Bariatric Surgery
Severe obesity is a chronic condition that is difficult to treat through
diet and exercise alone. Bariatric surgery is an option for people who
are severely obese and cannot lose weight by traditional means or who
suffer from serious obesity-related health problems. The operation
promotes weight loss and reduces the risk of type 2 diabetes by
restricting food intake and, in some operations, interrupting the
digestive process to prevent the absorption of some calories and
nutrients. Recent studies suggest that bariatric surgery may even
have a favorable impact on mortality (death) rates in severely obese
patients. The best results are achieved when bariatric surgery is
followed with healthy eating behaviors and regular physical activity.
The Normal Digestive Process
Normally, as food moves along the digestive tract, digestive juices
and enzymes digest and absorb calories and nutrients. After we chew
and swallow our food, it moves down the esophagus to the stomach,
where a strong acid continues the digestive process. The stomach can
hold about 3 pints of food at one time. When the stomach contents
move to the duodenum, the first segment of the small intestine, bile
and pancreatic juice speed up digestion. Most of the iron and calcium
in the food we eat is absorbed in the duodenum. The jejunum and
ileum, the remaining two segments of the nearly 20 feet of small
intestine, complete the absorption of almost all calories and nutrients.
The food particles that cannot be digested in the small intestine are
stored in the large intestine until eliminated.
How does surgery promote weight loss?
Bariatric surgery produces weight loss by restricting food intake and,
in some cases, interfering with nutrition through malabsorption.
Patients who undergo bariatric surgery must also commit to a lifetime
of healthy eating and regular physical activity. These healthy habits
help ensure that the weight loss from surgery is successfully
maintained.
What are the surgical options?
There are four types of operations that are commonly offered in the India & other part of world: adjustable gastric band (AGB), Roux-en-Y gastric bypass (RYGB), biliopancreatic diversion with a duodenal switch (BPD-DS), and vertical sleeve gastrectomy (VSG). Each has its own benefits and risks. To select the option that is best for you, you and your physician will consider that operation’s benefits and risks along with many other factors, including BMI, eating behaviors, obesity-related health conditions, and previous operations.
What are the complications of these operations?
Early complications of these operations can include bleeding, infection, leaks from the site where the intestines are sewn together, and blood clots in the legs that can progress to the lungs and heart.
Examples of complications that may occur later include malnutrition, especially in patients who do not take their prescribed vitamins and minerals. In some cases, if the malnutrition is not addressed promptly, diseases such as pellagra, beri beri, and kwashiorkor may occur along with permanent damage to the nervous system. Other late complications include strictures (narrowing of the sites where the intestine is joined) and hernias.
Two kinds of hernias may occur after a patient has bariatric surgery. An incisional hernia is a weakness that sticks out from the abdominal wall’s fascia (connective tissue) and may cause a blockage in the bowel. An internal hernia occurs when the small bowel is displaced into pockets in the lining of the abdomen. These pockets are created when the intestines are sewn together. Internal hernias are considered more dangerous than incisional ones and need prompt attention to avoid serious complications.
Research indicates that about 10 percent of patients who undergo bariatric surgery may have unsatisfactory weight loss or regain much of the weight that they lost. Some behaviors such as frequent snacking on high-calorie foods or lack of exercise can contribute to inadequate weight loss. Technical problems that may occur with the operation, like a stretched pouch or separated stitches, may also contribute to inadequate weight loss.
Some patients may also require emotional support to help them through the postoperative changes in body image and personal relationships.
Is surgery for you?
Bariatric surgery may be the next step for people who remain severely obese after trying nonsurgical approaches, especially if they have an obesity-related disease. Surgery to produce weight loss is a serious undertaking. Anyone thinking about undergoing this type of operation should understand what it involves. Answers to the following questions may help you decide whether weight-loss surgery is right for you.
Are you:
• Unlikely to lose weight or keep it off over the long term with nonsurgical measures?
• Well informed about the surgical procedure and the effects of treatment?
• Determined to lose weight and improve your health?
• Aware of how your life may change after the operation (adjustment to the side effects of the operation, including the need to chew food well and inability to eat large meals)?
• Aware of the potential risk for serious complications, dietary restrictions, and occasional failures?
• Committed to lifelong healthy eating and physical activity habits, medical follow-up, and vitamin/mineral supplementation?
Remember: Success is possible only with maximum cooperation and commitment to behavioral change and medical follow-up—and this cooperation and commitment must be carried out for the rest of your life.
