You may have already had bariatric surgery or you may be contemplating having the surgery done. Perhaps someone you know has had it and you are getting some helpful information from then. This article will focus on the medical aspect of bariatric surgery.
How does bariatric surgery help an obese person?
The main reason is to limit the size of the stomach so that people will lose weight.
The other reason is to stop the absorption of calories and some nutrients so that you will lose weight.
What are the medical requirement before undergoing this kind of surgery?
You need to be at least 100 pounds overweight and you have “high blood pressure, diabetes, asthma, GERD, severe loss of bladder control, or obstructive sleep apnea. (Your doctor will have the full list.) or BMI of 30-35 and you have diabetes or metabolic syndrome.”
There are different kinds of bariatric surgery
“You could have lap band surgery, gastric bypass surgery or gastric sleeve surgery. Other operations, such as the duodenal switch only bypass part of the intestine, so you absorb less food. Doctors call these malabsorptive surgeries.” It is important to discuss the right surgery for you with your doctor.
Screening procedure
The bariatric team must screen you to make sure you are truly ready for this operation. You need to be ready physically and psychologically. Some doctors will ask you to lose some weight, get your diabetes under control, or quit smoking. Your doctors want to know that you are ready and will go through with the new lifestyle change. Just before the operation your doctor will tell you to avoid anything with aspirin content in it and will get you to go on a liquid diet for 24-48 hours.
Surgical Methods
You will go under general anesthesia for these procedures. The procedures used are the open or the laparoscopic surgical method.
Laparoscopy is the easiest of the two, it leaves smaller scars, less complications, and a quicker recovery period. The doctor will make small keynote cuts for the laparoscope to enter the stomach. With the open surgery the doctor does have to open up the area and so the scars will be about 10 inches long.
Roux-en-Y Gastric Bypass
The doctor will bypass the stomach and create a new little pouch which will serve as your stomach. Though your original stomach will still be there, the food will go to the new pouch and it will only hold about an ounce of food.
Stomach Bypass
Your doctor will rearrange your inside by cutting your small intestine to attach a piece of it to the stomach pouch and the other piece further down the intestine to make a Y shape. Your original stomach will deliver chemicals that are need to digest your food. This part of the procedure is used for most of these types of surgeries.
Gastric “Sleeve”
This procedure requires taking out about 75 percent of your stomach creating “a tube-shaped stomach, or a gastric sleeve, that is still attached to your small intestine.” Your stomach will now only hold about 2 or 3 ounces of food. “You also won’t be as hungry because most of the tissue that makes the “hunger hormone,” called ghrelin, will be gone.” You cannot reverse this operation.
Adjustable Gastric Banding (AGB or Lap-Band)
In this procedure the doctor will insert a band around the top of your stomach and will inflate it so that it creates a small pouch. The food you eat will push up against the stomach and send signals that you are full to the brain. This procedure can be removed or readjusted if need be.
Vertical Gastric Banding (VGB, or “stomach stapling”)
This procedure is not used very often anymore. The doctor would cut a hole near the top of the stomach and wrap a band around it. Here the stomach was stapled to create a small pouch. The surgeon would also use a plastic band around the bottom of the stomach to prevent stretching. The food would move from the pouch through the rest of the stomach.
Biliopancreatic Diversion
This procedure will cut down the calories and nutrients that you absorb. The doctor will create a small pouch which hold only 6 to 8 ounces of food. The procedure will skip most of the stomach and the parts of the small intestine. Usually this particular type of bariatric surgery is reserved for people who need to lose the most weight.
After the procedure
Regardless of which surgery you choose, you will have a short hospital stay. The medical staff will monitor you to see that you are eating properly and your blood sugar is normal, you are not dehydrated and there are no blood clots. There will be pain so expect to have pain killers.
You will be on a liquid diet for a couple of weeks as you adjust to the surgery. Later you will be able to eat more. You will be speaking to a nutritionist who will help you plan your meals. You will probably have to take supplements because you are no longer absorbing as many nutrients from your food.
In some cases weight loss is quite rapid in the first three months. You may lose as much as a pound a day for the first three months. Usually this happens with the malabsorptive procedure but it is hard to get the proper nutrients.
Other Health Benefits
Weight related issues such as diabetes and high blood pressure may go away or lessen in severity. You may become more physically active and your arthritis, and aches and pains may go away.
Lifestyle Changes After Surgery
Anyone considering this operation must be prepared to make lifestyle changes. You would need to learn to eat several small meals a day which are nutritional and you will need to exercise. Exercise is difficult for obese people but is necessary to keep the weight off after you have the bariatric surgery.
Riska for bariatric surgery
There are risks but they are very rare. The people who are most at risk are people who are very obese, or have deep bone thrombosis which are blood clots. The best way to avoid this is to follow your doctor and nutritionist’s advice; this means going to all your follow up appointments as well.
Here are some more risks:
- Infection
- Blood clots
- Stomach ulcers
- Gallstones from weight loss
- Not getting enough nutrients
- Problems with the gastric band or sleeve
You may also need plastic surgery as your skin will sag but that should be considered only after 18 months.
Dumping Syndrome
Dumping syndrome is diarrhea which occurs because the stomach may not absorb the food or it goes too quickly through the intestine. This happens a lot when you eat sweets. You may also feel weak after eating sweets.
Supplements for Low Nutrient Levels
“After malabsorptive weight loss surgery, many people don’t absorb vitamins A, D, E, K, B-12, iron, copper, calcium, and other nutrients as well as they used to. Supplements can help you get what your body needs and prevent conditions like anemia and osteoporosis. You’ll need to take them for the rest of your life.”
Your new lifestyle
You might find it difficult to change your lifestyle at first but, you must persevere. Your emotions will run high and low. Make sure you talk to your doctor and medical team to help you through the adjustment period.
I will be going for bariatric surgery this year. I have made the decision because I feel I am slowly killing myself with all my medical issues related to obesity. It is time for me to make the change.
