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!

Obesity is a condition characterized by the accumulation of large quantities of fat in the body. This condition drastically increases the risks of health problems. The most important cause for obesity is the intake of larger number of calories than what are usually burned through exercises or other routine activities. One with a BMI (Body Mass Index) more than 25 is considered obese. The primary ways of treating obesity are through exercising regularly and following a healthy diet.

How can Ayurveda help?
Ayurveda is a holistic system of medicine which is free from side effects, unlike conventional methods of treatment. Ayurvedic treatments focus on getting to the root cause of the disorder instead of just focusing on the symptoms. There are multiple remedies in Ayurveda that are effective in controlling obesity. They are:

Restrict your calorie intake: While this may sound easy, it is actually difficult to implement. One of the major reasons for obesity is eating too much. The idea is to avoid overeating, so you need to be aware of your portion size. Eat frequent meals but in smaller quantities; this helps in keeping your metabolic rate elevated, that in turn is a prerequisite for greater fat burning.
Start exercising: Exercise is a great way to burn those extra calories around your middle. The best and simple way to go about it is to start jogging. Low intensity jogging done over a period of time is a great way to burn fat. If you want to gain muscle, then do weight based exercises instead of just doing cardio.
Meditate: The beneficial effects of meditation are well known. Apart from reducing your stress level, it also helps in boosting your focus and concentration. Being stressed can make you eat more and thus gain weight, so meditating on a regular basis can help manage stress effectively.
Get sufficient rest: Sleeping less than 6 hours a day? You are only setting your body for obesity. Not sleeping enough brings about hormonal changes in the body which increase your appetite.
Avoid junk food: Junk food should strictly be avoided as it can make you put on some serious pounds. Instead, opt for healthier food options, but keep in mind the portion sizes.

Obesity - How Ayurvedic Remedies Are Best For It?

Bariatric surgery is unlike other surgeries, the success is defined after 6-18months later. It is not without its complications. But complications managed well by Bariatric surgeons and the introduction of Laproscopy, it gives advantages of reduced post-op pain to less incisional hernias and less post-operative hospital stay. 

Sometime problems may happen like- 

Post-operative bleeding: Managed well by the surgeon. 
Dehydration: Chances of dehydration, therefore, one of the main post-op instructions, would be to increase water intake significantly, after the first week of course, when water is included in the diet. For someone who is not used to drinking lots of water, this can be difficult. 
Indigestion: Difficulty digesting food after the surgery is very common. There could be a burning sensation in the stomach. This is often managed by dietary changes like avoiding fatty foods, eating small frequent meals, avoiding too much sugary food items, etc. Too much fruits and vegetables should not be introduced early on, as fibre can be difficult to digest. Avoid fruits like nuts, seeds, fried foods, processed foods, etc. Gradually moving from water to pureed diet to semi-solids to solids can help in getting the stomach used to it. 
Vitamin and mineral deficiency: With the drastic cut in the amount of food consumption, there could be multiple problems including skin rashes, weak bones, dental issues, hair loss, gallstones, kidney stones, etc. All these are due to deficiency of various essential minerals like calcium, potassium, etc. This can be managed through minor diet modifications to ensure the body gets the required minerals and vitamins, even if they are in the form of supplements. 
Dumping syndrome: With a reduced size of the stomach, the food moves from the stomach into the smaller intestine much faster. Therefore, the sugar levels increase rapidly, producing various symptoms like bloating, diarrhoea, nausea, weakness, and anxiety. This is managed by eating less amount of sugars and fats and spacing out the meals through the day. Five to six small meals are preferred over 2 to 3 large meals. Some people also get relief from lying down after eating. 
Hernias: Less after laproscopic surgery but sometime it may happen. 
Diet changes: Whether it is medications or foods, some substances have to be knocked off your list. A detailed diet plan should be made with the doctor, as some can affect the stomach in an adverse manner. 
Altered bowel habits: Some people may have diarrhoea, others have constipation. Looking into one s diet and making suitable changes will help. Therefore, it is very important that you must keep regular follow-up and consultation with your surgeon, in order to avoid complications.

Bariatric Surgery - 8 Complications It Can Cause!

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!

Bariatric surgery is a surgery performed on the stomach and is usually recommended for people who are obese. If you have a BMI value more than 40, then this surgery is a very good option. Along with those having an obesity problem, this surgery is also said to be ideal for those people who are suffering from type 2 diabetes and having a BMI value between 35 to 40.

