Bariatric Surgery Treatment Of Obesity

Gastro Science | Posted on 05/11/2020 by RBH

Obesity is a condition in which the BMI (Body Mass Index) of a person is 30 or more, this is also dependent on the height of the person. A BMI of 30 or more is also an indication of several existing or impending health problems due to excess weight. Obesity is a stressful condition for many due to multiple factors including health risks, as well as social unacceptability.

Obesity can also be categorized per levels:

• Level 1: BMI level up to 35
• Level 2: BMI level up to 40
• Level 3: BMI level of 40 and above

While diet and exercise might work effectively to reduce some weight, obesity is a condition that often demands a more strenuous solution, more so in cases where the level of obesity is 2 or 3. One such method to reduce the excessive weight is a Bariatric Surgery.

The aim of bariatric surgery is to reduce body fat by making changes in the digestive system of the body. This surgery is a type of metabolic procedure that claims to reduce more than 50% of excess weight during the initial 6 months after the surgery. In bariatric surgery, the doctor will modify the digestive system to limit the intake of food by making the stomach smaller; thus, making one feel fuller even after a small meal. It may also involve making changes in the small intestines to limit the absorption of nutrients and calories from food.

Bariatric surgery is the most sought-after method in cases where diet and exercise have failed to produce results and obesity has been causing very serious health complications such as:

• High blood pressure
• Heart problems
• Chronic digestive disorders including GERD
• Type 2 Diabetes
• Stroke

Types of Bariatric Surgery

Some common types of bariatric surgeries include:

• Roux-en-Y: The most common and irreversible surgery that cuts off and seals the top of the stomach resulting in a small-sized pouch with extremely limited capacity to hold food; and also cuts the small intestines and directly attaches it to the small pouch. This prevents you from eating beyond a certain quantity of food, as well as also limits the absorption of nutrients and calories from food.
• Biliopancreatic Diversion with Duodenal Switch: A more complex form of the above surgery and usually recommended for people with a BMI of beyond 50. It involves cutting away almost 80% of the stomach and attaching the small remaining portion with the last part of the small intestines, completely bypassing the first two parts. It limits the intake of food, as well as the absorption of nutrients from food. It is very effective but also extremely complicated and risky.
• Laparoscopic adjustable gastric banding (LAGB): In this surgery, an inflatable band is positioned around the top part of the stomach, which when inflated compresses the stomach separating it into two parts – one of them being an extremely small pouch that communicates with the rest of the stomach through a passage created by the band. This procedure limits the amount of food you can eat, depending on the capacity of the upper pouch. The band is adjustable and hence, this is the most common type of weight-loss surgery opted for by people. Though the results may be lesser than other methods and the band might need periodic adjustments.
• Sleeve Gastrectomy: In this method, the structure of the stomach is changed to that of a tube that restricts the amount of absorption of calories and nutrients from food.

Risks of a Bariatric Surgery

Bariatric surgery can cause short-term and long-term effects.

Short-term risks include:

• Excessive bleeding
• Infection
• Reaction to anesthesia
• Blood clots in legs that transfer to the heart and lungs
• Breathlessness
• Lung diseases
• Gastrointestinal system leak
• Body pain
• Peeling and dry skin
• Excessive hair loss

Long-term risks include:

• Bowel impediment
• Diarrhoea
• Consistent nausea
• Vomiting
• Strictures
• Hernias
• Gallstones
• Low blood glucose
• Malnutrition
• Digestive problems
• Ulcers
• Intestinal issues
• Punctured stomach

Moreover, there are some additional risks that might incur post-bariatric surgery. These include:

• Pouch stretching to its original size over time
• Falling apart of staples
• Extreme nutritional deficiencies
• Stomal stenosis

Results of a Bariatric Surgery

Bariatric surgery can provide long-term weight loss, though the amount of weight lost depends on the type of surgery and the adherence of precautions and adaptation of lifestyle changes. On a good note, bariatric surgery can help lose half more or even more of excess weight over a span of two years after the surgery.

More so, loss of excessive weight also helps to improve or resolve various health conditions such as:

• Diabetes
• Heart problems
• High blood pressure
• Severe sleep apnea
• Acid reflux disease

It also helps to improve the quality of life by making you more active and efficient in performing routine activities.

That said In India, where more than 140 million people are suffering from obesity and related health problems, bariatric surgery is a very attractive and effective solution or treatment for obesity. If taken proper care of, its risks are lower as compared to its advantages in cases where obesity has resulted in several chronic health problems.