Introduction
In many wealthy nations, obesity is a serious epidemic and health issue, and it is also becoming a growing worry in developing nations. Currently, the only treatment option for morbid obesity that reliably results in and maintains significant weight loss, reduces the frequency and severity of obesity-related medical conditions and enhances the overall quality of life and survival is bariatric surgery.
The first human bariatric surgery was reported in 1954. In response to the ongoing demand for weight loss procedures, techniques were later created that were more concerned with gastric restriction and limited malabsorption.
Weight loss surgery (Bariatric surgery)
Weight loss surgery involves a surgical treatment that shrinks the stomach to aid in weight loss. The amount of food that may be consumed at one time is either limited or decreased when the stomach is made smaller. When a patient has extreme obesity, a BMI greater than 40, a BMI of 35, and problems like diabetes, hypertension, joint discomfort, abnormal blood cholesterol levels, sleep apnea, and a likelihood of developing heart disease, among other things, bariatric surgery is a possibility. Bariatric surgery is preferred by those who are unable to lose weight by medication or who continue to gain weight after drug treatment, dietary changes, and lifestyle adjustments. In order to bring down the size of the stomach, weight loss surgery uses four different types of techniques:
-
Adjustable gastric band through laparoscopy
-
Stomach bypass
-
Gastric sleeve surgery (gastric sleeve)
-
Duodenal switch and biliopancreatic diversion
After two years, patients who have gastric bypass surgery lose 65% of their body weight, compared to 56% for patients who have sleeve gastrectomy and 49% for those who have gastric banding. Therefore, bariatric surgery has a 50–70% success rate overall.
Pros and Cons of Weight Loss Surgery
There are a number of drawbacks to bariatric surgery in addition to its benefits. Practically speaking, there aren't enough doctors with the appropriate skill sets to execute the necessary operations given the enormous number of people who could be candidates for surgery.
-
A patient's medical history and other variables may make them ineligible for surgery if they are not improved or eliminated. For instance, individuals with binge eating disorders might keep up their problematic eating habits after surgery, which could lead to surgical failure at first or weight increase in the long run. Activated depression or other serious psychiatric diseases may have comparable negative effects.
-
It is obvious that bariatric surgery patients who also exhibit active lifestyle changes in terms of better eating habits and physical activity are the most successful. Concerns about some of these procedures' unknowable long-term effects continue, in part because many bariatric surgery patients are young and, as a result, have lengthy life expectancies.
-
Additional long-term complications include gastrointestinal (bleeding, small bowel bacterial overgrowth, variety of upper and lower gastrointestinal symptoms), nutritional (steatorrhea, protein-calorie malnutrition, micronutrient deficiencies), and surgical (symptomatic cholelithiasis, band-related complications, anastomotic strictures and leaks, bowel obstruction) consequences that require additional surgery.
-
Micronutrient supplementation and lifelong monitoring are necessary for these metabolic and nutritional effects. The potential negative effects of bariatric surgery listed might not outweigh the potential advantages for obese patients who also have several medical comorbidities, poor quality of life, and a shorter life expectancy. For the motivated patient, there is a no less intrusive procedure that is as beneficial in as many ways and over the long term as bariatric surgery (depending upon the operation performed).
-
Additionally, despite the upfront expenditures associated with the surgery, the economics of this course of therapy appear to favour bariatric surgery (depending, of course, on the effectiveness of the surgery and the requirement for any additional medical or surgical care for complications that arise.
Qualifications To Perform Weight-Loss Surgery In India
To undertake weight-loss surgery in India, a surgeon must possess the following qualifications:
-
DNB - General Surgery
-
FRCS - General Surgery (Upper GI)
-
MRCS (UK)
-
MCh - Surgical Gastroenterology/G.I. Surgery
-
DNB - Surgical Gastroenterology
-
MS - General Surgery
-
PhD - Gastrointestinal Surgery
-
FRCS - General Surgery
Bariatric Surgery Risks, Complications and Side Effects
Surgical operations are considered risky to some extent. Any queries you may have regarding potential long- and short-term complications of bariatric surgery will be addressed by your surgeon.
Among the hazards of bariatric surgery are:
-
Acid Reflux - The backward flow of stomach acid into the tube that connects your throat to your stomach is referred to as acid reflux, also known as gastroesophageal reflux (GER) (oesophagus). You might get a burning sensation in your chest when you have an acid reflux episode (heartburn). This might happen after a substantial meal, a cup of coffee, or a glass of alcohol.
-
Hazards associated with anaesthesia
-
Persistent diarrhoea and vomiting
-
Expanding of the oesophagus
-
Inability in consumption of certain foods
-
Infection
-
Leaks in the gastrointestinal system
-
Stomach obstruction Gaining or failing to shed weight
-
Excessive bleeding
-
Blood clots
-
Lung or breathing problems
-
Rarely, death
Long-Term Risks of Bariatric Surgery:
-
A disease called "dumping syndrome" can cause diarrhoea, dizziness, flushing, lightheadedness, nausea or vomiting.
-
Hypoglycemia Malnutrition - The blood sugar (glucose) level is below the normal range if onc has hypoglycemia. In such a case, the body uses glucose as its primary energy source. Hypoglycemia and diabetes management frequently go hand in hand. Low blood sugar can, however, occur in persons without diabetes due to a variety of diseases and other medications, many of which are uncommon.
-
Vomiting
-
Ulcers
-
Gallstones
-
Intestine blockage
-
Bowel Obstruction
-
Hernias - When an internal organ or other body component pushes through the muscle or tissue that surrounds it normally, it develops a hernia. The majority of hernias develop in the abdomen, between the chest and the hips.
If weight loss surgery is unsuccessful
Other weight-loss procedures like gastric bypass don't always work as well as it might have been thought of. A person might not lose weight and experience major health issues if a weight-loss surgery doesn't work or stops working.
After having weight-loss surgery, one must keep all of the scheduled follow-up appointments and consult the doctor concerned right away if no weight loss is experienced. One can track their weight reduction and assess any variables that might be holding them back from losing weight.
Even if the process itself is successful, it is still possible for the patient to fail to lose enough weight or to gain it back after having any sort of weight-loss surgery. If a person does not make the suggested lifestyle adjustments, such as increasing physical activity and eating healthier meals, weight gain may result.
Conclusion
In general, one might be eligible for bariatric surgery if
-
If body mass index (BMI), which is considered excessive obesity, is 40 or higher.
-
If one has an obesity-related serious health issue, such as type 2 diabetes, high blood pressure, or severe sleep apnea, and the BMI is between 35 and 39.9, which is considered obese. If the BMI is between 30 and 34 and then a person has major weight-related health issues, he might be eligible for some types of weight-loss surgery.
Not everyone who is extremely overweight should have bariatric surgery. To be eligible for weight-loss surgery, one needs to fulfil specific medical requirements. One has to probably go through a rigorous screening process to discover if one qualifies. To live a healthier lifestyle, one must also be prepared to make long-term adjustments. Bariatric surgeries must be preferred on a case-to-case basis, after an examination of the situation of the patient by a medical practitioner carefully. The patients must be properly made aware of all risks attached to the surgery as well, whilst also advising them of ways to cure their problems by taking precautions and following a healthy lifestyle.
Long-term follow-up programmes that track diet, way of life, and behaviour as well as health issues are reasonable expectations and must be religiously adhered to. Additionally, it is important to bear in mind the cost of bariatric surgery. To find out if such surgery is covered by a health insurance plan, one must contact their local Medicare or Medicaid office.