, leaving a long, tube-like pouch.
• Duodenal switch with biliopancreatic diversion.How much weight do I have to lose before bariatric surgery?Some people must reduce 10% of their body weight before having weight-loss surgery. Other patients can lower their risk of problems by dropping merely 15 to 20 pounds before surgery. Adherence to your surgeon’s pre-surgery dietary and nutritional recommendations is crucial.How quickly can I get bariatric surgery?The typical wait period is between 6 and 8 weeks from the initial appointment. You will go through preoperative testing at this time to determine whether surgery is a good option for you.