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Bariatric And Metabolic Surgery - When Should You go For It?

Dr. Praveen Sharma 86% (24 ratings)
MBBS, MD - General Medicine, DM - Gastroenterology
Gastroenterologist, Delhi
Bariatric And Metabolic Surgery - When Should You go For It?

Bariatric surgery (weight loss surgery) includes a variety of procedures performed on people who have obesity. Metabolic surgery is defined as “a set of gastrointestinal operations performed with the intent to treat diabetes (diabetes surgery) and metabolic dysfunctions (which includes obesity). Over the past 5 years, the term “metabolic surgery” has become increasingly popular. In 2002, it was suggested that gastrointestinal surgery could be used with the primary intent to treat type 2 diabetes. The idea derived from the factor that the gastrointestinal tract is a major player in the regulation of glucose homeostasis.

In patients with a BMI above 35, surgical treatment of diabetes is now recommended by virtually all professional organizations.

Weight loss is achieved by:

  1. Reducing the size of the stomach with a gastric band or through the removal of a portion of the stomach
  2. By resecting and rerouting the small intestine to a small stomach pouch.


Long-term studies show that the procedures cause significant long-term loss of weight, recovery from diabetes, improvement in cardiovascular risk factors, and a mortality reduction from 40% to 23%.

Indications for Bariatric Surgery

  1. Excess body weight affecting the quality of life and restricting routine activities
  2. Patients with a BMI of 40 kg/m2 or greater who instituted but failed an adequate exercise and diet program (with or without adjunctive drug therapy
  3. Patients who present with obesity-related comorbid conditions, such as hypertension, impaired glucose tolerance, diabetes mellitus, hyperlipidemia, and obstructive sleep apnea

Types of Bariatric Surgery

  1. Vertical sleeve surgery
  2. Gastric bypass surgery 
  3. Intragastric balloon surgery
  4. Duodenal switch surgery
  5. Lap band surgery

Eating Schedule After Bariatric Surgery

Immediately after bariatric surgery, the patient is restricted to a clear liquid diet until the gastrointestinal tract recovers from the surgery. This is followed by a blended diet for at least 2 weeks, consisting of a high protein diet and dairy products. Foods high in carbohydrates are usually avoided when possible during the initial weight-loss period. Many patients need to take a daily multivitamin pill to compensate for reduced absorption of essential nutrients. 

Effectiveness of Surgery

  • Weight loss
  • Reduced mortality and morbidity
  • Psychiatric/psychological health can improve after bariatric surgery

Adverse Effects of Surgery

  1. Metabolic bone disease manifesting as osteopenia and secondary hyperparathyroidism
  2. Rapid weight loss after obesity surgery contributing to the development of gallstones
  3. Hyperoxaluria that can potentially lead to oxalate nephropathy and irreversible renal failure
  4. Rhabdomyolysis leading to acute kidney injury and impaired renal handling of acid and base balance has been reported after bypass surgery
  5. Nutritional derangements due to deficiencies of micronutrients

Complications of Bariatric Surgery

2786 people found this helpful

How to Boost Your Metabolism

Dr. Kritika Bhola 91% (400 ratings)
BHOM, MD - Alternate Medicine, Diploma in Weight Loss, Diploma in Nutrition, DNHE
Dietitian/Nutritionist, Delhi
How to Boost Your Metabolism

A lot of diets claim to help ‘boost’ metabolism – but can you really do anything to help your body burn calories faster?

Let us understand a little about how your metabolism works. The metabolic process involves a complex network of hormones and enzymes that not only convert food into fuel, but also affect how efficiently you burn that fuel. How fast you burn calories is influenced by your age ; your gender  and proportion of lean body mass . So some people have high metabolic rate as compared to others.

Even though you are not born with “skinny genes” , you can still speed up your metabolism i.e.  increase your body’s ability to burn calories faster.

Exercise.  Working out builds muscle. Muscle speeds metabolism. As the body works more efficiently, it processes food faster.

Besides exercise there are other things which boost up your metabolim.

  1.  Spices: Research has found  red peppers  can rev up your metabolism, while also helping you feel full.  Hot sauce, hot peppers, ginger, cloves, cayenne, coriander, bay leaves, and dry mustard share this capacity to boost metabolism.


2. Caffeinate: Coffee, tea, or other caffeinated (but low or no-calorie) beverages may also help burn calories faster. In fact, caffeine may boost your metabolic rate for up to three hours after consumption. But don’t overdo caffeine if it gives you the jitters or keeps you up at night. For most people, 3-4 cups per day is tolerable.


3. Stay Hydrated: Even mild dehydration has been found to decrease your metabolic rate by 2%, so staying well hydrated is an easy way to help boost overall metabolic rate. People who drink either eight or twelve  glasses of water a day have higher metabolic rates than those who have four.


