What are Different Types of Bariatric Surgeries? 

Bariatric Surgery is one of the most popular options for obese people looking for a way to control their weight. To get bariatric surgery, one has to qualify for certain criteria like BMI (Body Mass Index), associated comorbidities like Diabetes, Hypertension, sleep apnea, infertility, hypercholesterolemia etc. There are many kinds of bariatric surgeries or weight loss surgeries, different surgeries work differently in order to give the desired effect, which is why it is important to understand these surgeries thoroughly. 

Weight loss surgeries are divided into different categories like - 

  Restrictive surgeries: Some bariatric surgeries are focused on limiting the amount of food that can be stored in the stomach. This allows a person to eat less than they used to, because of the limited capacity of the stomach. Sleeve gastrectomy, Adjustable gastric banding, Gastric imbrication, Gastric balloon surgery are examples of restrictive procedures. In sleeve gastrectomy, the stomach is divided into two halves first, then one half of the stomach is completely removed. The remaining part of the stomach is formed into a tube-like structure. This tube-like structure cannot hold enough food and restricts excessive food intake. It also limits the secretion of an appetite hormone called Ghrelin which limits the desire of a person to eat. 

  Malabsorptive procedures: In this procedure, a large segment of the small intestine is bypassed i.e the food is not allowed to enter a large segment of the small intestine and hence malabsorption will be there. Duodenal switch is a malabsorbtive surgery. 

To Summarize: The weight loss procedures that suit our Indian population are the Roux en Y gastric bypass and the sleeve gastrectomy. We do not come across any sign of malnutrition in patients who have undergone these procedures. For successful outcomes, vitamin, calcium and protein supplements are required. 

There are certain myths about bariatric surgery --- life will never be normal after the surgery, pregnancy is a problem after this surgery, one will never be able to eat after this surgery, marriage is a problem after this surgery etc. All these are incorrect as one live a better life after the surgery as one has shed the extra kilos, one is cured of existing problems like diabetes, high cholesterol, hypertension, obesity induced infertility and sleep apnea extra. IN FACT, the quality of life is phenomenal after this surgery. CHOICE of surgery depends on the existing BMI, existing associated problems and results of the investigations that are done prior to the surgery. Your surgeon is the best to decide the right procedure for you. As the procedure which your friend has undergone might not be good for you. Choice of procedure and proper follow up are the key points for a successful surgical outcome. 

  Combination of restrictive and Malabsorptive surgeries: In these procedures, the surgery is done on the stomach as well as the small intestine. It involves creating a small stomach pouch which is attached to the small intestine, thus bypassing a small segment of the small intestine to get the desired effect if the person has diabetes associated. The rest of the stomach produces important digestive juices and is also connected to the intestine so that it can transfer these digestive juices in it. As a part of the stomach and few centimetres of the small intestine are bypassed i.e food does not enter this part, the surgery is called the gastric bypass. The Roux en Y gastric bypass and the Mini Gastric bypass surgeries are examples of these combination procedures.

Bariatric Surgeries - Know Forms Of Them!

Laproscopic Bariatric Surgery allows Surgeons to perform minimally-invasive treatments to obese patients who have had repeated failure in losing weight through diet change and exercise. Bariatric Surgery is a procedure that does not require any incisions. Patients can return home within 2-3days without much discomfort. In this procedure, inserting operative instruments through multiple holes along with a camera which displays video images on monitor without making a single incision. The camera allows the Surgeons to witness the internal condition and perform the procedure safely. The three most well-known Laproscopic bariatric surgery procedures include gastric bypass, gastric sleeve, and mini-gastric bypass. 

Most common types of Laparoscopic bariatric surgery: 

Gastric sleeve: This is a more drastic mode of surgery and is a new addition to the bariatric endoscopic surgery procedures. Through this procedure, 90 percent of a patient s stomach is removed to facilitate the loss of hunger. This also helps in portion control of food. 
Gastric bypass: This is the most widely used bariatric procedure to cut down fats and control hunger across the globe. The digestive system is re-routed to suppress the hunger of the patient in this procedure. It also contains minimal risk to a healthy individual. 
Mini-Gastric bypass: Similar to Gastric bypass but shorter procedure with approximately equal results in comparison to gastric bypass. 
Other procedures for weight loss are: EndoBarrier therapy and Intra-gastric balloon The procedure is decided by the Surgeons and depending on which types of the procedure will suit you the most. 
Bariatric Surgery allows doctors to perform minimally-invasive treatments to obese patients who have had repeated failure in losing weight through diet change and exercise. Bariatric Surgery is a procedure that does not require any incisions. Patients can return home within the few day without much discomfort. A keyhole procedure involves inserting camera and instructions within abdominal cavity and operations performed by viewing over the monitor. The camera allows the doctor to witness the internal condition and perform the procedure safely. 

