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About Bariatric Surgery

Bariatric surgery is a weight reduction procedure that helps people lose weight permanently. Bariatric surgery can be restrictive, malabsorptive, or a combination of restrictive and malabsorptive. Restrictive bariatric surgery enhances weight loss by decreasing the size of the stomach to lessen the food volume it can contain.

Malabsorptive bariatric surgery promotes weight loss by making changes to the small intestine parts to hinder calorie and nutrient absorption.

This weight loss surgery is done to severely obese people that a healthy diet, exercise, medications, and change of lifestyle have not worked. This weight reduction procedure is also done because their health is already compromised due to complications brought about by being obese.

Why it’s done help

Bariatric surgery is advised if the person has made all efforts to lose weight but is not effective. The person may experience or already experienced severe health problems precipitated by obesity. Some of the severe health complications one can get due to obesity include:

  • Hypertension
  • Cardiovascular diseases
  • Severe sleep apnea
  • Cerebrovascular disease and stroke
  • Type 2 Diabetes
  • Gastroesophageal reflux disease (GERD)
  • High risk for cancer
  • Respiratory problems

Who it’s for

Weight loss surgery is not for all obese persons. The physician or the gastric surgeon screen an individual if he can undergo bariatric surgery. Gastric surgeons have to consider the benefits and complications a person can get from the weight reduction procedure.

The doctor will check the body mass index (BMI). A BMI of 40 and above or a person with a BMI of 35 but with a serious health condition is a candidate for bariatric surgery. A person with a BMI of 30 but with a serious health problem can also be a candidate for bariatric surgery. But the bariatric surgeon will perform gastric band only.

What you can expect

Bariatric surgery is performed by a Gastric surgeon in the operating theatre. Before you enter the operating theatre, a nurse will put an intravenous line and administer some pre-operative medications ordered by the anesthesiologist. This will help you relax prior to the procedure. As the procedure starts in the operating room, the anesthesiologist will use general anesthesia through the endotracheal tube. This will put the patient to sleep to minimize pain and discomfort during weight loss surgery.

The gastric surgeon will start the bariatric surgery- open or laparoscopic method. In open method, the gastric surgeon will make a midline incision on the abdomen for about 8 to 10 inches. While the laparoscopy method, the surgeon will make 5 to 6 small incisions where he can insert the laparoscope and surgical instruments. The method used will be discussed to the patient prior to the surgery so he can choose between the two.

There are several bariatric surgery types and the surgeon will discuss to the patient what type will be suitable to him after proper screening.

Types of Bariatric surgery

There are several stomach operations to lose weight and they are classified according to their function. Weight loss surgery can be restrictive, malabsorptive or a combination of two. Here are the four common surgical ways to lose weight:

Restrictive Weight Reduction Procedure

  1. Sleeve Gastrectomy Surgery is most of the time done in the laparoscopic method. In this stomach pouch surgery, about 80 percent of the stomach is eliminated, leaving a banana- shaped form of the stomach. Due to the reduction of stomach size, an individual can feel fullness in his stomach easily. People who underwent sleeve gastrectomy may experience vitamin deficiencies, thus lifelong vitamin supplementation is necessary. Average weight loss bariatric surgery: more than 50 percent of excess weight.
  2. Gastric Band Surgery is another weight reduction surgery where a gastric surgeon puts an inflatable band on the upper portion of the stomach to create a small pouch on the stomach. The small stomach pouch will make an individual eat less but satisfied. This type of stomach pouch surgery is done in the laparoscopic method. Average weight loss bariatric surgery: 40-50 percent of excess weight.

