WEIGHT LOSS SURGERY
Gastrointestinal surgery for obesity, also called bariatric surgery, alters the digestive process so as to achieve rapid weight loss.
The concept of Weight Loss Surgery (Bariatric Surgery) to control obesity grew out of results of operations for cancer or severe ulcers that removed large portions of the stomach or small intestine.
Because patients undergoing these procedures tended to lose weight after surgery, some doctors began to use such operations to treat severe obesity. The first operation that was widely used for severe obesity was a type of intestinal bypass. This operation, first used 40 years ago, caused weight loss through malabsorption (decreased ability to absorb nutrients from food because the intestines were removed or bypassed).
Weight Loss Surgeries at Medifit Biologicals are performed laparoscopically (Key hole), which is a less invasive & sophisticated.
3 Major Bariatric Surgeries performed commonly are
- Roux-en-Y Gastric Bypass
- Adjustable Gastric Banding or Lap Band
- Sleeve Gastrectomy
Weight loss surgery is used as a last resort to treat people who are dangerously obese (carrying an abnormally excessive amount of body fat).
This type of surgery is to treat people with potentially life-threatening obesity when other treatments, such as lifestyle changes, haven’t worked.
Potentially life-threatening obesity is defined as:
- having a body mass index (BMI) of 40 or above
- having a BMI of 35 or above and having another serious health condition that could be improved if you lose weight, such as type 2 diabetes or high blood pressure
For people who meet the above criteria, weight loss surgery has proved to be effective in significantly and quickly reducing excess body fat.
WEIGHT LOSS SURGERY (EXPLANATION IN BRIEF)
Bariatric surgery (weight loss surgery) includes a variety of procedures performed on people who are obese. Weight loss is achieved by reducing the size of the stomach with a gastric band or through removal of a portion of the stomach (sleeve gastrectomy or biliopancreatic diversion with duodenal switch) or by resecting and re-routing the small intestines to a small stomach pouch (gastric bypass surgery).
Clinically severe obesity (also called “morbid” obesity) causes many different risks to health. The aim of surgery for obesity (called “Bariatric Surgery” or “Metabolic Surgery”) is to not only to lose weight but, more importantly, to improve health and increase the life-span. Bariatric surgery achieves this aim by various operations on the stomach or the intestines. Bariatric operations produce important hormonal changes that dramatically reduce the appetite and correct diseases, such as diabetes. Liposuction is not a bariatric operation. In liposuction, fat is removed from different parts of the body, using a hollow tube and a suction device. Liposuction is purely cosmetic surgery that aims to produce an attractive body-shape. Liposuction is performed by Plastic/Cosmetic Surgeons and not by Bariatric Surgeons. Liposuction may work well for some people, who want an operation only to “look good”. Liposuction does not have the health-benefits of bariatric surgery. Weight loss surgery helps people with extreme obesity to lose weight. It may be an option if you cannot lose weight through diet and exercise or have serious health problems caused by obesity.
In India, how popular are bariatric surgeries for weight loss?
In India, 5% of the total population is morbidly obese, of which, around 10- 15% of these obese patients are coming for the surgical option nowadays. The demand has been on the rise over the last decade.
The procedure and recovery time
The procedure is performed laparoscopically or robotically with 5-6 small skin incisions ranging from 5 mm-12 mm with the patient being under general anaesthesia. The procedure usually takes anywhere between 3-5 hours on an average and the patient is hospitalised on average for 3 days and discharged on day 4 if the surgery is uneventful.
Suitable candidate for this surgery?
Bariatric surgery is a major operation and should be considered only after non surgical weight-loss methods have failed. If you’re considering weight-loss surgery, you must make a serious, lifelong commitment to lifestyle changes.
Our program follows the WHO guidelines for Asian patients for selection. These guidelines have also been endorsed by the Ministry of Health, Government of India. If you have a BMI (Body Mass Index) of 37.5 or more, or a BMI of 32.5 or more with illness related to excess weight, and have not been able to sustain weight loss through diet and exercise, you probably are a candidate for weight-loss surgery.
If you do not meet these guidelines, or we find that you are not eligible for surgery for health reasons, don’t despair. Through our intensive non-surgical weight management program, we can help you lose weight by helping you change your eating habits, modify your behaviour and increase your physical activity.
Benefits of surgery
The extent of weight loss can be 30-40% of body weight (35-45 kg for a 120kg person). Most of the weight loss occurs during the first year after the operation. There may be some further weight loss during the second year and a plateau is then reached. The true benefit of surgery is better measured in terms of the cure of obesity-related illnesses and improvement in quality of life. The most dramatic effect is on diabetes – diabetes is cured (i.e. blood sugar remains normal without any medication) in 80% of diabetic patients. High blood pressure and high cholesterol may be cured in 60-80% of patients. Even if the disease is not completely cured, it often becomes less severe and is better controlled with less medication. Marked improvement or cure is also seen in cases of fatty liver, obstructive sleep apnea, obesity hypoventilation and infertility. Treatment of obesity can help with arthritis (joint pains) and reduce the risk of several cancers and heart attack. Large studies have shown that bypass patients live considerably longer than obese persons who did not have surgery.
LONG-TERM SUCCESS OF SURGERY: WHAT IS THE CHANCE OF WEIGHT RE-GAIN?
The majority of bariatric surgery patients maintain the weight loss, lifelong. A healthy diet and regular exercise are very important for long-term success in weight-control. Large studies have shown that about 25% of patients do regain some of the lost weight, during long-term follow-up. The weight regain is usually partial (e.g. a person, who originally lost 45 kg, regains 10 kg at 8 years after the operation) so that a large part of the benefit of bariatric surgery is maintained. There can be several causes for weight regain: often, there is failure to follow the advice of the doctor or dietician. Structural problems, such as widening of the reduced stomach, are uncommon after gastric bypass or sleeve gastrectomy but can occur – in such cases, further surgery (called “revisional surgery”) or endoscopy procedures are available.
Potential risks of surgery
Obesity surgery can be conducted very safely. But, like any major operation on the human body, there is some risk of side-effects and complications. Risks can vary for individual patients, depending on their age, weight, obesity-related illnesses, past medical history and type of operation. Scoring systems have been developed to estimate the risk of surgery for individual patients and need to be discussed in detail during a consultation with the surgeon.