Bariatric surgery is the most effective method of losing weight in obese patients.

Bariatric surgery is the most effective method of treating obesity. It allows you to lose up to 75% of your body weight. Obesity surgery is primarily aimed at people aged 18–60 who are extremely obese. If the patient meets the eligibility requirements.

Bariatric surgery is a type of surgery that helps people lose weight and lowers their risk of diseases that are linked to being overweight. It is usually performed laparoscopically and requires local and general anaesthesia.

The most common bariatric surgery is sleeve gastrectomy, which involves the excision of 4/5 of the stomach and the formation of a narrow sleeve with a capacity of 100–150 ml. Surgical instruments are inserted into the abdominal cavity through small openings.

Thanks to the drastic reduction of this organ, the patient feels full faster, the feeling of hunger decreases, he eats less, and he loses weight. Full recovery after bariatric surgery takes several weeks.
 

Gastric banding is less commonly used. Both sleeve resection and bandaging are considered restrictive operations. It is also known as disabling procedures (biliopancreatic bypass) or restrictive-disabling procedures ( gastric bypass, mini gastric bypass ).
 

Gastric bypass surgery divides the stomach into two parts, with a small upper portion connected to the small intestine and the larger portion connected to the rest. This causes the patient to feel full faster, eat less, and lose weight.

Who is bariatric surgery indicated for?

The basic criteria for qualifying a patient for the procedure are age and BMI . Bariatric surgery is indicated for patients between the ages of 18 and 60 who:

  • have  a BMI ≥ 40 kg/m2 ,
  • have a BMI of 35–40 kg/m2 and obesity-related comorbidities, e.g., type 2 diabetes, cardiovascular diseases, apnea, joint diseases, as well as psychological problems,
  • or have a BMI of 30-35 kg/m2 and the doctor considers that there are individual indications for bariatric surgery depending on the type of comorbidities.

Bariatric surgery is performed to help obese people eat less and have a better chance of losing weight. Exercise and diet, which have been used for years, may not work, especially for people who are very overweight. Obesity increases the risk of diabetes, heart disease, joint and spine diseases, and a fatty liver, so it is important to lose weight for both cosmetic and health reasons.

Contraindications to bariatric surgery

Not every obese person can undergo bariatric surgery.The main contraindications include:

  • incurable diseases leading to destruction of the body, e.g. cancer,
  • obesity caused by hormonal disorders, e.g. Cushing’s disease ,
  • diseases that may be life-threatening as a result of surgery, e.g. COPD , recent heart attack,
  • significant psychiatric disorders – personality disorders, severe depression ,
  • alcoholism,
  • drug abuse,
  • pregnancy, 
  • no possibility of proper, long-term postoperative care.

There are also several relative contraindications to surgery (they require individual assessment of the patient), such as active peptic ulcer disease or high BMI (BMI 35–39.9 kg/m 2 ) in the absence of comorbidities. 

Bariatric surgery – effects

Bariatric surgery is the most effective way to treat obesity, reducing body weight by up to 50% in as little as a year. It also has many health benefits, such as weight loss and improved health.

  • breathing difficulties,
  • diabetes ,
  • headache,
  • depression,
  • joint diseases,
  • sleep apnea,
  • hypertension,
  • bad cholesterol level
  • reflux,
  • stress urinary incontinence,
  • risk of heart and vascular diseases. 

Research shows that obese people after bariatric surgery have an 89% lower risk of dying within 5 years and a much better life. However, it is not a lifetime guarantee and requires constant contact with the doctor and dietician and good habits to maintain. Constant contact with the doctor and dietician is essential.

Bariatric surgery – safety 

Bariatric surgery, like any other surgical procedure, is associated with certain risks. Possible complications that the patient should be informed about before surgery include:

  • bleeding from the operated site,
  • deficiencies of vitamins and minerals,
  • postoperative depression,
  • postoperative wound infection,
  • heartburn _
  • pneumonia.

Complications after bariatric surgery occur in 20% of patients. 

Recommendations after bariatric surgery

After bariatric surgery, the patient should:

  • regularly attend medical, psychologist and dietitian consultations,
  • use bariatric support groups,
  • take medications and supplements recommended by a doctor,
  • follow the diet recommended by the doctor,
  • avoid alcohol and cigarettes, 
  • exercise at least 3 times a week and lead an active lifestyle (walking, Nordic walking),
  • report any problems related to the operation. 

Following the above recommendations increases the chance of long-term treatment effects. 

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Author: DoctorMaryam.org

4th Professional Medical Student. Karachi Medical and Dental College.

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