Bariatric surgery

bariatric surgery

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Surgical methods that help patients lose weight by altering their digestive systems are referred to as bariatric surgery. Numerous operations, including gastric bypass and other weight loss surgeries, might be categorized as “bariatric surgery,” which is a general phrase.

After undergoing bariatric surgery, people seem to have a lower chance of dying from the majority of causes. According to a retrospective study by Trusted Source that was just released in the journal Obesity, bariatric surgery reduced the fatality rate from diabetes by 72%. Nearly 22,000 individuals who underwent one of the four forms of bariatric surgery between 1982 and 2018 had their health records examined. Bariatric surgery patients’ death rates from all causes and particular cause illnesses, such as cancer, diabetes, and cardiovascular disease, were compared to non-surgical individuals who were matched for age, sex, and body mass index.

The results revealed:

  • All-cause mortality was 16% lower in patients who had surgery compared to those who did not
  • Mortality from cardiovascular disease decreased by 29%
  • Mortality from cancer decreased by 43%
  • Mortality from diabetes decreased by 72%
  • Death rates from the chronic liver disease were 83% higher in those who had had surgery

Bariatric operations are all fairly serious treatments even though they all operate differently.

Different types of bariatric surgery

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The effects of bariatric surgery vary depending on how much food the stomach can contain, how well the body can absorb nutrients or a combination of the two. The most popular bariatric procedures include a duodenal switch, adjustable gastric band, sleeve gastrectomy, and gastric bypass.

Gastric bypass:

One of the most popular types of bariatric surgery is the gastric bypass procedure. The technique is divided into two steps, to put it simply. The top of the stomach is first separated from the remainder of the stomach by a tiny pouch.

The first segment of the small intestine is then separated, and its lower end is joined to the newly formed tiny pouch in the stomach. Last but not least, the divided small intestine’s top and bottom halves are joined, altering the food stream and resulting in alterations to gut hormones. In addition to limiting the amount of food the stomach can hold, this treatment also prevents nutrients and calories from being properly absorbed.

Sleeve gastrectomy:

With a sleeve gastrectomy, about 80% of the stomach is removed. A sleeve, or tube-shaped bag, is all that is left. The stomach can no longer hold as much food since it is smaller. The ghrelin hormone, which controls appetite, is also produced less.

Gastric band: 

An inflatable band is wrapped around the top of the stomach using the adjustable gastric band, creating a smaller pouch above. Patients feel full more quickly and less food can be stored. The band gets smaller over time as modifications are made repeatedly.

Duodenal switch: 

The Biliopancreatic Diversion with Duodenal Switch (BPD/DS) also consists of two sections. First, a tube-shaped pouch is made out of a part of the stomach (similar to sleeve gastrectomy). Second, a large section of the small intestine is bypassed. This limits the amount of food the stomach can hold and expedites the process of feeling full. The absorption of nutrients is also decreased. Despite being a very successful procedure, it also involves greater risks, such as vitamin deficiencies or malnutrition.

Why is bariatric surgery done?

Having bariatric surgery can assist people who are extremely overweight to lose weight and reduce their chance of developing serious, life-threatening health issues, including:

  • Heart condition
  • Stroke
  • High blood pressure
  • Alcohol-unrelated fatty liver disease
  • Slumber apnea
  • Diabetes type 2

Keep in mind that not everyone who is overweight should undergo bariatric surgery. Medical requirements must be met. It is often recommended when other weight-loss strategies, such as modifying your diet and exercising more, don’t work.

Benefits of Bariatric surgery

People who have bariatric surgery can lose a large amount of weight over time. Many patients who need to drop 65 pounds or more have made numerous attempts to do so on their own. “While they may initially have some success, less than 5% of persons manage to maintain their weight loss for at least five years. In reality, most people regain weight in less than a year. Losing weight just to gain it back again has little effect on the potential health issues linked to obesity. For the weight loss to be regarded as successful and one that can lead to a happier, healthier you, you must maintain the weight off for at least five years.

The benefits of bariatric surgery go beyond just losing weight:

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1. Long-term type 2 diabetes remission:

According to one study, type 2 diabetes can go into long-term remission after bariatric surgery. According to the study’s findings, the technique is very successful in treating type 2 diabetes and obesity, enabling almost all patients to avoid using insulin and other related medications for at least three years following surgery.

2. Increased cardiovascular fitness:

A person’s risk of peripheral heart disease, coronary heart disease, and stroke is reduced after weight loss surgery. Additionally, one study even claimed that the weight loss brought on by the procedure could lower the risk of dying from heart attacks, strokes, and hypertension. cholesterol and blood pressure readings can return to normal, or near normal after surgery, reducing these risks and improving overall well-being. 

3. Depression relief

A lot of obese persons experience depression as a result of their negative self-perception and societal stigma. Even younger people who are significantly overweight find it challenging to engage in activities they might normally love, which can result in social isolation and despair. These patients’ emotional health can be improved by losing this extra weight. It was discovered that those who underwent bariatric surgery saw a reduction in the depression of 32.7% at the time of surgery and a reduction of 16.5% six to twelve months afterward.

