Bariatric Surgery and Weight Loss: Risk and Facts

Obesity is a worry for many today and while diet and exercise are effective mediums to reduce extra weight, sometimes it requires more than just these factors to shed of those heavy pounds. Obesity is a condition where a person’s Body Mass Index (BMI) – relation of the weight in correspondence of height – is 30 or more. Obesity also has levels: class 1 obesity is up to 35 BMI level, class 2 obesity is up to 40 BMI levels, while class 3 obesity refers to a BMI of 40 or more. No matter the class, obesity is always undesirable and hence, methods other than exercise and diet are required to lose those extra kilos. One of the highly desirable and sought after methods is a Bariatric Surgery.

A bariatric surgery is a metabolic surgery that reduces the fat in the body by making changes to the digestive system. A general bariatric surgery helps a person lose 50% of the excess weigh during the first 6 months. The surgery makes the stomach smaller and limits the amount of food one can eat at one time by making you feel fuller earlier. More so, the surgery may involve changes in the small intestine so that there is limited absorption of calories and nutrients form food and beverages. A bariatric surgery may include one of these techniques or could include both, depending on case to case.

As mentioned earlier, a bariatric surgery is opted where diet and exercise are no longer effective and the excess weight has started to cause adverse health effects such as high blood pressure, heart problems, Gastroesophageal reflux disease, severe sleep apnea, diabetes, stroke, etc. However, not everyone qualifies for a bariatric surgery and there is an in-depth screening before the doctors consider you fit for the surgery. A bariatric surgery can be one of the following types:

Gastric bypass surgery: where the stomach is divided into a smaller size to reduce food intake

Gastric band surgery: where a band is places around the stomach to reduce the food consumption. This is a reversible process.

Patrial gastrectomy: also known as sleeve gastrectomy, this procedure removes the stomach replacing it with a small portion plate which results in reduction of appetite due to suppressing of hormone ghrelin.

No matter the type of bariatric surgery, it is vital to understand the procedure, know the facts and risks associated with it.

Some facts about bariatric surgery are:

  • Bariatric surgery is ideal for obese people, however, it can also be opted for people who are overweight and suffer serious health problems due to excess weight.
  • The benefits of a bariatric surgery beyond weight loss and help to resolve severe health problems such as diabetes, high blood pressure, etc.
  • The risks associated with a bariatric surgery are lower than those of a gallbladder surgery.
  • The recovery post a bariatric surgery is quick and easy, approximately between 2-4 weeks.
  • Eating after a bariatric surgery needs proper care and attention especially for the 1-2 months after the surgery. Slow eating and smaller portions are recommended.
  • A bariatric surgery is a journey and not a destination.  A person will lose 50% of their weight in the first 6 months and the rest of excess weight in the following 12 months.
  • The surgery needs discipline and routine in eating and lifestyle
  • The surgery does not leave big scars. It involves three to five incisions of approximately 1/2 to 1 inch length.
  • Intake of liquids during meals needs to be avoided to avoid discomfort.
  • Bariatric surgery does not cause any deficiency in the body provided proper diet chart as recommended by the doctor is followed.
  • One can eat anything post recovery from the surgery but always in limited quantity. A doctor in very rare cases might restrict certain food items which could trigger health issues.
  • The surgery has high success rates (more than 85%) and very low chances of side effects and failure. Its risks are in fact lower than the harmful effects of obesity.
  • Not everyone qualifies for a bariatric surgery. Doctors screen you for certain medical conditions to ensure you are qualified to undergo surgery.

Some of the risks associated with bariatric surgery include:

The surgery may cause short-term and long-term effects.

Short-term risks are:

  • Excessive bleeding
  • Infection
  • Reaction to anesthesia
  • Blood clots in legs that move to the heart and lungs
  • Shortness of breath
  • Lung problem
  • Leaks in the gastrointestinal system
  • Body ache
  • Dry skin
  • Hair loss

Long-term risks are:

  • Bowel impediment
  • Diarrhoea
  • Nausea
  • Vomiting
  • Strictures
  • Hernias
  • Gallstones
  • Low blood sugar
  • Malnutrition
  • Digestive problems
  • Ulcers
  • Blocked intestines
  • Stomach puncture
  • Death (very rarely)

With the more than 140 million people suffering from obesity and related health problems in India, a bariatric surgery is highly sought after and effective method to reduce the health impacts. Overall, if both risks and benefits of the surgery are weighed, the benefits outweigh the risks in conditions where obesity has led to excessive health issues.

Weight loss surgery and controlling diabetes

Weight-loss surgery or medically called bariatric surgery is a metabolic surgical method that involves making changes to the digestive system to reduce the overall body fat. A general bariatric surgery helps a person lose 50% of the excess weight during the first 6 months. The surgery makes the stomach smaller and limits the amount of food one can eat at one time by making you feel fuller earlier. More so, the surgery may involve changes in the small intestine so that there is limited absorption of calories and nutrients form food and beverages. Bariatric surgery may include one of these techniques or could include both, depending on case to case.

