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?

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!

Looking good and feeling good are sometimes one and the same thing which can be achieved with good skin and a fit body. One can turn to many measures to achieve the same, including cosmetic procedures. Cosmetic surgery like liposuction is generally used to remove the excess fat in the body which cannot be treated with normal exercise or diet control measures. This surgery is conducted by a plastic surgeon. Here is everything you need to know about liposuction.

About: Liposuction is a cosmetic procedure. It removes the excess fat present in one s body with the help of a procedure known as body contouring. This kind of contouring may be carried out in various parts of the body including the calves, knees, buttocks, hips, abdomen, upper arms, breasts and even the neck and chin area. These are the areas that generally end up accumulating excessive fat which does not go away easily. For some people, persistent diet control and exercising may help. But for severe and chronic cases, one will have to make use of measures like liposuction.

Types of Liposuction: Depending on your case as well as the individual system of the patient, one can go in for one of the various types of liposuction. The fluid injection based liposuction is the most popular and common form where a large dose of medicated solution is injected with a local anaesthesia blended into it. This helps in contracting the blood vessels so that the fat can be suctioned out. The next type is the super wet liposuction where the amount of liquid solution injected is the same as the amount of fat that has to be removed. Ultrasound assisted liposuction uses ultrasonic waves in order to transform the fat cells into liquid which can be vacuumed out later. Further, laser assisted liposuction makes use of laser pulses and beams in order to make the fat cells liquid before they are vacuumed out of the system.

The procedure: The plastic surgeon will make use of a special liposuction machine and cannulas or special instruments, so that the surgery may be carried out in a proper manner. Also, depending on the type of procedure you are going in for, you will require local or general anaesthesia. A small incision is made so that the tube may be inserted for the liquefaction process to begin. After this, the fat that has been dislodged will be vacuumed away through the same suction tube. Small drainage tubes will be inserted to remove blood and fluid from the deflated areas and in some rare cases, blood transfusion or fluid replacement may also be required. High blood pressure and cardiovascular cases should not use this option.

Liposuction - How It Can Help You?

Abdominoplasty, also known as  tummy tuck  is a surgical procedure aimed at removing excessive skin from the abdomen. This surgery removes the extra fat and skin, thus making the abdomen flatter, resulting in tighter muscles near the walls or border of your abdomen. You should consult your doctor and strictly follow prescribed procedures before and after the surgical process. It must not be confused with liposuction i.e. the cosmetic surgery which removes excessive fat deposits in the body. 

Abdominoplasty or tummy tuck is beneficial to you, 

If you possess good physical health. 
If you are a non-smoker or have recently quit smoking. 
If you have a stable health and realistic expectations about the outcome of the surgery. 
If you have been pregnant previously and now need to lose weight and fat deposits. 
The surgery is not suitable for the following cases: 

If you are planning to get pregnant, then it is recommended to perform the surgery after delivery. This is due to the fact that your muscles can be stretched again after the surgery. 
If the appearance of scars after tummy tuck is a problem, consult your doctor about the scar replacement procedure. 
If you still smoke or are absolutely unable to quit. 
Types: 

There are two procedures of tummy tuck. These are decided by the surgeon during your consultation and some pre-surgery medical tests. The procedures are: a) Complete Abdominoplasty and b) Partial or mini abdominoplasty. 

In Complete Abdominoplasty, the surgeon cuts the abdomen from hipbone to hipbone and your skin, tissue and muscle will be operated. In the case of partial or mini abdominoplasty procedure, the fat deposits are usually located below the navel region and the surgeon may not move your belly button. The entire procedure may take around two to three hours. 

Aftercare: 
Proper nutrition and healthy meals are required for this surgery. You must follow a balanced diet and focus on post-operative care.

Tummy Tuck Surgery - Abdominoplasty!

When dieting and exercising fail to help an obese person manage their weight, bariatric surgery may be suggested. One of the most popular types of bariatric surgery is a gastric sleeve surgery or sleeve gastrectomy. The main aim of this surgery is to reduce the amount of food that can be consumed in one sitting. It does not affect the amount of nutrients and fats absorbed from the food that has been eaten. A majority of the weight loss resulting from this surgery happens within 12-18 months.

A gastric sleeve surgery is a relatively safe, straightforward and short surgery. Prior to surgery, few patients would have been given a special diet.  This surgery is always  performed laparoscopically popularly known as keyhole route. More than half the outer side of the stomach is removed. The remaining part of the stomach takes the form of a tube. 

Though recovery from any surgery varies from person to person, most patients are able to walk and allowed sips of water by evening. Though certain amount of pain and discomfort is expected, this remains in bearable range with pain killers. Usually liquid diet is advised for 2 weeks followed by soft foods for 4 weeks.

You will notice that you feel fuller much faster and are able to consume a very limited portion of your normal food intake. It is essential to drink plenty of water to remain adequately hydrated and to prevent constipation.

On an average, this surgery can help people lose up to 70% - 100%% of their excess body weight. However, this depends largely on your understanding and compliance of post operative dietary changes. A dietician can also help you make right food choices, decide meal portions and address the right number of meals needed by your body. For long term weight maintenance it is important not to fall back to your earlier lifestyle and to maintain a positive attitude.

Gastric Sleeve Surgery - What Is The Process Of It?

Obesity is a major problem across the world. In India, fast foods and an unhealthy lifestyle have led to widespread obesity as well. While following a proper diet and leading a healthy life can help manage obesity and weight gain in most cases, severely obese people require surgeries to lose weight.

Weight loss surgery, known as bariatric surgery, aims to reduce hunger and appetite in extremely obese people. However, simply undergoing surgery does not guarantee positive results. In fact, the lifestyle changes post-surgery is the most important factor to keep the extra weight off your body.

Recovery post bariatric surgery:

If you undergo a bariatric surgery, your lifestyle changes will depend on the procedure of the surgery. For instance, in laparoscopic bariatric surgery, the recovery period is short. In this surgery, the doctor will make 5-6 very small incisions on your stomach. He will then insert a tube-like equipment with a camera in your stomach and carry out the surgery.

Since very small incisions are made instead of a large cut, you will be discharged within a week. Furthermore, you can return to your normal routine within a month.

Lifestyle changes to follow:

1. Eating healthy: Post the surgery, you will need to follow a low sugar and low-fat diet. If this is a break from your usual diet then you need to get used to this diet, since you will need to stick to it for a long time. Immediately after the surgery, you will need to stick to a liquid diet, so that your stomach can adjust to the food.

Once your stomach starts adjusting to the sudden change, consume soft proteins. You will be able to return to solid foods around six months after your surgery. In the initial six months, it is essential to avoid foods such as white bread, pasta, and potatoes. Furthermore, you need to consult your doctor before consuming certain medicines such as painkillers.

2. Exercise daily:

Exercise becomes vital in your long-term goal of losing excess weight after the surgery. Your doctor will first need to clear you to take part in light activities, which will help enhance your body s metabolism. Joining a gym is helpful in this regard   you will have access to trainers and training equipment to help you exercise correctly. However, make sure to inform your instructor of your surgery before beginning an exercise regimen.

Most people fail to understand that you do not magically lose weight after bariatric surgery. You will need to maintain a healthy lifestyle if you want to achieve an ideal body mass and stay in shape. Therefore, you need to be committed to the procedure for the rest of your life.

Lifestyle After Bariatric Surgery!

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