Benefits of Laparoscopic Bariatric Surgery: 

Being a minimally-invasive procedure, laparoscopic bariatric surgery has its own advantages. Since minimal incisions are made, the risk of operative complications is easily mitigated. Bariatric surgery is also a long-term solution.

Most Common Types Of Laparoscopic Bariatric Surgery!

Obesity is a serious, chronic disease that can have a negative effect on many systems in your body. People who are overweight or obese have a much greater risk of developing serious conditions, including:

Heart disease
Type 2 diabetes
Bone and joint disease
The prevalence of childhood obesity has increased dramatically over the past few decades, and obesity during adolescence is associated with significant medical morbidity during adulthood. Eating disorders and obesity are usually seen as very different problems but actually share many similarities. Eating disorders (EDs) are the third most common chronic condition in adolescents, after obesity and asthma.

In fact, eating disorders, obesity, and other weight-related disorders may overlap as girls move from one problem, such as unhealthy dieting, to another, such as obesity. Understand the links between eating disorders and obesity and promote healthy attitudes and behaviors related to weight and eating.

What is an Eating Disorder?

Eating Disorders describe illnesses that are characterized by irregular eating habits and severe distress or concern about body weight or shape. Eating disturbances may include inadequate or excessive food intake which can ultimately damage an individual s well-being. The most common forms of eating disorders include Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder and affect both females and males.

Signs & Symptoms of an Eating Disorder:

A man or woman suffering from an eating disorder may reveal several signs and symptoms, some which are:

Chronic dieting despite being hazardously underweight
Constant weight fluctuations
Obsession with calories and fat contents of food
Engaging in ritualistic eating patterns, such as cutting food into tiny pieces, eating alone, and/or hiding food
Continued fixation with food, recipes, or cooking; the individual may cook intricate meals for others but refrain from partaking
Depression or lethargic stage
Avoidance of social functions, family and friends. May become isolated and withdrawn
Switching between periods of overeating and fasting
What are the health risks associated with these disorders?

Stunted growth.
Delayed menstruation.
Damage to vital organs such as the heart and brain.
Nutritional deficiencies, including starvation.
Cardiac arrest.
Emotional problems such as depression and anxiety.
What is Obesity?

Obesity means being overweight by the accumulation of excess fat within the body. Obesity is defined to some extent by measuring Body Mass Index (BMI). People become obese by consumption of excess calories, imbalance between calories intake and calories outgoing, leading a sedentary life, lack of sleep , disturbances in lipid metabolism and intake of medications that put on obese.

What are the risks associated with obesity?

Obesity increases the risk for:

High blood pressure
Stroke
Cardiovascular disease
Gallbladder disease
Diabetes
Respiratory problems
Arthritis
Cancer
Emotional problems such as depression and anxiety
How eating disorder and obesity are related?

Eating disorders and obesity are part of a range of weight-related problems.

Body dissatisfaction and unhealthy dieting practices are linked to the development of eating disorders, obesity, and other problems.
Binge eating is common among people with eating disorders and people who are obese.
Depression, anxiety, and other mood disorders are associated with both eating disorders and obesity.
The environment may contribute to both eating disorders and obesity.
Help adolescents develop healthy eating habits:

Help children learn to control their own eating.
Offer children a variety of healthy foods at meal and snack times.
Eat dinner together as a family most days of the week.
Be aware of your child's emotional health or else consult a psychologist
Encourage children to participate in sports, dance, swimming and other physical activities.
Counteract harmful media messages about body image. 
The splendid approach:

The approach should be quite simple. A proper diet plan, nutritious foods and fruits with proper exercise can do a world of good to you. 

Obesity Due To Eating Disorders!

Are your regular exercises and the strict diet proving futile on your quest for a tighter and a flatter tummy? You can consider getting an 'abdominoplasty' or 'tummy tuck' done. This cosmetic surgery helps in flattening your abdomen by taking off the extra skin and fat and tightening up the muscles in the walls of your abdomen.

The procedure
1. The first step involves choosing a surgeon for consultation.
2. There are two types of  tummy tuck  surgery, both carried out under general anesthesia.  Complete abdominoplasty  whereby, your surgeon would dissect your abdomen from one hipbone to the other and then give an outline to your muscle, tissue and skin.  Mini or partial abdominoplasty  are recommended for people whose fat deposits are underneath their naval region.

Complete Abdominoplasty
 Complete Abdominoplasty  involves making a big incision around the lower part of the tummy from one hip to another, making a second cut in order to free the belly of the tissue that surrounds that region, separating the skin from the walls around the abdomen, re-aligning the muscles in the abdomen, removing the supplementary skin and fat and then pulling forth the skin remains and stitching them too.

Partial Abdominoplasty
Partial Abdominoplasty requires making a large cut on the lower belly, separating the skin from your abdominal wall, cutting out the excess fat, removing the additional skin and holding the remaining part of the skin together and finally stitching it in place.

