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?

Obesity can shorten your lifespan by decades and also limit and reduce the quality of your life. Obesity cannot always be controlled by dieting and exercise and thus more complicated means such as bariatric surgery has to be employed.

Types of bariatric surgery
Most bariatric surgeries either limit your ability to consume food and thus make you feel fuller quickly or limit the absorption of nutrients from the food you eat. Certain surgeries use a combination of the two in varying degrees. Mentioned below are the most commonly employed forms of bariatric surgery  

Gastric Balloon   This is a form of surgery wherein a specially made balloon is inserted into the stomach. In certain cases even two balloons are inserted into the stomach to reduce the room left for food. This causes you to have less food resulting in weight loss over a period of time.
Gastric Sleeve   This is a form of surgery wherein a major portion of the stomach is removed through the procedure. Also known as Vertical Sleeve Gastrectomy, the surgeon creates a pouch within the stomach which essentially becomes a connecting tube between the esophagus and the large intestine. The reduced stomach size causes fewer hunger related enzymes and hormones to be secreted, causing less hunger and also reducing your food intake capability. This results in weight loss over a period of time.
Gastric Bypass   Gastric bypass uses the combination of two techniques, lesser absorption of minerals as well as reduced intake capacity. In this method, a part of the stomach is rearranged akin to the gastric sleeve. However the leftover portion of the stomach is not removed as it can continue to secrete stomach acids. Because of the reduced size of the stomach, you would eat less and if you happen to over eat, it would cause dumping syndrome (quick and repeated bowel evacuation) which would deter you from eating more.
Lap band surgery   This is one form of surgery where the stomach is not reduced or cut but rather limited by a band that is put around it. This band constricts the stomach and causes the upper part to become smaller. Hence you would feel fuller from eating less, thus resulting in weight loss.
V-bloc therapy   This is a very modern approach to bariatric procedures which works in a very similar way to a pacemaker. A device is placed just under your skin and two leads or wires are connected to the vagal nerve. This nerve is responsible for sending the hunger signals to the brain from the stomach. This device acts as a block to the nerve signals and thus ensures you eat less.
Duodenal switch   This surgery is also known as a Biliopancreatic Diversion wherein the surgeons cut out the part of the stomach similar to a gastric sleeve surgery but also make adjustments to the pancreatic chain and the small intestine to reduce the absorption of minerals.

6 Types Of Bariatric Surgery You Can Think of!

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?

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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