Bariatric surgery

Bariatric surgery, also known as weight loss surgery, involves various procedures designed to help individuals with severe obesity lose weight. These surgical interventions alter the digestive system, either by limiting the amount of food the stomach can hold, reducing nutrient absorption, or both. Bariatric surgery is typically recommended for individuals who have not achieved significant weight loss through diet, exercise, or medication, and who have serious health issues related to obesity.

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Types of Bariatric Surgery

1. Gastric Bypass (Roux-en-Y):
   • Procedure: The stomach is divided into a small upper pouch and a larger lower section, with the small intestine rearranged to connect to both.
   • Effect: Significantly reduces the amount of food the stomach can hold and alters the gut hormones, leading to decreased hunger and increased satiety.
2. Sleeve Gastrectomy:
   • Procedure: Approximately 80% of the stomach is removed, leaving a tube-like structure.
   • Effect: Reduces stomach capacity and hunger hormones, resulting in substantial weight loss.
3. Adjustable Gastric Banding:
   • Procedure: An inflatable band is placed around the upper part of the stomach to create a small pouch.
   • Effect: Limits food intake by making the patient feel full sooner. The band can be adjusted or removed as needed.
4. Biliopancreatic Diversion with Duodenal Switch (BPD/DS):
   • Procedure: Involves a sleeve gastrectomy along with a large portion of the small intestine being bypassed.
   • Effect: Significantly reduces nutrient absorption, leading to substantial weight loss and changes in gut hormones.

Benefits

1. Significant Weight Loss: Patients typically lose 50-70% of their excess weight within two years post-surgery.
2. Improvement in Obesity-Related Conditions: Conditions such as type 2 diabetes, hypertension, sleep apnea, and heart disease often improve or go into remission.
3. Enhanced Quality of Life: Many patients experience improved mobility, self-esteem, and overall quality of life.

Risks and Considerations

1. Surgical Risks: As with any major surgery, risks include infections, blood clots, and complications from anesthesia.
2. Nutritional Deficiencies: Because the surgery can affect nutrient absorption, patients may need to take vitamins and minerals for life.
3. Lifestyle Changes: Successful outcomes require a lifelong commitment to dietary changes, regular physical activity, and possibly psychological support.

Eligibility

Bariatric surgery is typically considered for individuals who:

1. Have a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related health conditions.
2. Have tried and failed to achieve significant weight loss through diet and exercise.
3. Are committed to making long-term lifestyle changes and attending follow-up appointments.