Bariatric Surgery Procedure for Weight Loss
Bariatric surgery is a surgery performed with the intent to have significant and sustainable weight loss in obese patients who have tried other means of weight loss but couldn’t achieve substantial weight loss.This surgery changes the digestive system to achieve weight loss. Bariatric surgery is also called metabolic surgery.
Who needs Bariatric surgery?
Individuals who are obese to an extent that hampers their day-to-day life. Individuals with obesity and associated co-morbidities like diabetes, hypertension, heart disease, sleep apnoea, and metabolic syndrome are awaiting knee replacement. Individuals with a BMI >35 Individuals with BMI >30 with comorbidities like diabetes, hypertension, heart disease, sleep apnoea, metabolic syndrome
Different Types Of Bariatric Surgeries
Gastric Bypass (Roux-en-Y Gastric Bypass): In this procedure, a small pouch is created near the top of the stomach. It's then connected directly to the small intestine, bypassing a part of the stomach and upper intestine. This helps limit the food you can eat and lower the number of calories your body absorbs.
Sleeve Gastrectomy: In this method, a large part of the stomach is removed, making a smaller, curved "sleeve" that looks like a banana. This reduces the stomach's capacity and produces hormonal changes that can help control appetite and blood sugar levels.
Adjustable Gastric Band (Lap-Band): A band is placed near the top of the stomach, making a tiny pocket. The ring can be changed to control the opening between the pocket and the rest of the stomach, which helps control how much you eat.
Biliopancreatic Diversion with Duodenal Switch (BPD/DS): This complex procedure involves removing a part of the stomach, creating a smaller stomach pouch, and rerouting a significant portion of the small intestine. It combines restrictive and malabsorptive components to achieve weight loss.
Bariatric Revision Surgery: In some cases, individuals who have undergone previous bariatric surgeries may require revision surgery to address complications, inadequate weight loss, or other issues.
Indications and purposes of Bariatric Surgery
The purpose of bariatric surgery is to promote weight loss, improve or resolve obesity-related health problems, and enhance overall quality of life. Here are the main indications and purposes of bariatric surgery:
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Get A Second OpinionIndications
Severe Obesity
Bariatric surgery is typically recommended for those with a BMI of 40 or higher. It can also be considered for individuals with a BMI of 35 or higher if they have obesity-related severe health issues.
Obesity-Related Health Conditions
Bariatric surgery may benefit individuals with health conditions that improve with weight loss, including:
- Type 2 diabetes
- Hypertension (high blood pressure)
- Sleep apnea
- High cholesterol
- Non-alcoholic fatty liver disease
Failure of Non-Surgical Methods
Candidates for bariatric surgery usually have attempted weight loss through:
- Diet changes
- Exercise
- Behavioural modifications
If these methods haven't worked, surgery may be an option.
Motivation and Commitment
Post-surgery success requires a commitment to:
- Healthy eating
- Regular exercise
- Follow-up appointments
Make sure you are ready to make these lifestyle changes!
Purposes:
Weight Loss Benefits of Bariatric Surgery
- Effective Weight Loss: Bariatric surgery helps with lasting weight loss by reducing stomach size or changing the digestive process. This limits how much food you can eat or absorb, leading to gradual weight loss.
Improvement of Health Conditions
- Health Boost: It can significantly improve or resolve obesity-related issues like hypertension, type 2 diabetes, and sleep apnea, lowering your risk of health complications.
Better Quality of Life
- Quality of Life: Successful weight loss can improve mobility, reduce joint pain, boost self-esteem, and enhance overall well-being.
Long-Term Weight Management
- Long-Term Success: Bariatric surgery helps maintain weight loss better than non-surgical methods. However, you still need to commit to a healthy lifestyle with dietary changes and regular exercise.
Lower Mortality Risk
- Lower Risk: Studies show bariatric surgery reduces mortality risk in severely obese individuals significantly when related health conditions are improved.
Steps Involved in Bariatric Surgery
During a bariatric surgery procedure, several specific steps are taken to achieve the desired weight loss and metabolic changes. The exact details may vary depending on the type of surgery being performed, but here's a general overview of what happens during bariatric surgery:
Anesthesia
You will be administered anaesthesia to ensure you are comfortable and pain-free during the procedure.
