Excess body fat and weight gain are major concerns for a significant part of the global population. Generally speaking, it is the result of improper diet, lack of adequate exercise, glandular imbalance, disease and substance abuse. In most cases, the remedy is correcting the diet, exercising regularly and in the right amount, and treating underlying physical conditions and making lifestyle changes. However, in some cases, this does not produce the required results and because of this, a surgical option is advised.
Bariatric Surgery
Bariatric surgery, or weight loss surgery as it is often called, involves procedures to alter the digestive system and cause the body to lose weight. It is undertaken when other attempts at weight loss have failed and obesity is causing serious health concerns. There are 2 basic types of bariatric surgery. In one, the amount of food a person can eat is restricted. In the other, the body’s ability to absorb fats and calories is reduced. It must be noted that while bariatric surgery is becoming an increasingly common way of dealing with serious obesity problems, it is a major procedure and there are risks and side-effects attached to it. It is also not a magical solution – after the surgery, a patient will need to control his or her diet and get enough exercise to enable the surgical procedure to be a long-lasting success.
Why It May Be Required
The overall objective of bariatric surgery is to help the patient lose excess weight and by doing so, reduce the possibility of serious weight-related health problems from developing or, if they already exist, to treat or control them. Among the conditions for which weight loss surgery is advised are:
- Various types of cancers
- High blood pressure
- High cholesterol levels
- Heart disease and stroke
- Type 2 diabetes
- Nonalcoholic fatty liver disease (NAFLD)
- Nonalcoholic steatohepatitis (NASH)
- Sleep apnea
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Types of Procedures
There are 3 ways in which bariatric surgery is done:
- Sleeve gastrectomy
- Bi-gastric bypass (Roux-en-Y)
- Biliopancreatic diversion with duodenal switch (BPD/DS)
The surgeon will, after conducting tests and physical examinations which confirm the need for weight loss surgery, decide on which procedure is right for the patient and explain the details of the procedure. These procedures are performed after attempts to reduce weight through diet control, exercise or medication have been unsuccessful.
Who Are Candidates for Bariatric Surgery?
As already mentioned, a surgeon will decide on the need for the surgery. That said it is typically advised when:
- The body mass index (BMI) is between 35 to 39.9 which defines obesity.
- The BMI is 40 or higher which denotes a condition of extreme obesity.
- In some cases, it may be advised for those with a BMI of 30 to 34.9, if the patient has serious weight-related health issues.
BMI is a measure of body fat based on the height, weight and age of a person. There are established tables and formulas which are used to evaluate BMI.
Before a decision is taken regarding bariatric surgery, a detailed physical and mental screening procedure is done to ensure that the patient is ready for the surgery and the post-surgical lifestyle changes that will be required.
As with any major surgery, there are potential health risks, some of which could be serious. A person considering the procedure must discuss the risks with the doctor and fully understand the potential health problems that may arise.
Preparing for the Surgery
Once bariatric surgery is decided on, the patient will be given detailed instructions on how to prepare for the procedure. There will be limits on what can be eaten or drunk, and if any medication is being taken for other medical issues, these may be reduced or modified. A physical activity plan may be formulated to help prepare the body for the procedure. A plan of post-surgical care and recovery at home will also be created to ensure that when the patient returns from the hospital, the house is ready to meet the special needs of the recovery period.
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The Procedure
The surgery is done under general anesthesia. Today, most bariatric procedures are performed laparoscopically which means only small incisions are made and miniature cameras and instruments are inserted through the incisions to enable the surgeon to perform the surgery. While traditional surgical techniques are used in some cases, laparoscopic procedures have the advantage of reduced scarring and faster recovery.
Recovery
After the surgery, the patient is typically required to remain in the hospital for 1 or 2 days so that the initial recovery can be monitored. Once the doctors are satisfied with the progress, the patient may return home to continue the medically supervised recuperation, which will include regular follow-up visits to the hospital. In the initial stages, there will be a great deal of restrictions on diet. These will be gradually reduced as the recovery progresses.
It is important to understand that after the surgery, a common sense approach to diet and exercise, as advised by the doctors, should be followed to ensure that the benefits of the surgery are maintained.
Being overweight is not healthy for anyone – it carries the risk of developing all kinds of health issues, some of which could be life-threatening. When a person is obese and other attempts to lose weight have failed, the right course of action would be to seek medical advice at a leading multispecialty hospital. This is where a full range of medical specialists and state-of-the-art medical and surgical treatment options will be available. This will ensure that the need for the surgery is justified and that other options will be ineffective. The patient can then go in for the procedure with the knowledge that the best medical decisions have been taken by the leading experts in the field.