4. Eat More Often:   Small, frequent meals help keep your metabolism  high , and that means you’ll burn more calories overall. When you put too many hours between meals, your metabolism actually slows down to compensate. If you then eat a huge meal — at the same time your metabolism is functioning as if you’re starving — your body wants to hold on to every calorie. While this won’t make much difference on an occasional basis, it can become more difficult to lose weight or maintain weight a healthy weight if you frequently skip meals.

3 people found this helpful

Boost Your Metabolism

Dr. Tariq Khan 90% (109 ratings)
Homeopath, Gorakhpur
Boost Your Metabolism
  1. Take proper sleep of eight hours.
  2. Drink plenty of water, if you don't like plain water add cucumber, lemon, pineapple, mint etc to add flavor.
  3. Add chilli peppers to your regular diet.
  4. Dont skip your regular meals.
  5. Take low carbs.
8 people found this helpful

Gastric Bypass - Be It Bariatric Or Metabolic Surgery, Get Amazing Results!

Dr. Tulip Chamany 88% (89 ratings)
MBBS, Fellowship In Minimally Invasive Bariatric Surgery, Fellowship In Minimally invasive(Keyhole) Surgery
Bariatrician, Bangalore
Gastric Bypass - Be It Bariatric Or Metabolic Surgery, Get Amazing Results!

The “Roux en Y Gastric Bypass” surgery was first performed by Professor Mason in 1966. Being done in the conventional way (i.e by open surgery) earlier and later laparoscopically, the Gastric Bypass has stood the test of time over the last 52 years.

Over 50 years the Gastric bypass surgery is being performed across the globe. It has given excellent results in terms of significant and long-standing weight loss in the morbidly obese, as well as remission of Type 2 diabetes in properly selected patients. Selection of the patient to undergo this procedure is paramount. 50 years of successful results are enough to term this procedure as the GOLD Standard.

Obesity and Diabetes have been a menace over the last 2 decades world over. In India obesity is growing in such a rampant way that we can equate it to an epidemic.

As we all know, India is considered to be the Diabetic Capital of the world. Type 2 diabetes contributes to the major chunk of diabetes affected population. We Indians get affected by diabetes at very early ages and hence complications are seen at very early ages among us. Strikingly important to notice is that Diabetes is seen not only in the obese category of people but also in the normal weight people.

Diabetes is feared of only because of the complications it is capable of causing affecting the vital organs like the brain, heart, eyes, kidneys.

Intermittent or elevated surges in the blood sugars levels during the course of the day are responsible for causing microangiopathies ( damage to the small vessels supplying blood to the vital organs).

We have seen that diabetes is accompanied by high blood pressure and dyslipidemia in most of the cases. So, when a person has diabetes, high blood pressure and dyslipidemia, we label them as having the metabolic syndrome.

Oral hypoglycemic agents (OHA) and insulin form the mainstay of treatment in getting sugars under control. But these are not able to avoid these surges in high sugar levels. This does not mean that OHA’s and Insulin are not the right way to treat diabetes- they indeed are.

We are going a step higher, in an attempt to get control of diabetes without OHA and insulin. Not only this, we are trying to tackle not just diabetes, but the metabolic syndrome on the whole i.e one procedure that will take care of diabetes, dyslipidemia and hypertension. This procedure is popularly known and referred to as the “Gastric Bypass” or the “Roux en Y Gastric Bypass”. Thus, In short, the gastric bypass surgery offers ICE BURG treatment.

Now, the first question is that “Is this possible”. The answer is YES. The second question is that is this procedure applicable for all diabetics. The answer is NO. Only Type 2 diabetics are the beneficiaries of this procedure where insulin resistance has a major role to play. (This procedure does not benefit Type 1 diabetics) Reasons for this will be explained later. The third and important question is that, “Is the Gastric bypass going to give remission of diabetes in all type 2 diabetics?” The answer is NO.

There is strict selection criterion or eligibility criteria to select a patient for The Roux en Y Gastric Bypass surgery. Best results of the Gastric Bypass surgery are seen when it is confirmed that the person is suffering from Type 2 diabetes, duration of diabetes is less than 5 years, the pancreatic reserve is good and showing good levels of C -peptide in the blood, the person has a family history of diabetes, Insulin was not required to control sugar levels within the first 5 years of onset of diabetes and person should not be underweight( BMI > 27.5 preferred).

Losing weight is not easy and even if we lose weight, weight regain is very common. Most of us would have already experienced it. When we are tackling just the weight issue, we are talking into consideration only the morbidly obese people who have a BMI > 37.5. In the morbidly obese, at first, it is very difficult to lose significant weight by the normal method of diet and exercise. Even if weight loss does occur, weight regains or bouncing back is sure.