Combination of Restrictive and Malabsorptive Weight Reduction Procedure

  1. Roux-en-Y Gastric Bypass Surgery is another weight reduction surgery that is also called gastric surgery. This type of obesity surgery involves a reduction in the size of the stomach. The top part of the stomach, approximately an ounce, will be divided from the majority of the stomach. Then, the gastric surgeon divides the small intestines, and the end part of the intestine will be attached to the small pouch of the stomach. Thus, this stomach pouch surgery limits the food intake of an individual because of the small capacity of the new stomach. An individual should follow strictly to dietary recommendations, should go to scheduled check-ups, and long term vitamin supplementation. Average weight loss bariatric surgery: more than 50 percent of excess weight.
  2. Biliopancreatic diversion with Duodenal Switch (BPD/DS) Surgery is a malabsorptive and restrictive type of weight reduction procedure. The stomach is reduced by forming a tubular pouch and removing the excess part of the stomach. About three- fourths of the small intestines will be bypassed. The distal end of the small intestines will be connected to the tubular stomach pouch. The bypassed part of the small intestines will be attached to the distal part of the small intestines so that the bile and pancreatic enzymes will still be utilized.
    This type of obesity surgery is most efficacious against type 2 diabetes. Weight loss happens because the majority of calories and nutrients from food intake are directly routed to the colon, where absorption does not take place. People who underwent this stomach reduction surgery are at high risk of malnutrition and vitamin deficiencies. Average weight loss bariatric surgery: 60-70 percent of excess weight.

Results

Bariatric surgery is indeed an effective weight reduction procedure. It has long term effects on weight loss after the surgery but the amount of weight an individual can lose varies from the bariatric surgery he went through. Maintaining a balanced weight also depends on how well a person handled his diet, exercise, and lifestyle after weight loss surgery.

Aside from effective weight loss, it may also correct or alleviate serious health problems such as:

  • Hypertension
  • Cardiovascular diseases
  • Severe sleep apnea
  • Cerebrovascular disease and stroke
  • Type 2 Diabetes
  • Gastroesophageal reflux disease (GERD)
  • High risk for cancer
  • Respiratory problems

However, regular check-ups are still required so the doctor can monitor the status of an individual after the weight reduction surgery, and prior health problems due to obesity.

Risks and Complications

Like any surgical intervention, there are risks and complications could occur. But every surgical intervention like bariatric surgery usually outweighs benefits from the risks and complications that could happen.

Some bariatric surgery risks that can happen post-operatively are an infection, respiratory problems, bleeding, the formation of blood clots, adverse effects from anesthetics, leaks or obstruction in the gastrointestinal system, nausea, and vomiting.

The long term bariatric surgery risks and complications that an individual could experience include: bowel obstruction, the formation of gallstones, dumping syndrome-nausea, vomiting, dizziness, abdominal pain, and light-headedness, hypoglycemia, malnutrition, hernia, ulcers, stricture, stomach perforation, and internal bleeding.

Recovery Time

Recovery time after stomach pouch surgery is on average 2 to 5 days, depending on if it is the open bariatric surgery method or laparoscopy method. Laparoscopy requires a shorter stay in the hospital. If complications arise, an individual will be required to stay in the hospital for observation and management.

FAQs

What is obesity?

Obesity pertains to having an excessive amount of fat in the body. Obesity can be determined through computing body mass index (BMI) of an individual. An individual with a BMI of 30 and above is considered obese. Being obese is not just an image problem but it can precipitate serious health problems. Obesity can lead to hypertension, cardiovascular diseases, severe sleep apnea, cerebrovascular disease and stroke, diabetes, gastroesophageal reflux disease (GERD), high risk for cancer, and respiratory problems. There are various surgical ways to lose weight, contact your doctor to discuss it.

What is Bariatric Surgery?

Bariatric surgery is an effective weight loss management for obese individuals through surgery. This obesity surgery is recommended if a balance diet, exercise, changes in lifestyle, and other interventions did not work out. This is performed also because an individual is at high risk to develop serious health problems or is diagnosed with a certain disease that requires him to lose weight.

What is the best treatment for weight loss?

There are a number of ways to lose weight such as eating a healthy diet, regular exercise or physical activity, and weight loss medications. But if all these ways did not work out, an individual can consult a doctor or a bariatric surgeon if he is a good candidate for bariatric surgery. Bariatric surgery is the best treatment for obese people to avoid or eliminate severe health problems.

