What is Obesity Surgery (Bariatric Surgery) ?
Gastric bypass and other weight loss surgery, known collectively as bariatric surgery, involves making changes to your digestive system to help you lose weight. Bariatric surgery is performed when diet and exercise do not work or when you have serious health problems because of your weight.
Although bariatric surgery can provide many benefits, all types of weight loss surgery are serious procedures which can carry serious risks and side effects. You must also make ongoing healthy changes to your diet and exercise regularly to ensure the long-term success of bariatric surgery.
What is the causes of the Obesity ?
Obesity may be caused by a variety of conditions. The most significant are excessive and insufficient eating habits, as well as a lack of physical exercise. Other reasons of obesity include genetics, age, gender, educational level, socio-cultural variables, psychiatric issues, hormonal and metabolic abnormalities, the number of births and time between births, and the use of certain medicines.
What diseases are Obesity-Related ?
Obesity is linked to a variety of illnesses, including cardiovascular disease, hypertension, type 2 diabetes, high cholesterol, sleep apnea, asthma, musculoskeletal issues, and infertility. Breast, large intestine, renal, uterine, and prostate cancers are among the malignancies that may be caused by it. Obesity has a significant impact on people's psychological well-being in addition to physical problems. Obese persons live 20 percent fewer years than normal-weight people due to the chronic illnesses that obesity causes and the detrimental effects it has on life.
Obesity has become a severe health concern as a result of all of these factors. The World Health Organization estimates that there are over 2 billion obese people on the planet. In our nation, the situation is not much different. Obesity affects 20% of males and 40% of women over the age of 18.
Who is a good candidate for Obesity Treatment ?
Patients with a BMI of 40 or above, a BMI of 35-40 with an additional condition induced by obesity, or a BMI of 30-35 with diabetes or metabolic syndrome are candidates for obesity surgery. Furthermore, patients who have been obese for at least three years, have tried other methods (diet, sports, medicine, etc.) but have not been able to lose weight permanently, have hormonal disorders that cause obesity, are non-alcohol and substance addicts, and have an acceptable surgical risk are candidates for these operations.
What types of Obesity Surgery (Bariatric Surgery) exist?
Biliopancreatic diversion with duodenal switch (BPD/DS)
Gastric bypass (Roux-en-Y)
Sleeve gastrectomy
Why should you have Obesity Surgery (Bariatric Surgery) ?
Bariatric surgery is performed to help you lose excess weight and reduce your risk of potentially life-threatening weight-related health problems, including
- Heart disease and stroke
- High blood pressure
- non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH)
- Sleep apnoea
- Type 2 diabetes
Who needs Obesity Surgery (Bariatric Surgery) ?
Bariatric surgery is not suitable for everyone who is seriously overweight. To be eligible for weight loss surgery, you must meet certain medical guidelines. You are likely to undergo an extensive assessment process to find out if you qualify. You must also be willing to make permanent changes to lead a healthier lifestyle.
You may be required to participate in long-term follow-up plans that include monitoring your diet, lifestyle and behaviour as well as your health status.
How do you prepare for Obesity Surgery (Bariatric Surgery) ?
You may have to have various laboratory tests and examinations before surgery. You may have restrictions on eating and drinking as well as taking medication. You may be required to start a physical activity programme and stop smoking.
How is Obesity Surgery (Bariatric Surgery) performed?
Roux-en-Y gastric bypass (roo-en-wy). This operation is the most common method of gastric bypass. This operation is generally not reversible. It works by reducing the amount of food you can eat in one sitting and reducing the absorption of nutrients.
The surgeon cuts open the top part of the stomach, separating it from the rest of the stomach. The resulting pouch the size of a walnut holds only about an ounce of food. Normally, the stomach holds about 3 pints of food.
The surgeon then cuts open the small intestine and sews part of it directly into the pouch. Food goes into this small stomach pouch and then directly into the small intestine sewn into it. Food bypasses most of the stomach and the first part of the small intestine, and enters directly into the middle small intestine.
Sleeve gastrectomy. A sleeve gastrectomy removes about 80% of the stomach, leaving a long, tube-like sac. This smaller stomach cannot hold as much food. It also produces less of the appetite-regulating hormone ghrelin, which can reduce the desire to eat.
The benefits of this procedure are significant weight loss and no need for bowel diversion. Sleeve gastrectomy also requires a shorter hospital stay than most other procedures.
Biliopancreatic diversion with duodenal switch. This is a two-part operation in which a procedure similar to a sleeve gastrectomy is performed in the first stage. The second involves connecting the terminal bowel to the duodenum next to the stomach (duodenal switch and biliopancreatic diversion), bypassing most of the bowel.
This operation limits the amount of food and reduces the absorption of nutrients. Although it is extremely effective, it carries great risks, including malnutrition and vitamin deficiency.
What results should I expect after Obesity Surgery (Bariatric Surgery) ?
Gastric bypass and other bariatric surgeries can provide long-term weight loss. The amount of weight lost depends on the type of surgery and changes in lifestyle habits. Half or more of this excess weight can be lost within two years.
In addition to weight loss, gastric bypass surgery can improve or eliminate conditions often associated with being overweight, including:
- Heart disease
- High blood pressure
- Obstructive sleep apnoea
- Type 2 diabetes
- Non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH)
- Gastroesophageal reflux disease (GERD)
- Osteoarthritis (joint pain)
Gastric bypass surgery can also improve your ability to carry out normal daily activities, which can improve your quality of life.
What risks can occur after Obesity Surgery (Bariatric Surgery) ?
Risks associated with the surgical procedure may include
- Excessive bleeding
- Infection
- Adverse reactions to anaesthesia
- Blood clots
- Lung or breathing problems
- Gastrointestinal leaks
- Death (rare)
The long-term risks and complications of weight loss surgery depend on the type of surgery. These can include:
- Intestinal obstruction
- Dumping syndrome, resulting in diarrhoea, hyperemia, dizziness, nausea or vomiting
- Gallstones in the gallbladder
- Hernias
- Low blood sugar (hypoglycaemia)
- Malnutrition
- Ulcers
- Vomiting
- Acid reflux
- Need for repeat or revision surgery or procedure
- Death (rare)
What type of anaesthesia is used in Obesity Surgery (Bariatric Surgery) ?
Bariatric surgery is carried out in hospital using general anaesthesia. This means that you are unconscious during the operation.
How many hours will Obesity Surgery (Bariatric Surgery) take?
The operation usually takes several hours. After the operation, you will wake up in a recovery room where medical staff will monitor you for complications. Depending on the type of surgery, you may need to stay in hospital for several days.
NUTRITION FOR POST-OPERATIVE CARE of Obesity surgery (Bariatric Surgery) ?
Before returning to a regular diet after gastric sleeve surgery, patients will go through two phases of eating.
Stage 1: Liquid Diet (Days 1–15)
Stage 2 – Soft – Puree Diet – Day 16 – 30
Solid food is introduced after the first month.
