Bariatric Surgery: What is it

 

  • Weight loss surgery or bariatric surgery has emerged as the most  successful approach and is now considered the best strategy for  the treatment of severe obesity. The advantages of bariatric or obesity  surgery extend beyond weight loss and lead to remission of chronic diseases or metabolic disorders like diabetes, hypertension or respiratory problems like asthma, obstructive sleep apnea.
  • On the other hand, medical weight loss programs does not produce desirable and long term weight loss in obese patients especially severely obese patients.  Weight loss precipitated by lifestyle modifications such as  increased physical activity, healthy diet, is difficult to sustain for long time.
  • Type 2 diabetes mellitus, prior to bariatric and metabolic surgery, was thought to be a progressive and incurable disease requiring lifelong medication and lifestyle modification. However, with the advent of this modality, 85 percent of diabetic patients have marked improvement and  78 percent of patients have complete remission following  bariatric surgery.
  • Bariatric or weight loss surgery is presently  the only modality that provides outstanding and sustained weight loss for morbidly obese patients, with resultant improvement in obesity-related co-morbidities.

How weight loss or bariatric surgery works:

obesity

we can broadly divide our digestive system into two parts

Stomach: acts as a storage organ and has a usual capacity to store at least 1.5 litres of food at a given point of time.

Intestines: it’s an approximately 6-meter-long tube through which our food travels and absorption of food, minerals and calories takes place.

Bariatric surgery essentially either decreases the storage capacity of our stomach so that limited amount of food can be consumed at a given point of time. Along with that it may or may not bypass a few meters of intestine by rerouting of the intestines through surgery. As a result, complete absorption of food or calories does not take place resulting in further weight loss.

  • When surgery is performed only on the stomach and no intestines are readjusted, it is restrictive type of weight loss or bariatric surgery.
  • When surgery is performed only on the intestines (bypass or rerouting of the intestines) without altering the stomach, it is malabsorption type of surgery.
  • When the weight loss surgery involves both the components i.e. restriction and malabsorption it is combined type of bariatric surgery.

Apart from that, bariatric surgery also brings different types of hormonal changes in the body resulting in decreased appetite, reduced cravings for sweets, altered taste for sweets and increased secretion of certain hormones causing resolution of diabetes and also helps in maintaining weight loss.

Each surgery has its own advantages and mechanism for causing weight loss and resolution of co-morbidities and therefore every patient should be thoroughly evaluated, his concerns addressed and depending upon his habits, expectations, life style and type of comorbidities patient should be offered a particular type of surgery.

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