There are many studies which show that there is a great improvement in people with type 2 diabetes after bariatric surgery. Even the cholesterol and blood pressure levels can also be controlled with the help of this surgery. Post-surgery, you will have to take fewer medicines or in some cases, you need not have to take medicine at all.

How does the doctor decide if you need bariatric surgery?
Basically, there are two things that will be considered by the doctor. The first one is the BMI value, which should be above 35. And the second parameter to consider is if you have tried any other methods to lose weight but did not succeed. Based on these and if you are ready to face the mental and physical challenges after the surgery, you will be advised to go through this surgery. You should make sure that you are doing regular exercise and also eat less.

Types of bariatric surgeries for type 2 diabetes

Gastric bypass: In this kind of surgery, the stomach is divided into two parts. One small part at the top is separated from the lower part of the stomach. Whatever you eat, will go into this small part of the stomach and that makes you feel full faster. Also, fewer nutrients and calories are absorbed into the body. After this kind of surgery, more than 80 percent of diabetes patients showed no signs of diabetes at all.
Gastric sleeve: In this surgery, a large portion of the stomach is removed and hence you will be able to eat less. This also reduces the amount of ghrelin, the hormone responsible for making you feel hungry, produced. This is successful in 60 percent of people with type 2 diabetes.
Adjustable gastric band: A small inflatable band is placed around the stomach. This will look like a small pouch at the place where the food goes in. This pouch will get full a lot quicker and hence you will not be able to eat too much.
Does it help?
Some surgeries show 80 percent success rate and some show 60 percent success rate, but that is in terms of diabetes levels. Due to less food, the body will not get the required minerals and vitamins, which will result in other health complications. Some surgeries are also irreversible. So, it is your doctor who understands the surgery and your health better and they will always suggest the best option for you.

Bariatric Surgery For Type 2 Diabetes - Does It Help?

Is there a relation between weight loss surgery and type 2 diabetes? Yes, there is and a very promising one. Many diabetics may not know this but a key hole procedure called metabolic/ bariatric surgery can help resolve type 2 diabetes.

It s scientifically proven that these surgeries can normalize blood sugar levels and control diabetes in most patients. This means that you may not need any medicines post such a surgery. One long-term study which tracked 400 people with type 2 diabetes showed that six years after bariatric surgery, 62% diabetics showed normal blood sugar levels. Apart from this, they also showed better blood pressure, cholesterol and blood triglyceride levels that can cause heart disease.

Should you get a metabolic/bariatric surgery done? You are a fit candidate for bariatric surgery if your:

BMI is 27.5 or higher
And if are finding it difficult to maintain blood sugar with medicines & lifestyle changes.
Your doctor will give you a physical exam to check whether you are fit for a major surgery and if you are emotionally ready to commit to necessary lifestyle changes like eating healthy and exercising regularly.

Types of weight loss/diabetes surgery:

The most popular type of weight loss surgery is one in which the size of your stomach is reduced so that you feel full even after small meals. Other types of bariatric surgeries change the way your body absorbs calories and nutrients and vitamins. A few other types of bariatric surgeries do both.

Gastric Bypass: In this surgery, your surgeon makes a small stomach pouch by dividing the top of the stomach from the rest. This small pouch is connected to intestine so other part of stomach is bypassed. So, when you eat, food goes into this small pouch, which makes you feel full faster and also makes it possible for your body to absorb fewer calories. This is a very promising type of bariatric surgery for diabetics as up to 80% of people have normal blood sugar after it. And they also lose 60% to 80% of their extra weight on an average.
Gastric Sleeve: In this surgery, your surgeon will remove a major part of your stomach. When your stomach is small, you will feel full faster. It also reduces hunger pangs. This type of surgery is also very effective in reducing diabetes and losing weight.
Adjustable Gastric Band: In this surgery, your surgeon puts an inflatable band around the top of your stomach. This forms a small pouch which makes you feel full faster. The good point is that your stomach is not cut and your intestines are not shifted. There are thus lesser complications. It also helps in controlling diabetes. The con is that you lose less weight in this type of surgery.
Biliopancreatic Diversion: This is an uncommon surgery but most effective for diabetics. In this the doctor removes a large part of your stomach and also changes the way the food goes to your intestines. This helps in losing weight but also affects digestion long term.
As with any major operation, all bariatric surgeries come with potential risks of bleeding, infection, and leaks in the digestive system. It is necessary to change lifestyle to avoid weight regain.

Is There A Relation Between Weight Loss Surgery & Type 2 Diabetes?

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