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Last Updated: Jan 10, 2023
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All You Need To Know About Weight Loss Surgery!!

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Dr. Premkumar BalachandranSurgical Gastroenterologist • 34 Years Exp.MBBS, MS - General Surgery, M.Mas, Diploma In Minimal Access Surgery, Fellowship In Minimal Access Surgery, Fellowship In Robotic Surgery, FICS, F.I.A.G.E.S, FAMASI
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Weight loss surgeries or bariatric surgeries sound nothing short of miraculous. Research proves that they help you lose oodles of sticky fat and you are also able to toss away your type 2 diabetes medications just days after undergoing a weight-loss surgery.

Just the idea of becoming svelte again after a lifetime of being obese is a good inducement to going under the knife, even if you are not a diabetic. But before you take this big risk- bariatric surgery is a major surgery with its own attendant risks- understand whether you are a good candidate for it, which type of bariatric surgery is most effective? And what are the long-term effects?

Rushing in for surgery without having complete knowledge about it could end up causing more problems than it is intended to solve.

Read on to get answers to the fundamentals of bariatric surgery-

Bariatric surgery is digestion redesigned

Bariatric surgery is a work in progress. The procedures are still being fine-tuned since the first bariatric surgery which was carried out in 1956 in America. There are at least seven procedures in bariatric surgery at this time, out of which four are very common. Let’s have a quick look at these four-

1. Gastric Bypass
This is the most frequently performed bariatric surgery. Most gastric bypasses are done laparoscopically in which your surgeon uses a laparoscope to see and work inside your body through just a small incision.
He leaves only a very small part of the stomach, the pouch after a bypass.

Pros
As it shrinks the size of the stomach by over 90 percent, from roughly the size of a fist to that of a thumb, a bypass reduces the amount of food you can eat at a time as you feel full faster because the pouch can't hold a lot of food. And also the food you eat bypasses the rest of the stomach, going straight from the pouch to your small intestine which means that lesser calories are absorbed. It also leads to dramatic and quick weight loss and diabetes mellitus reversal.

Cons
The re-routing of the food also hinders the absorption of vitamin and minerals, which is why you have to take vitamins to stop deficiencies after a bypass. About 1 out of 5 bypass patients also develop "dumping" syndrome, in which too much-undigested food goes into the small intestine causing diarrhoea and abdominal cramps.

2. Adjustable Gastric Banding
This surgery is also performed laparoscopically and here a fluid-filled belt is wrapped around your stomach. Tightening this belt divides your stomach into two pouches, a small upper pouch that receives food from the esophagus and a larger lower pouch that opens into the small intestine.

Pros
This belt's tightness can be adjusted by adding or subtracting saline solution by your doctor. If you tighten the belt, you eat less and lose more weight.


Cons
Banding can lead to gastrointestinal distress, such as nausea or bloating especially if you eat too much quickly. Complications with the band can also happen like it might slip out of place or become too loose, or begin to leak. You may have to undergo correction surgeries and infection is always a risk.

3. Sleeve Gastrectomy
This is another form of restrictive weight loss surgery and in this the surgeon removes about 75% of your stomach. What remains of your stomach is a narrow tube or sleeve, which connects to the intestines.

Pros
For people who are very obese or sick, this surgery is a heaven send opportunity to lose weight. It has fewer complications as compared to other weight loss surgeries.

Cons
It’s an irreversible surgery.

4. Maestro Rechargeable System
Electrical devices are implanted like pacemakers to deliver electrical pulses to the vagus nerve between the stomach and brain. Vagus tells your brain when the stomach is full. The electrical device is implanted in your abdomen and has a remote control that you can adjust from outside. It works by controlling hunger.

You can die of a bariatric surgery even though it’s considered a safe surgery. Death rates are higher for gastric bypass as compared to banding. Therefore, you must take the decision to have this kind of surgery after serious consultations with doctors.

You are an ideal candidate if-

  1. You're an extremely obese adult with a BMI of over 35
  2. If you have a weight-related condition like type 2 diabetes
  3. You have tried everything and failed.

After Bariatric surgery

Life changes forever after such a surgery. You have restrictions imposed on what types of food you can have and in what quantities. Like, you may only be able to have soft foods, less simple carbs than before and other such dos and don’ts which you have to follow for the rest of your life.

If you don’t obey these diet restrictions your operation can fail or you may not get any benefit. Other long-term side effect of weight loss surgery is nausea, vomiting and digestive distress. You also have to exercise regularly after this surgery to rep benefits. If you wish to discuss about any specific problem, you can ask a free question.

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