Time taken for the surgery
The surgery may stretch from one to about five hours.

Pre-requisites

You will have to cut down on the consumption of alcohol and especially smoking; smoking leads to more complication and slows down the healing process.
It is recommended to have a well-balanced meal before the surgery.
After-care

You may suffer from swelling and pain in the days after the surgery, for which your doctor would prescribe pain-killers.
Regardless of the type of surgery conducted, the portion that was operated on would be stitched and bandaged. Therefore, it is very important to abide by the surgeon s instructions about how you should take care of the dressing in the days to follow.

Tummy Fat - Can Surgery Be Considered to Reduce it?

Tummy tuck surgery or Abdominoplasty is a cosmetic plastic surgery procedure which tightens the muscles of your tummy. Loose skin and fat from your abdomen are also removed and as a result, the abdomen gets flat and toned. This surgery is common among women after pregnancy who want to restore their figure. This surgery also assists patients who have lost a large amount of weight in a short time period. Most tummy tuck surgeries are carried out for cosmetic reasons. However, there are certain medical benefits, which are gained after an abdominplasty is carried out. They are enlisted below.

Stress urinary incontinence is reduced: After giving birth, many women develop Stress Urinary Incontinence (SUI). This is a bladder control disorder that causes leakage of urine without control when you sneeze, cough or laugh loudly. Usually, this disorder can be treated without having a surgery, but in certain cases a tummy tuck enables speedy recovery in patients who did not have a caesarian section. A slight amount of bladder obstruction is created, which reduces the SUI.
Gives you a better posture and enhanced abdominal tone: The stomach muscles sometimes become distended due to extreme loss of weight or because of pregnancy. A tummy tuck surgery helps in tightening of the weak muscles, removes excess fat and skin and the abdomen gets flattened. After carrying out a tummy tuck, people get an improved posture as the tightened muscles provide better support to the vertebrae.
Correction of ventral hernia: A ventral hernia occurs due to the breake down of intestinal or abdominal tissues through the abdomen walls, and a sack is formed. The causes include abdominal weakness as a result of huge weight loss or previous surgeries.
The symptoms that lead to a ventral hernia correction are similar to the symptoms of a tummy tuck, as both the surgeries rectify abdominal muscles. Once you have a ventral hernia correction, you may need to repeat it again. In case you have this type of surgery, it is recommended that you should also have a tummy tuck done. This might prevent future occurrence as the combined methods leave you in a much safer condition. Medical expenses and recovery time are also reduced.

Tummy tuck surgery is becoming increasingly popular these days. It is a major surgery which requires almost five hours to be completed successfully. A tummy tuck can remove up to ten pounds of fat from a person s abdomen. It takes several weeks to recover after having a tummy tuck surgery.

Tummy Tuck -  Understanding the Benefits!

Being overweight is becoming a common sight. However, opting for bariatric surgery is not the first option for everyone who is obese. Also to remember is that morbid obesity is not an isolated condition. It affects a person s overall physical and mental health in various ways, and therefore bariatric surgery becomes an option only as a last resort. 

Some defining criteria for this surgery would be:

A male who is at least 100 pounds overweight for his height or a female who is at least 80 pounds overweight for her height. This puts them at a body mass index (BMI) of more than 40.
If the BMI is in the range of 35 to 39 and if there are significant health issues like metabolic syndrome, then bariatric surgery can be done. For BMI less than 35, other conservative measures are usually tried before resorting to a surgical approach.
Most people with BMI in the range of 35 and above will have health issues like sleep apnoea, heart disease, lipid disorders, and metabolic syndrome.
Conservative measures to lose weight including diet changes and exercise have failed to produce any desired results.
The person, in addition to physical health, should also be emotionally strong to undergo the demands of bariatric surgery. There are changes involving almost all body systems including digestive, respiratory, cardiac, and musculoskeletal, and so the person needs to be prepared for a lifestyle change.
Strict lifestyle changes including diet and exercise are required, so the person needs to be counseled and convinced about these. A person who can see the long-term benefits will be willing to take the effort.
It is also essential that the person has a strong social support system. For immediate post-op care when skin flaps need to be managed, and for long-term emotional support to manage emotional issues, it works wonders if there is a strong social network. The results are usually better in such people.
A person s overall health would be screened to make sure the lab tests are well within acceptable limits before surgery. It would be unreasonable to get these numbers within limits, if they are way too beyond acceptable limits.
Not the least consideration, but bariatric surgery is an expensive affair. It requires not just surgical costs, but also post-op costs. The good thing, however, is that overall healthcare costs would come down, once the results are visible.
Identifying the right candidate for a bariatric surgery is very essential, as doing this extensive surgical approach on an unsuitable candidate would be a failure.

Bariatric Surgery - Who Is Eligible For The Same?

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