Severe obesity is a chronic condition that is difficult to treat through
diet and exercise alone. Bariatric surgery is an option for people who
are severely obese and cannot lose weight by traditional means or who
suffer from serious obesity-related health problems. The operation
promotes weight loss and reduces the risk of type 2 diabetes by
restricting food intake and, in some operations, interrupting the
digestive process to prevent the absorption of some calories and
nutrients. Recent studies suggest that bariatric surgery may even
have a favorable impact on mortality (death) rates in severely obese
patients. The best results are achieved when bariatric surgery is
followed with healthy eating behaviors and regular physical activity.
The Normal Digestive Process
Normally, as food moves along the digestive tract, digestive juices
and enzymes digest and absorb calories and nutrients. After we chew
and swallow our food, it moves down the esophagus to the stomach,
where a strong acid continues the digestive process. The stomach can
hold about 3 pints of food at one time. When the stomach contents
move to the duodenum, the first segment of the small intestine, bile
and pancreatic juice speed up digestion. Most of the iron and calcium
in the food we eat is absorbed in the duodenum. The jejunum and
ileum, the remaining two segments of the nearly 20 feet of small
intestine, complete the absorption of almost all calories and nutrients.
The food particles that cannot be digested in the small intestine are
stored in the large intestine until eliminated.
How does surgery promote weight loss?
Bariatric surgery produces weight loss by restricting food intake and,
in some cases, interfering with nutrition through malabsorption.
Patients who undergo bariatric surgery must also commit to a lifetime
of healthy eating and regular physical activity. These healthy habits
help ensure that the weight loss from surgery is successfully
maintained.
What are the surgical options?
There are four types of operations that are commonly offered in the India & other part of world: adjustable gastric band (AGB), Roux-en-Y gastric bypass (RYGB), biliopancreatic diversion with a duodenal switch (BPD-DS), and vertical sleeve gastrectomy (VSG). Each has its own benefits and risks. To select the option that is best for you, you and your physician will consider that operation’s benefits and risks along with many other factors, including BMI, eating behaviors, obesity-related health conditions, and previous operations.
What are the complications of these operations?
Early complications of these operations can include bleeding, infection, leaks from the site where the intestines are sewn together, and blood clots in the legs that can progress to the lungs and heart.
Examples of complications that may occur later include malnutrition, especially in patients who do not take their prescribed vitamins and minerals. In some cases, if the malnutrition is not addressed promptly, diseases such as pellagra, beri beri, and kwashiorkor may occur along with permanent damage to the nervous system. Other late complications include strictures (narrowing of the sites where the intestine is joined) and hernias.
Two kinds of hernias may occur after a patient has bariatric surgery. An incisional hernia is a weakness that sticks out from the abdominal wall’s fascia (connective tissue) and may cause a blockage in the bowel. An internal hernia occurs when the small bowel is displaced into pockets in the lining of the abdomen. These pockets are created when the intestines are sewn together. Internal hernias are considered more dangerous than incisional ones and need prompt attention to avoid serious complications.
Research indicates that about 10 percent of patients who undergo bariatric surgery may have unsatisfactory weight loss or regain much of the weight that they lost. Some behaviors such as frequent snacking on high-calorie foods or lack of exercise can contribute to inadequate weight loss. Technical problems that may occur with the operation, like a stretched pouch or separated stitches, may also contribute to inadequate weight loss.
Some patients may also require emotional support to help them through the postoperative changes in body image and personal relationships.
Is surgery for you?
Bariatric surgery may be the next step for people who remain severely obese after trying nonsurgical approaches, especially if they have an obesity-related disease. Surgery to produce weight loss is a serious undertaking. Anyone thinking about undergoing this type of operation should understand what it involves. Answers to the following questions may help you decide whether weight-loss surgery is right for you.
Are you:
• Unlikely to lose weight or keep it off over the long term with nonsurgical measures?
• Well informed about the surgical procedure and the effects of treatment?
• Determined to lose weight and improve your health?
• Aware of how your life may change after the operation (adjustment to the side effects of the operation, including the need to chew food well and inability to eat large meals)?
• Aware of the potential risk for serious complications, dietary restrictions, and occasional failures?
• Committed to lifelong healthy eating and physical activity habits, medical follow-up, and vitamin/mineral supplementation?
Remember: Success is possible only with maximum cooperation and commitment to behavioral change and medical follow-up—and this cooperation and commitment must be carried out for the rest of your life.