Who Needs Bariatric Surgery?

Not all individuals are a candidate for obesity surgery. The doctor or a bariatric surgeon has guidelines to consider before an individual can go through this weight reduction surgery. Body mass index (BMI) will be checked and the health condition of the person will be assessed. Candidates for stomach reduction surgery are individuals with a BMI of 40 and above; BMI of 35 but with a serious health condition; BMI of 30 but with a serious health problem.

How to know if I am ready for weight loss surgery?

Anxiety is common in patients who are about to undergo surgery, the same case in people for stomach pouch surgery. Always ask your doctor or your bariatric surgeon if you have concerns or clarifications about the surgery such as the outcome, benefits and effects, risks and complications, recovery, and other things about the weight reduction procedure. You can also consult your anesthesiologist if you have concerns about the anesthetics, pain control after surgery, risks and complications after anesthesia, and other concerns you want to clarify. Knowing what to expect during and after surgery will ease off your anxiety and making you ready for surgery.

How many types of bariatric surgery?

There are four common surgical ways to lose weight: sleeve gastrectomy surgery, gastric band surgery, roux-en-y gastric bypass surgery, and biliopancreatic diversion with duodenal switch (BPD/DS) surgery. You might ask what is the best and safest weight loss surgery, your gastric surgeon will screen you and tell you what procedure suits you.

Which is the new technique in Bariatric surgery?

The new technique in performing bariatric surgery types is through laparoscopy. In laparoscopy, the bariatric surgeon will make 5 to 6 small incisions where he can insert the surgical instruments and the laparoscope- a long fiber-optic instrument with a high-intensity light and high definition camera to clearly view the organs in the abdominal cavity. The surgical instruments used in the laparoscopic technique have a long and thin body as well.

What are the main advantages of bariatric surgery?

One main advantage of stomach operations to lose weight is having a good quality of life. Obesity can lead to a lot of serious health issues. But balanced weight should be maintained after the weight reduction surgery to achieve optimum health. The main advantages that a person can get after obesity surgery include resolved or controlled type 2 diabetes, prevention of fatty liver disease, normal blood pressure, and cholesterol levels, improved emotional health, eliminate sleep apnea, joint pain relief, improved fertility, and cancer prevention.

What are the myths of bariatric surgery?

There are a lot of myths or misconceptions about stomach operations to lose weight but before believing in those things, it is best to consult a doctor or a bariatric surgeon to know facts. You have to believe in information from a reliable source because these are facts and based on studies.
Some myths about stomach operations to lose weight include: bariatric surgery is unnecessary, diet and exercise will reduce a person’s weight; weight gain after bariatric surgery; infertility; malnourishment; death after obesity surgery; leads to alcoholism; and depression, anxiety, and suicide.

What are the risk factors of Bariatric surgery?

Like any other surgical procedure, there are risks involved but it can all be prevented and managed. The key is to follow the doctor’s instructions, take prescribed medications, report any unusualities, and take enough rest. Bariatric surgery risks include infection, respiratory problems, bleeding, formation of blood
clots, adverse effects from anesthetics, leaks or obstruction in the gastrointestinal system, nausea, and vomiting, bowel obstruction, formation of gallstones, dumping syndrome-nausea, vomiting, dizziness, abdominal pain, and light-headedness, hypoglycemia, malnutrition, hernia, ulcers, stricture, stomach perforation, and internal bleeding.

Is bariatric surgery worth it?

Yes, bariatric surgery is worth it because aside from long term weight loss effects, a person can achieve a good quality of life because obesity can lead to a number of severe health problems.

Can bariatric surgery cure type 2 diabetes?

Yes, studies have shown that some people had normal sugar levels after stomach pouch surgery, while most of them did not present any signs or symptoms of type 2 diabetes after a few years.

What’s life like after weight loss surgery?

Good quality of life has been experienced by people after going through stomach operations to lose weight. Obesity precipitates and causes a number of serious health problems, and being healthy is incomparable.

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