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Weight Loss Surgery: Your Questions Answered

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weight loss (Bariatrics)

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December 2, 2017

 

There are clear indications and benefits of surgery when the appropriate procedure is performed. Weight loss surgery helps one lose weight, but one has to be prepared for it and know what to expect and what to do afterwards. One needs to prepared and highly motivated to have surgery with clear understanding of the risks and benefits.

The surgery is an invaluable first step in the quest for weight loss. This also means one is committing all his/her life for healthy lifestyle.

Bariatric (weight loss) surgery is no longer considered cosmetic surgery. It is preventive surgery at its best or curative surgery at the least.

I eat less but I still put on weight. Is it possible?

It is not possible unless you suffer from some medical conditions such as hypothyroidism or you are on medicines such as steroids.

The food we eat gives us energy in calories, and energy used to do any work is counted in calories. Once you understand this, consider the following to be true in almost all conditions:

1.Calories consumed = Calories used = No weight gain

2.Calories consumed > Calories used = Weight gain

3.Calories consumed < Calories used = Weight loss

You might feel you are eating less, but if you consume high calorie food, then you are likely gain weight. Most times, snacking in between food itself gives enough calories for the day.

How does weight loss surgery (bariatric surgery) work?

Ones you understand the above weight gain logic, it is easy to understand how the surgery work:

1.Reduces/restricts the amount one can eat—significantly reduces the size of the stomach. By doing so, one will feel full early and has to recognize and stop eating

2.Reducex the absorption of food/calories—This can be done by bypassing part of the gastro-intestinal track.

3.Combination of both—This will induce significant weight loss.

How should one look at bariatric surgery?

One should look at bariatric surgery as a helping hand in the vicious cycle of weight gain. Once one is overweight, he/she has to significantly reduce the amount one is eating, which is very difficult as the stomach is expanded to accommodate previous habits and will constantly feel hunger when one does not eat enough. One already has side effects such as arthritis, which significantly impair the ability to do exercise to lose weight.

Bariatric surgery will break the vicious cycle and induce weight loss, and one has to be motivated to maintain it throughout the life.

What are the indications for weight loss surgery?

BMI >37.5

BMI > 32.5 with co morbidities (hypertension, diabetes, sleep apnea, severe arthritis)

If ones BMI is >50, then surgery is recommended before trying a diet.

What are the benefits of weight loss surgery?

  1. Cure of type 2 diabetes induced by obesity
  2. Cure of hypertension induced by obesity
  3. Cure of obstructive sleep apnea (stopping of breathing while sleeping)
  4. Cure of arthritis induced by obesity
  5. Cure of infertility
  6. Cure of metabolic syndrome

Bariatric surgery significantly increases not only a person’s survival rate but also the quality of life. Life expectancy is significantly increased in these people.

What are the different kinds of weight loss surgery?

  1. Sleeve gastrectomy: This is the most suitable procedure for Indians. It is mainly restrictive as > 75 percent of the stomach is removed. There is very little malabsorption and hence suited to the Indian subcontinent.
  2. Gastric bypass ( Roux – En – Y): Both restrictive and malabsorption. It might lead to nutritional deficiencies if supplements are not taken regularly.

The above two are the most common procedures. New evidence suggests that sleeve gastrectomy is as beneficial as gastric bypass in motivated patients with less immediate and long-term complications. Hence, it has emerged as the first choice in India.

  1. Adjustable gastric banding: This needs repeated adjusting to reach optimum level. The patient needs more motivation. Long-term benefits are yet to be proven.

4.Gastric balloon: It is temporarily restrictive for 3/6 months.

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