4. Eliminate obstructive sleep apnea.

Eliminate obstructive sleep apnea. Getting to and maintaining a healthy weight range frequently enables persons with sleep apnea to discontinue using a CPAP machine at night. One year following surgery, 80 to 85% of patients report that their sleep apnea has resolved.

5. Relief from joint pain:

Your weight-bearing joints experience a great deal of stress when you carry around excess weight, which frequently results in chronic pain and joint deterioration. Following bariatric surgery, large and sustained weight loss lessens the strain on joints, frequently enabling people to cease taking painkillers and enjoy significantly greater mobility.

6. Boost fertility

Boost fertility In the years before having children, weight loss surgery can also increase fertility. According to one study, bariatric surgery may reduce the chance of miscarriage and help women who don’t ovulate have better menstrual cycles.

7. Alleviate other medical conditions. 

 Metabolic syndrome, pregnancy difficulties, gallbladder disease, and other conditions can all be helped by weight loss surgery.

With obesity and its associated health complications rising at an alarming rate, bariatric surgery certainly represents a powerful tool for providing sustained relief for overweight people. When making this decision, it’s important to choose a facility with extensive experience in performing these procedures. 

Bariatric Surgery risks

The way the digestive system breaks down food is completely altered by many bariatric surgery treatments. Chronic diarrhea or other altered bowel habits may occur from this. Bariatric surgery can result in malabsorption and malnutrition because the small intestine is altered, making it difficult for the body to utilize and absorb essential nutrients. To counteract this, dietary supplements must be taken every day. Eating is severely restricted because eating too much or the incorrect foods can make you throw up. The choice of the type of bariatric surgery is crucial because many of these lasting alterations result from bariatric treatments and cannot be undone.

The practice of “dumping” is another drawback. This occurs when the bloodstream absorbs sugar, fat, and alcohol too quickly, resulting in symptoms including nausea, a rapid heartbeat, and vomiting. After eating, some people become extremely drowsy. Additionally, there are emotional effects that frequently result in divorce; divorce rates following bariatric surgery are greater than the national average.

An adjustable band known as the “lap band” is used in new bariatric surgical methods. Although this operation is reversible, the same issues persist while the lap band is in place.

Many morbidly obese persons have rapidly worsening health and have been unable to decrease weight using any other methods. Most times, their only remaining option is bariatric surgery. Although it requires some major lifestyle changes, and there are risks of complications, losing weight by bariatric surgery has the added advantage of saving lives.

Deciding whether to have bariatric surgery

The new study offers details that clinicians can discuss with their patients to help them make decisions.

Dr. Brian Quebbemann, a bariatric surgeon, founder of the N.E.W. program in Orange County, California, and author of “Dietary Rebuild,” stated that most people who struggle with being overweight have two goals in mind when trying to lose weight: one is to improve their health going forward, and the other is to improve the quality of life and ability to be active and involved, on a daily basis.

The quality of life has improved, according to other studies. According to this study, there is a decreased risk of dying early as a result of the improvements in their health. In addition, Quebbemann said, “I’ll use the information on liver illness to caution my patients about their alcohol consumption after surgery.”

Qualifications for bariatric surgery might vary from doctor to doctor.

The American Society for Metabolic and Bariatric Surgery lists these as people with a BMI of 35 or more and people with a metabolic disorder who have a BMI between 30 and 35. Jenkins argued that it was crucial for everyone to undertake psychiatric testing, particularly in light of the study’s finding that post-operative suicide rates had increased. “The patient’s level of confidence is one of the factors I consider. Do they think this will be successful? Do they think their life will be better after the operation? Are they confident this is the right thing, and they can follow the diet after the surgery?”

Many bariatric programs and insurance carriers require a psychological screening before surgery. “Perhaps looking deeper into the screening process and finding more effective ways to spot those at-risk individuals is needed,” Ali said. “Careful, long-term follow-up has always been an integral part of our program. I think it is and should be an essential part of every comprehensive weight loss program.”

What to do following bariatric surgery

According to the University of California San Francisco, people frequently experience common post-operative symptoms in the days following surgery, including exhaustion, discomfort around the incision, weakness, loss of appetite, indigestion, and emotional ups and downs. The fastest path to recovery is to resume activity as soon as you can while being supervised by a medical expert. After bariatric surgery, exercise is crucial. The same day or the day after, try to get up and move around, according to experts. Consider engaging in leg workouts along with at least three daily walks. You can select how much movement is ideal with the aid of your physical therapist.

Exercise is crucial for keeping weight off following bariatric surgery, according to Quebbemann. “Every patient says they wish to reduce their weight so they can get more exercise. Before and after surgery, medical personnel should reiterate this objective and reassure patients that increasing their physical activity ensures their long-term success.

Dietary modifications following bariatric surgery

People who have had the procedure must eat very slowly and in tiny bits because of their smaller stomachs. The inability to consume liquids while eating is one of the hardest adjustments for patients. Although it doesn’t take most people long to acclimate, patients should drink their fluids at least 30 minutes before or 30 minutes after eating.

A nutritionist who counsels patients after the procedure recommends vitamins and nutrients to those who have had the surgery. After your operation, your dietitian could also suggest meal plans and a particular diet. Consult your doctor to see if you’re a candidate for bariatric surgery and the benefits it could provide for your overall health and weight loss.