Bariatric surgery is recommended medically in cases where a person is unable to lose weight through diet and exercise, and the excessive weight has been causing increasing health problems such as diabetes, high blood pressure, heart issues, Gastroesophageal reflux disease, severe sleep apnea, stroke, etc. However, today a bariatric surgery has become very common since it is medically very safe and often provides effective results.

Weight-loss surgery and controlling diabetes

Weight-loss surgery can effectively treat patients with Type 2 Diabetes. For some patients, weight-loss surgery can help normalize the blood sugar levels completely, implying that the patient is cured of diabetes and hence, will need no medications or maybe lesser ones. 

A couple of researches have validated the effectiveness of weight-loss surgery in treating type 2 diabetes. Additionally, the surgery also helps to maintain healthy levels of blood pressure, cholesterol, and triglyceride levels. However, it might not be the ideal solution in case of all patients. 

A diabetic person can be a good candidate for weight-loss surgery provided the following conditions are met:

  • BMI is 35 or higher
  • Other non-invasive methods of weight loss have failed to provide results and control diabetes

Moreover, the doctor will conduct a full physical examination of the general health of the person and also assess the emotional well-being before proceeding with the weight-loss surgery to cure diabetes. The willingness of a person to make the required lifestyle amendments and diet changes also helps justify the candidature for the surgery.

Types of weight-loss surgery to control diabetes

A weight-loss surgery aiming to control diabetes and related complications work by helping to reduce the extra fat, which tampers the body’s ability to effectively use insulin to bring glucose to the body cells. However, it is best to get the surgery done early in life since the beta cells in the pancreas store and release insulin; and overtime as diabetes progresses, these bets cells burn out and at one point, completely stop functioning. Hence, it is best to have surgery when the beta cells are functioning. 

Some of the common types of weight-loss surgery used to control diabetes include:

Roux-en-Y: In this type of surgery,the doctor cuts off the top of the stomach and seal it to form a small pouch that has very limited capacity to hold food.The doctor also removes the small intestine and directly attached the mechanism to the newly-formed pouch. This is one of the most common and also an irreversible form of bariatric surgery. This method enables a person to intake limited food and also restricts the absorption of nutrients and calories from food.

Biliopancreatic Diversion with Duodenal Switch: This form of surgery is a complex form ofRoux-en-Y in which the surgeon cuts away most of the stomach (80% of it) and attaches the remaining part with the last portion of the small intestines, completely bypassing the first two portions. This surgical form is recommended for patients with a BMI of more than 50 since it limits the intake of food, as well as the absorption of nutrients from food. This is a very complicated and also a very risky procedure.

Laparoscopic adjustable gastric banding (LAGB): In this type of bariatric surgery, the surgeon places an inflatable band around the top portion of the stomach, which is inflated to compress the stomach separating it into two parts. One part is a very tiny pouch that communicates with the rest of the stomach through a passage created by the band. A LABG limits the amount of food consumption, depending on the capacity of the new pouch. However, the band is adjustable and that makes this the most preferred form of bariatric surgery. Though results of this procedure may be less effective in comparison to other methods, since the band might lose its grip over time and would require adjustments.

Sleeve Gastrectomy: In this form of bariatric surgery, the surgeon changes the overall structure of the stomach to represent that of a tube which restricts the absorption of calories and nutrients from food intake.

The type of surgery varies per the effectiveness and speed of result, as well as the medical condition of the person. 

Risks of a Weight-loss Surgery

Though safe, weight-loss surgery can cause several short and long-term complications.

Short-term risks such as below:

  • Excessive bleeding
  • Infection
  • Reaction to anaesthesia
  • Blood clots in legs that transfer to the heart and lungs
  • Breathlessness
  • Lung diseases
  • Gastrointestinal system leak
  • Body pain
  • Peeling and dry skin
  • Excessive hair loss

Lon-term risks such as below:

  • Bowel impediment
  • Diarrhoea
  • Consistent nausea
  • Vomiting
  • Strictures
  • Hernias
  • Gallstones
  • Low blood glucose
  • Malnutrition
  • Digestive problems
  • Ulcers
  • Intestinal issues
  • Punctured stomach

In addition to these, some other risks that might incur after a weight-loss surgery include (but are not limited to):

  • Pouch stretching to its original size over time
  • Falling apart of staples
  • Extreme nutritional deficiencies 
  • Stomal stenosis

That said, even after the complications and risks of weight-loss surgery for controlling diabetes, it is still a very safe and highly effective method to control Type 2 diabetes. However, the results will vary depending on the type of surgery, the level of diabetes, age of the patient, as well as other general health conditions. Moreover, a weight loss surgery should be opted only in cases where the BMI of a person is more than 40 or all other methods of weight loss and reducing the health ailments such as diabetes, have failed to provide any successful results.

Hi, How Can We Help You?