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Bariatric surgery – The ultimate weight loss solution?

weight loss surgery, weight gain after weight loss surgery

For years diet and exercise were the only two methods of tackling obesity. Even today, they are essential for healthy weight loss and maintaining a healthy body weight.  

However, in some cases, losing weight is not as simple as increasing one’s physical activity and decreasing their daily calorie intake. This is when weight loss surgery or bariatric surgery comes into the picture.  

In earlier times, obesity was not considered a medical condition. People struggling with obesity were often judged harshly. This increased the psychological impact of the condition. Today, we know that obesity is the result of a complex interplay of factors including genetic, environmental and lifestyle.  

Obesity is linked to a wide range of chronic and acute health conditions such as heart disease, type II diabetes, hypertension etc. For people who are suffering from serious weight related conditions and have a BMI (body mass index) greater than 35, weight loss surgery or bariatric surgery is a good option.  

What is bariatric surgery? 

Bariatric surgery is a surgical procedure that aids in weight loss. In this procedure, changes are made to the digestive system.  

Bariatric surgery is used in combination with lifestyle and dietary changes to effectively treat obesity. People who are obese and have serious health conditions such as type II diabetes or sleep apnoea (due to their weight) are considered for bariatric surgery.  

What are the types of weight loss/bariatric surgery? 

Weight loss surgery can be broadly classified into two categories: 

In open bariatric surgery, the doctor makes a single large cut in the abdomen to make the necessary changes in the digestive system. In laparoscopic procedures, the surgeon inserts thin surgical tools including a small scope into the abdomen through several small incisions. Laparoscopic procedures are preferred as it is associated with lower risks, post-op pain and recovery time.  

Furthermore, bariatric surgeries can either be malabsorptive or restrictive. In restrictive bariatric surgery weight loss is achieved by limiting the food intake while in malabsorptive, it is achieved by limiting the absorption of nutrients and calories.  

The different types of weight loss surgeries are: 

  1. Biliopancreatic diversion with duodenal switch 
  2. Gastric bypass (Roux-en-Y) 
  3. Sleeve gastrectomy 

Of these, gastric bypass (Roux-en-Y) and sleeve gastrectomy are the most common procedures.  

In Roux-en-Y, the surgeon makes a direct connection between the stomach and the small intestine. This enables the consumed food to bypass most of the stomach and the first half of the small intestine, hence limiting absorption of nutrients and calories. 

In sleeve gastrectomy, the surgeon takes out a part of the stomach to make the stomach smaller. This decreases the amount of food that can be held in the stomach hence limiting the intake of food.    

How much weight loss can be expected after the surgery? 

The amount of weight lost after undergoing bariatric surgery depends on the patient’s health as well as the type of bariatric surgery performed. Studies show that patients who have had the Roux-en-Y shed around 70% of their excess body weight while patients who underwent a sleeve gastrectomy loose up to 60% of their excess body weight. 

What are the benefits of bariatric surgery? 

Bariatric surgery is an effective way to reduce body weight when exercise and diet are not effective enough. It helps in preventing a wide spectrum of health conditions which are linked to obesity. These include:

  • Type II diabetes 
  • Hypertension 
  • High cholesterol 
  • Sleep apnoea 
  • Urinary incontinence 
  • Body ache 
  • Knee and hip pain 

Patients also claim that their weight loss has improved their quality of life as well as their psychological health.  

What are the risks of bariatric surgery? 

Every surgery has some or the other risks associated with it. Before opting for any type of bariatric surgery, it is essential that you understand the procedure and the risks it involves. The short-term complications that may arise after any weight loss surgery is similar to the risks associated with any abdominal surgery. These include: 

  • Bleeding  
  • Infection 
  • Blood clots 
  • Breathing difficulty  
  • Leaks in the gastrointestinal system 
  • Adverse reaction to anaesthesia 

Bariatric surgery can also lead to complications that may arise later in life. The long-term risk of weight loss surgery includes: 

  • Bowel obstruction 
  • Dumping syndrome  
  • Gallstones 
  • Hernia 
  • Hypoglycaemia (low blood sugar) 
  • Malnutrition 
  • Stomach perforation 
  • Ulcers 
  • Vomiting 

Is bariatric surgery the ultimate weight loss solution? 

Bariatric surgery is no magic solution to obesity. Medical professionals believe that a multi-disciplinary approach is the best way to ensure long term results. After getting weight loss surgery, exercise and diet are key to avoid gaining weight again. You can get tailored exercise regimens with a physiotherapist. Dieticians and nutritionists can help you come up with a diet that suits your body’s requirements.  

Obesity can also have a severe psychological impact. Psychologists can help patients overcome psychological barriers, improve self-control and regain their confidence.  

Patients generally discharged 2-5 days after the surgery, if complications do not develop. Once the hospital stay is over, you can resume mild exercise to improve blood circulation, prevent blood clots and hasten to heal. Consult your doctor before you perform any type of physical activity.  

Remember, any type of weight loss surgery does not guarantee that you will not regain the weight. Bariatric surgery may not be the magic solution to stubborn and dangerous weight but it certainly is an important ingredient.  

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