Surgical therapy for obesity (Bariatric surgery) is the only available modality associated with best and sustained weight loss in subjects with morbid obesity associated with comorbidities. Evidence shows that well-performed Bariatric surgery in carefully selected patients and a good multidisciplinary support team substantially improves the morbidities associated with severe obesity
PRINCIPLES OF BARIATRIC SURGERY
Three primary principles involved in Bariatric / Metabolic surgery are :
- Reducing the size / volume of the stomach (Restriction)
- Decreasing the nutrient absorption of intestines (Malabsorption)
- Inducing feeling of fullness early (Satiation)
The main objectives of the surgery are aimed at :
- Reduction of energy intake.
- Increase in the patient’s energy output.
- And thus help the body to achieve new energy balance.
The surgery also helps to modify metabolic insufficiency thus aiding in the improvement of associated comorbidities / diseases.
BENEFITS OF BARIATRIC SURGERY
- Diabetes Mellitus can usually be helped and based upon numerous studies of diabetes and the control of its complications; it is likely that the problems associated with diabetes will be arrested in their progression when blood sugar is maintained at normal values. Abnormal Glucose Tolerance or Borderline Diabetes is even more likely reversed by Bariatric Surgery.
- High Blood Pressure can often be alleviated or eliminated by weight loss surgery.
- Heart Disease in obese individuals is certainly more likely to be experienced when compared to persons who are of average weight and adhere to a strict diet and exercise regimen. There is no hard and fast statistical data to definitively prove that weight loss surgery reduces the risk of Cardiovascular Disease, however, common sense would dictate that, if we can significantly reduce many of the comorbidities that we experienced as someone that is obese, our health may be much improved if not totally restored.
- High Blood Cholesterol in 80% of patients can be alleviated or eliminated and in as little as 2-3 months postoperatively.
- Asthma sufferers may find that they have fewer and less severe attacks, or sometimes none at all. When asthma is associated with gastroesophageal reflux disease, it is particularly benefited by gastric bypass.
- Sleep Apnea Syndrome sufferers can receive dramatic effects and many within a year or so of surgery find their symptoms were completely gone, and they had even stopped snoring completely!
- Gastroesophageal Reflux Disease can be greatly relieved of all symptoms within as little as a few days of surgery.
- Gallbladder Disease can be surgically handled at the time of the weight loss surgery if your doctor has cause to believe that gallstones are present.
- Stress Urinary Incontinence responds dramatically to weight loss, usually by becoming completely controlled. A person who is still troubled by incontinence can choose to have specific corrective surgery later, with a much greater chance of a successful outcome and a reduced body weight.
- Low Back Pain, Degenerative Disk Disease, and Degenerative Joint Disease can be considerably relieved with weight loss, and greater comfort may have experienced even after as few as 25 lost pounds.
POSSIBLE POST SURGICAL COMPLICATIONS
Like any major surgery, bariatric and metabolic surgeries post potential health risks, both in the short term and long term. Risks associated can include:
- Adverse reaction to anaesthesia
- Deep Vein Thrombosis (Blood clots)
- Lung or breathing problems
- Excessive bleeding
- Leaks from stomach / gastrointestinal system
- Bowel obstruction
- Dumping syndrome causing diarrhea, nausea or vomiting
- Incisional Hernias
- Low Blood sugar
- Vitamin, Mineral & Protein Malnutrition
- Ulcers & Reflux diseases