Here we bring in the trump card – The “Roux en Y Gastric Bypass” that helps the :

  1. “Morbidly Obese” (BMI >37.5) to lose significant weight and reach their ideal weight.
  2. “Obese” (BMI >32.5) who also have comorbidities (like diabetes, hypertension, dyslipidemia, sleep apnea, obesity-induced infertility) not only to lose significant weight and reach their ideal weight but also to get control of the associated comorbidities.
  3. “Type 2 Diabetics” (BMI > 27.5) to get Remission from type 2 Diabetes.
  4. “Metabolic Syndrome” (BMI > 27.5) to get remission from type 2 diabetes, dyslipidemia and Most cases hypertension.

Type 2 diabetics can be offered this procedure even if they are not morbidly obese, is what I would like to bring it to notice.

Exposure to Type 2 diabetes for long years can lead to potential complications like coronary heart disease, chronic kidney failure, brain stroke, gangrene of the lower limbs.

In some, in spite of talking OHA’s, Insulin, sugars are not under control. In these cases, the gastric bypass can be offered to those who fulfil the eligibility criteria.

Remission of diabetes after the gastric bypass procedure is very quick, ranging from a week to a month in most of the cases. However, in some, The sugar levels come to normal the very next day after the surgery in some without the OHA and /or insulin.

Gastric bypass is done through laparoscopy i.e through tiny holes over the tummy, requiring 3 days hospital stay. Supplements need to be taken following the procedure on a daily basis. Following the procedure, intake is reduced to a great extent which increases over few months as the gastric pouch stretches.

In case you have a concern or query you can always consult an expert & get answers to your questions!

2923 people found this helpful

Metabolism boosting foods

Dt. Neha Suryawanshi 97% (15574 ratings)
M.Sc. in Dietetics and Food Service Management , Post Graduate Diploma In Computer Application, P.G.Diploma in Clinical Nutrition & Dietetics , B.Sc.Clinical Nutrition & Dietetics
Dietitian/Nutritionist, Mumbai
Metabolism boosting foods
Metabolism boosting foods

1. Cocoa
2. Water
3. Blueberries
4. Flax
5. Sweet potato
6. Avocado
7. Tomato
8. Yogurt
9. Cinnamon
10. Garlic
11. Beans
12. Lemon
13. Almond
14. Apple
15. Egg white
16. Soybean
17. Ginger
18. Brussel sprout
19. Spinach
20. Fish
21. Olive oil
22. Oats
23. Cottage cheese
24. Chick peas
25. Lima beans.

55 people found this helpful

Metabolic training

Dr. P Nagaraj 89% (3801 ratings)
FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
Metabolic training
Metabolic training

Metabolic training is basically about giving people fitness that is time effective which helps them burn fat get lean muscle and improve cardio vascular health. The key about metabolic is taking multiple pieces of fitness techniques combining them together in a way that is fast.
53 people found this helpful

Improvement In Metabolic Rate

Dt. Ms. Archana Desai 88% (10 ratings)
BSc - Dietitics / Nutrition, P.G.In Dietitics
Dietitian/Nutritionist, Mumbai
Improvement In Metabolic Rate

To slow down your metabolic rate and put on weight quickly, you can make sure that breakfast, lunch and dinner are huge and well spaced out.

2 people found this helpful

Enhancing Your Metabolism!

Dt. Neha Suryawanshi 97% (15574 ratings)
M.Sc. in Dietetics and Food Service Management , Post Graduate Diploma In Computer Application, P.G.Diploma in Clinical Nutrition & Dietetics , B.Sc.Clinical Nutrition & Dietetics
Dietitian/Nutritionist, Mumbai
Enhancing Your Metabolism!

Enhancing Your Metabolism!

What is metabolism and how does it affect you?

Dr. Sreepada Kameswara 92% (12908 ratings)
DHMS (Diploma in Homeopathic Medicine and Surgery)
Homeopath, Hyderabad
What is metabolism and how does it affect you?
The food you take every day has to be absorbed in the system to give you energy to work, for your growth and for building the defence system to fight diseases.
Metabolism is the word used to indicate the chemical changes which take place in the body necessary for fulfilment of its vital functions.
The rate of metabolism is high when you are physically and mentally very active. Normally, your daily activity starts in the morning hours and therefore, don’t miss your breakfast.
Similarly, your rate of metabolism is the lowest in the night when you rest physically and mentally. Accordingly, your night meal has to be light and early so that it is mostly digested before you go to sleep. Avoid late night dinners.
With this kind of balancing, you can be free from OBESITY
76 people found this helpful

Body metabolism is a reflection of our diet

Dr. Rahul Poddar 93% (735 ratings)
MBBS, DNB (General Surgery), MNAMS (Membership of the National Academy) (General Surgery) , Fellowship in Minimal Access Surgery, Fellow of Indian association og gastro intestinal endo surgeons
General Surgeon, Ghaziabad
Body metabolism is a reflection of our diet
Eat green vegetables more and more in each meal to for balancing your metabolism.
93 people found this helpful

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