Incisions
Small incisions are made in the abdomen to allow the surgeon access to the surgical area. Some surgeries may be performed using minimally invasive techniques (laparoscopic surgery) with tiny instruments and a camera.
Access to the Stomach
The surgeon gains access to the stomach and digestive tract through the incisions.
Surgical Technique
Depending on the type of bariatric surgery, different techniques are employed:
- Gastric Bypass (Roux-en-Y): The surgeon creates a small pouch at the top of the stomach and connects it to a lower portion of the small intestine, bypassing a section of the stomach and small intestine.
- Sleeve Gastrectomy: A large portion of the stomach is removed, leaving a smaller, banana-shaped "sleeve."
- Gastric Banding (Lap-Band): A band is placed around the top part of the stomach to create a small pouch.
- Biliopancreatic Diversion with Duodenal Switch (BPD/DS): A portion of the stomach is removed, creating a smaller pouch, and a larger portion of the small intestine is bypassed.
Closure and Healing
The incisions are carefully closed using sutures or staples, and the healing process begins.
Recovery and Monitoring
Following the operation, you'll be moved to a recovery zone, where healthcare experts will keep an eye on your vital signs and ensure you're safely awakening from anaesthesia.
Hospital Stay
Depending on the type of surgery and your condition, you may stay in the hospital for a few days to recover and receive post-operative care.
Diet Progression
You'll begin by drinking clear liquids, slowly moving on to mushy foods, and finally, regular foods, all based on the special instructions given by your healthcare experts.
Follow-up Care
Regular check-up appointments will be scheduled to monitor your progress, adjust medications, and provide guidance on diet and lifestyle changes.
Who Performs Bariatric Surgery?
Bariatric or metabolic surgery is performed by a surgeon who specialises in treating obesity and related conditions. These surgeons have advanced training to ensure the procedure's safety and success.
Typically, bariatric surgeons have a background in general surgery and additional expertise in managing complex obesity cases. They work with a multidisciplinary team, including dietitians, psychologists, nurses, and other specialists, to offer complete care before and after surgery.
How to Prepare for Bariatric Surgery?
Preparing for bariatric surgery involves a series of essential steps to ensure that you are physically, mentally, and emotionally ready for the procedure and the lifestyle changes that follow. Here's a comprehensive guide on how to prepare for bariatric surgery:
Consultation and Evaluation
- Book a consultation with a bariatric surgeon to discuss your candidacy and surgery options.
- Medical evaluation: Physical exams, imaging, and blood tests to assess health and risks.
Education and Counseling
- Informational sessions: Learn about the surgery, outcomes, and post-op lifestyle.
- Meet with a dietitian for nutritional guidance before and after surgery.
- Psychological evaluation: Consult with a mental health professional to address emotional aspects and weight management.
Pre-Operative Requirements
- Follow dietary guidelines to reduce liver size for surgery.
- Complete tests: Blood work, EKG, and pulmonary tests may be required.
Lifestyle Changes
- Adopt a healthy lifestyle: Balanced diet and regular physical activity.
- Quit smoking if applicable, as it increases surgery risks.
Medical Management
- Manage chronic conditions (e.g., diabetes, hypertension) with your healthcare provider.
Support System
- Build a support system of family and friends for emotional help during recovery.
Pre-Operative Diet
- Follow a specific diet (low-calorie or liquid) as provided by your healthcare team before surgery.
Psychological Preparation
- Address emotional factors: Through counseling or support groups, work on eating habits, body image, and stress management.
Medications
- Consult your doctor about medication adjustments before surgery.
Logistics
- Plan your hospital stay: Arrange transportation and home recovery preparations.
Post-Operative Preparation
- Stock up on supplies: Protein supplements, vitamins, and medications.
- Clear your schedule for recovery and plan time off work if necessary.
Final Consultation
- Final surgeon consultation: Address any last-minute concerns or questions before surgery.
