What is Bariatric/metabolic/diabesity/weight loss surgery?
Obesity is an epidemic, with India being the third most obese country in the world. There are many physiological and psychological factors that contribute to obesity but are often misunderstood. No two people have the exact same metabolism and body type, thus what may work for some people may not work for others.
Bariatric surgery is a weight-loss surgery that gives patients a new lease of life. But like any surgery, there are several misconceptions that make people hesitant about talking to their doctor about this line of treatment.
1.Anyone who is overweight is a candidate for bariatric surgery?
Answer: Bariatric surgery is a metabolic surgery, designed to help the patient lose 50% or more of their excess weight within the first 6 months. The right candidates for bariatric surgery are:
A person having a BMI of 40 or above, who have not been able to lose weight despite diet control and exercise.
A person having a BMI of 35 or above and have serious health issues such as diabetes, arthritis, hypertension, sleep apnea.
In some cases, a person with a BMI > 30 with serious health complications may be eligible.
2.Are all Bariatric surgeries same?
Answer: The approach to bariatric surgery depends on the patient profile and your surgeon:
Gastric bypass surgery: In this type of surgery, the stomach is divided into a smaller size (pouch) to reduce the food intake. This type of surgery is recommended for the morbidly obese (BMI>40) & those suffering from diabetes.
Gastric band surgery: A band is fitted around the stomach which helps reduce the intake of food. This is a reversible procedure. This type of surgery is done for people who can be extremely disciplined and wish to remove the band after their weight loss.
Partial gastrectomy/Sleeve gastrectomy: The stomach is cut away, leaving a banana-sized portion late. This is the most common weight-loss procedure recommended. Due to the removal of most of the stomach, the “hunger” hormone ghrelin is suppressed, resulting in a decrease of appetite.
3.Bariatric surgery is for people who want the easy way out. With enough willpower and determination, you can lose weight on your own
Answer: This is one of the most common and damaging misconceptions. Most people who opt for bariatric surgery come after multiple failed attempts of diet and exercise. Obesity is not a choice; it’s a disease that is determined by metabolic, physiological, psychological & environmental factors. Research shows that people who lose weight end up burning fewer calories than those who have never lost weight. Basically, a person who has gone from 80 kg to 65 kg will burn fewer calories than someone who has always been 65 kg. This kind of metabolism makes it difficult for people to lose weight or maintain their goal weight.
4.Bariatric is an elective surgery. It’s a risky procedure and recuperation time is too long.
Answer: Yes, bariatric surgery has its own set of risks, as it is with every other surgery. In fact, living with a high BMI and/or with co-morbidities such as sleep apnea, hypertension, diabetes is riskier as it can result in heart attacks, stroke, and kidney diseases.
Recuperation time is comparatively shorter to other surgeries. You will stay in the hospital for a few nights and will be able to get back to your daily schedule within 2 weeks.
5.Once I get the surgery, I can eat all that I want without worrying about weight gain
Answer: Bariatric surgery is not a magical fix-all. It is the first step towards overhauling your lifestyle. Prior to your surgery, your surgeon will introduce you to a nutritionist who will help you make healthy choices. Post-surgery, diet control and exercise is required to maintain a healthy weight loss. Those who still eat calorie-laden food with minimal nutritional content are the ones who put on weight post-surgery. Thus, bariatric surgery is a lifelong commitment.
6.This means I can never have cakes, pastries, fried food etc. ever again.
Answer: While you may not be able to gorge on sweets and fast food like you used to, you can still partake a well-earned piece of cake or a small bowl of chips. The aim is not to eat like you used to and balance your meals so that you’re not deprived of your favourite foods. A common rule of thumb is 80 % of the week is healthy food; 20 % is your cheat meals.
7.Isn’t liposuction similar to bariatric surgery?
Answer: Liposuction is a cosmetic procedure where fat is removed from a certain area whereas bariatric surgery is a metabolic surgery to help control obesity & resolve co-morbidities.
8.Bariatric only leads to deficiency of vitamins and nutrients
Answer: In gastric bypass as the portion of the intestine is bypassed so vitamins are required for life-long but in the gastric sleeve, the requirement for minerals and vitamins are only for some time.
9.If I get bariatric surgery, I can’t get pregnant/have a healthy pregnancy
Answer: To the contrary, obesity has been linked to infertility in women. However, it has been seen that women who undergo bariatric have a higher chance of having a normal, healthy pregnancy than those who are obese. Those who were obese before getting pregnant have a higher chance of developing pre-eclampsia, blood clots, gestational diabetes, infections and premature birth.It is recommended to wait for a year after the bariatric surgery in order to get pregnant. After talking to your surgeon and gynaecologist, with regular follow ups & proper dosage of supplements, you can have a healthy pregnancy.
10.Bariatric surgery has no other health benefit besides weight loss
Answer: Bariatric surgery, apart from initiating a weight loss of 50 % or more excess weight, has numerous health benefits.
Those diagnosed with diabetes 2 prior to the surgery end up in long-term remission.Up to 70% of people who had sleep apnea don’t need to use a CPAP anymore.Your cardiovascular health improves greatly, with people suffering from hypertension no longer needing medication.There is joint pain relief after you lose the weight.