Bariatric surgery, also known as weight loss surgery, is a surgical procedure that treats morbid obesity. Obesity can be a life-threatening condition that may need this type of surgery if lifestyle changes fail to work. Obesity can be potentially life-threatening when:
- Your body mass index (BMI) is above 40
- Your BMI is 30 or higher and you have another health condition, such as type 2 diabetes or high blood pressure, requiring that you lose weight
Aside from morbidly obese people with a BMI of 40 or higher, some people, especially adults who have been diagnosed with type 2 diabetes, may be considered for bariatric surgery when they have a BMI of 30 – 35 or higher. For people to be considered for bariatric surgery, they need to meet certain criteria. However, bariatric surgery has been proven to be a quick, effective way to reduce excess body fat.
Losing excess weight through physical exercise and a low-calorie diet is always recommended before bariatric surgery is considered. This is because bariatric surgery is associated with a lot of complications and future lifestyle changes. Because of the risks associated with this type of surgery, many doctors or surgeons will consider the need for bariatric surgery only for medical purposes and not for purely cosmetic reasons.
Who Can Have Bariatric Surgery?
Bariatric surgery is recommended only for someone with a BMI of 40 or higher. Your doctor may also see the need for weight loss surgery if you have other health complications requiring you to lose weight such as high blood pressure and type 2 diabetes and your BMI is at least 30. Weight loss surgery is also recommended only if you can satisfy the following conditions:
- Your body is healthy enough to withstand the effects of surgery and anesthesia
- You agree to commit yourself to clinical follow-up treatment after weight loss surgery
- You have tried non-surgical remedies for weight loss such as exercise and diet and they failed to produce any observable effects on your weight
Types of Bariatric Surgery
Every type of bariatric surgery procedure is aimed at causing you to lose weight either by restricting the amount of food your stomach can hold or by causing the malabsorption of nutrients by allowing the food to bypass a part of the small intestines, or both. Bariatric surgery can also cause variations or changes in your hormonal system. Most weight loss surgeries are invasive (laparoscopic surgery). The 4 most common types of bariatric surgery are discussed below. Each of them has its own advantages and disadvantages.
- Gastric Bypass - The result of this procedure is such that the digestive process bypasses past most of your stomach so that less food is digested. This is done by separating the stomach's upper part (from the rest of the stomach) and connecting it to the ileum, so that the digestive enzymes and stomach acids from the bypassed stomach mix with the ingested food. With this, one is likely to take fewer meals which means fewer calories are absorbed.
- Sleeve Gastrectomy - This procedure is achieved by removing, at most, 80% of your stomach, leaving a small tubular pouch resembling a banana. This is aimed at reducing the amount of food that one consumes in a day. This also impacts some other weight-related factors such as satiety, hunger and blood sugar control.
- Adjustable Gastric Band - This procedure involves placing an inflatable band around the stomach's upper part and then creating a stomach pouch above that band as well as the rest of your stomach below the band, creating a small stomach. A person who undergoes this will feel full after eating a small amount of food. The feeling of fullness will mainly depend on the size of the opening. The medical principle behind it is that the band reduces hunger, which helps make patients lessen the food, and therefore calories, they consume.
- Biliopancreatic Diversion - This procedure, also known as duodenal switch, has two major components. In the first component, a small and tubular pouch is made in the stomach by removing a portion of the stomach. This component is similar to sleeve gastrectomy. After this, a large part of the ileum is bypassed. After the procedure, food no longer mixes with the pancreatic juices and bile until it reaches the end of the small intestines. The procedure is aimed at reducing the amount of fat, proteins, and vitamins that aid fat absorption that is absorbed by the body.
Life After Bariatric Surgery
Bariatric surgery can help you achieve excellent results in terms of the weight you lose. However, one should not see this surgery as a magical cure for obesity. Those who have undergone bariatric surgery should stick to a rigorous and lifelong plan in order to avoid long-term complications and putting on weight again.
This plan will normally include:
- Exercise - Losing weight and maintaining it does not only involve reducing the number of calories you consume but also exercising to burn excess calories. Regular exercise is also important for its health benefits. These include reducing your risk of getting cardiovascular disease or cancer. Exercise will also help boost your well-being and self-esteem. Everyday activities such as walking, cycling, swimming, and gardening are recommended after bariatric surgery.
- Diet - After weight loss surgery, you should consistently follow a controlled diet to benefit from the procedure. Diet plans may differ depending on the type of bariatric surgery.
Risks and Side Effects of Bariatric Surgery
The major and common side effects of bariatric surgery include diarrhea, nausea, excessive sweating, vomiting, bloating, dizziness, and increased gas in the belly. Serious side effects and complications include infection, excessive bleeding, fluid leaking out of the surgical site, and blood clots that are likely to move to the lungs and heart. These side effects are uncommon, however.
Long-term complications after weight loss surgery may depend on the type of procedure you underwent. For example, a gastric bypass may be associated with dumping syndrome, which is characterized by the quick movement of food through the ileum. Dumping syndrome is accompanied by symptoms such as faintness, diarrhea, nausea, and sweating. The condition can occur in up to 50% of people who undergo gastric bypass surgery but can be prevented by avoiding foods high in sugar, opting for high-fiber foods instead.
Gallstones can also be another long-term complication of bariatric surgery. To avoid gallstones, your surgeon may recommend supplemental bile salts for you to take in the first 6 months after the operation.
Bariatric surgery can be an effective method to treat obesity as long as one is willing to stick to the agreed plan after the surgery. This procedure can effectively reduce your weight and also help treat other conditions related to obesity such as diabetes and high blood pressure. After bariatric surgery, many people lose weight for 18 to 24 months. After this point, many may regain some of the weight they had lost. Although very few gain all of it back, it is important for someone who had bariatric surgery to stick to a diet and exercise plan to avoid future complications.
- Bariatric surgery's major aim is the treatment of obesity, when a person's Body Mass Index (BMI) is 40 or higher.
- Some people, especially adults who have been diagnosed with type 2 diabetes, may be considered for bariatric surgery when they have a BMI of 30 – 35 or higher.
- Bariatric surgery is important when weight loss measures such as physical exercise and diets fail.