Recovery After Bariatric Surgery
The recovery process after bariatric surgery is a crucial phase that involves adjusting to your new digestive system, adopting a modified diet, and gradually resuming physical activity. Recovery times can change depending on the type of surgery, individual health, and adherence to post-operative guidelines. Here's an overview of what to expect during the recovery period:
Immediate Post-Operative Period (Hospital Stay)
- After surgery, you'll spend a few days in the hospital for monitoring and recovery.
- You'll be encouraged to start moving around and walking as soon as possible to prevent blood clots and aid in healing.
- Pain management medications will be administered to keep you comfortable.
Week 1-2
- You'll gradually transition from clear liquids to full liquids and then to pureed or soft foods, following your surgeon's guidelines.
- Sip fluids slowly and avoid carbonated beverages.
- Attend follow-up appointments with your surgical team to monitor your progress and address any concerns.
- Take prescribed medications as directed, including vitamins and minerals.
Week 3-4
- You may start introducing more solid foods, starting with soft, protein-rich options.
- Continue to focus on small, frequent meals and thorough chewing to aid digestion.
- Begin light physical activity, such as short walks, as advised by your surgeon.
Month 2-3
- Continue to progress your diet, incorporating a wider variety of foods and textures.
- Gradually increase the intensity and duration of your physical activity, aiming for regular exercise.
- Monitor your weight loss and health improvements, and address any issues with your healthcare team.
Long-Term Recovery and Beyond
- Maintain regular follow-up appointments with your surgeon and healthcare team.
- Adhere to a balanced and nutritious diet to ensure proper nutrient intake.
- Continue to focus on portion control and mindful eating.
- Stay hydrated and prioritise protein intake.
- Make sure to participate in consistent physical activity to assist in weight reduction and promote your overall well-being.
- Address any emotional or psychological challenges related to food and body image through counselling or support groups.
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Book an AppointmentLifestyle Changes After Bariatric Surgery
Undergoing bariatric surgery necessitates significant lifestyle changes to ensure successful weight loss, improved health, and long-term well-being. These changes are designed to support your body's new digestive system and promote healthy eating habits. Here are the key lifestyle changes you'll need to make after bariatric surgery:
Eating Habits
- Portion Control: Focus on small, controlled portions to prevent overeating and support weight loss.
- Slow Eating: Chew thoroughly and eat slowly to help digestion and recognise fullness.
- Nutrient-rich foods: Prioritize protein, vegetables, fruits, and whole grains for balanced nutrition.
- Hydration: Drink fluids between meals, but avoid excess during meals to prevent discomfort.
Nutritional Guidelines
- Balanced Diet: Include essential nutrients, vitamins, and minerals in your diet.
- Vitamins & Supplements: Take prescribed supplements to avoid deficiencies.
- Avoid Empty Calories: Minimize sugary, high-calorie, and processed foods.
Meal Planning
- Regular Meals: Stick to three main meals and plan snacks daily.
- High-Quality Protein: Include lean proteins to maintain muscle and boost metabolism.
Physical Activity
- Regular Exercise: Engage in walking, swimming, or strength training as advised.
- Slow Progression: Increase exercise intensity gradually to avoid injury.
Emotional & Psychological Health
- Counselling & Support: Seek professional help or join support groups for emotional well-being.
- Healthy Coping: Develop non-food strategies for managing stress and emotions.
Behavioural Changes
- Self-Monitoring: Track your food intake using a journal or app.
- Goal Setting: Set realistic goals for weight loss and fitness.
Follow-Up Care
- Medical Appointments: Attend regular check-ups to monitor progress.
- Blood Work: Have routine tests to check nutrient levels and overall health.
Social Support
- Family & Friends: Share your goals with loved ones for support.
- Support Groups: Join bariatric surgery groups to connect with others on a similar journey.
Mindful Choices
- Mindful Eating: Eat only when hungry, and avoid emotional eating.
- Healthy Cooking: Learn to cook balanced, nutritious meals at home.
Conclusion
Bariatric or metabolic surgery helps obese individuals reduce weight and reduce or reverse their comorbidities, like Type 2 diabetes. It helps achieve significant and sustainable weight loss, which in turn improves quality and longevity of life.
