Overweight & obese individuals have four choices
1. Accept their existing weight with additional diseases like blood pressure, diabetes, high infertility, joint pains and more.
2. Change their physical activity levels and diet.
3. Use weight loss Medication.
4. Weight loss (bariatric) Surgery.
Poor results, high risk & relatively high costs are the main reasons for failure of medical therapy (1, 2 & 3) of obesity whereas weight loss surgical procedures despite the fear of surgery, have most reliable & successful outcome (proved by different scientific studies
SURGERY IS MOST RELABLE & SUCCESSFUL OPTION
There are different types of weight loss surgeries like GASTRIC BYPASS, SLEEVE GASTRECTOMY & GASTRIC BANDING. Person can loose from 50 % to 80 % of excess weight depending upon type of procedure chosen. Beside weight loss diabetes, high blood pressure can also be reversed. Since laparoscopic method (minimal invasive surgery) has been introduced to carry out these surgeries, these surgeries have become very safe like any other surgery
Weight loss surgery keeps diabetes at bay
So now there is shift in bariatric surgery ( weight loss) perception ,which is not only recommended for weight loss but also for reversal of these associated diseases with obesity esp. Diabetes type 2. So one should not think only of reduction in body weight in terms of kilograms but should keep in mind about cure/ improvement in diabetes, high blood pressure & cardiovascular diseases.
Weight loss surgery beneficial to heart health
Infertility, reduction in mortality also, which in my view are very much added benefits of these surgeries.
Why surgery for weight loss ?
Obesity is a very morbid condition that has several health consequences. Mild obesity is still controllable by nutrition and exercise. However as it advances it becomes more difficult because of metabolic changes, physical limitations, psychological effect and social inhibition. When exercise and dieting does not help control the weight bariatric surgery may help loose weight and bring a person back to ground Zero where he can start working on his lifestyle and maintain weight.
So What are the different procedures to reduce weight?
There are two ways it can help loose weight-
Restrictive surgery. In these procedures the stomach is made smaller. A section of your stomach is removed that helps to limits the amount of food it can hold and causes you to feel full.
Malabsorptive surgery. Most of digestion and absorption takes place in the small intestine. Surgery to this area shortens the length of the small intestine and/or changes where it connects to the stomach, limiting the amount of food that is completely digested or absorbed .
Through food intake restriction, malabsorption or a combination of both, you can lose weight since less food either goes into your stomach or stays in your small intestine long enough to be digested and absorbed
WEIGHT LOSS BY NONSURGICAL METHOD:
The prevalence of overweight & obesity in most countries has been increasing markedly over the past 2-3 decades .Obesity is a major risk factor cardiovascular diseases, type2 diabetes, high blood pressure & cancer, whre it affects not only health but also life span. To date, nonsurgical treatments like dieting , medications have not been very effective & surgery like sleeve gastrectomy , gastric bypass, gastric band is currently accepted as the only treatment approach with long lasting success.But many people are afraid of surgery or are not fit for surgical criteria, for these people gastric ballon procedure is an alternate and effective choice.
- What is gastric balloon ?
Gastric balloon is soft silicone balloon that is inserted into stomach via mouth using endoscope.it is day care procedure means person has to come for 6-8 hours only.The procedure takes about 20- 30 minutes only.
- How it works?
By Partially filling the balloon system induces feeling of satiety, thus reducing intake of food & aiding weight loss.
- who is going to benefit?
It is indicated for weight loss therapy for overweight and obese people with a body mass index (bmi)>27kg/m2
- Who should consider this procedure ?
Person who has gastric ulcer, kidney failure, pregnancy etc.
- How much weight will the person might lose?
It depends upon many factors like how well they adopt to balloon and how they alter their ating behavior. A good aim is to try to average a loss of 1 kg per week, throughout the six months that they have balloon system in their stomach, giving a total loss of about 10- 25 kg.
- how long a person can keep this & how it is removed?
Baloon is indicated for a maximum of 6 months and than it is removed , by mouth using endoscope.
WEIGHT LOSS BY SURGICAL METHOD:
- Roux en Y Gastric Bypass:As “gastric bypass surgery” implies, this surgical procedure routes food past most of the stomach and the first part of the small intestine. In addition to restricting food intake, a Roux-en-Y Gastric Bypass reduces nutrient absorption.Gastric bypass surgery involves three main steps:
1. Creating a new, smaller stomach (gastric pouch) from the existing stomach.
2. Bypassing 3 to 4 ft. of the small intestine (normally 20 ft. long).
3. Connecting the bypassed digestive section to the lower section of the small intestine, where necessary digestive juices mix with food.
The small pouch of stomach can hold about 1/3 cup of food. After this, it begins to stretch, giving you the feeling of fullness. Although in most people it will give a feeling of fullness, in some people the stretching may give a feeling of discomfort. The small stomach pouch will need time to digest the food and push it through the GJ (gastrojejunostomy) opening into the small bowel. If you do not give enough time to do this, you may start vomiting.
Post-Op Dietary Plan for Roux en Y Gastric Bypass Surgery Patients
As with all surgical weight-loss programs, it is imperative that Roux en Y patients adhere to dietary recommendations following surgery. For the first 18 months after gastric bypass surgery, patients must restrict themselves to consuming less than 800 calories per day; after 36 months, patients may consume no more than 1200 calories each day. In addition, patients must avoid eating sugars and fats to prevent “Dumping Syndrome.”
Surgical Procedure and Hospital Stay -Over 98% of Gastric Bypass Surgery RYGBâ€™s are performed laparoscopically, with an average of 6 small incisions. They all require full general anesthesia and about 2 hours of surgical time. Most patients stay one or possibly two nights in the hospital.
How much weight loss is achieved?
The vast majority of patients lose 50 to 80% of their excess weight in the first 12 months of Weight Loss after gastric bypass surgery. With the roux-en-y gastric bypass, most patients keep 50% to 70% of their excess weight off after 10 years. However, some patients can regain some or much of their original weight.
After the first 2 years, there is a very slow weight loss depending on the eating habits and exercise commitment of the patient. If you successfully use the preoperative period to adapt your lifestyle and train yourself to eat differently, this small pouch helps to remind us to eat less food. Thus, the intake of food is dramatically limited and enables us to lose weight, and keep the weight off lifelong. Although there is some malabsorption of certain types of minerals and vitamins as described above, the food that is eaten will be well digested and nearly completely absorbed. This enables us to maintain good nutritional status and remain healthy with proper eating.
- Vertical Sleeve GastrectomyThe Vertical Sleeve Gastrectomy (VSG) or Laparoscopic Sleeve Gastrectomy (LSG) is an emerging weight loss procedure. It involves reducing the size of the stomach only, without any intestinal bypass or artificial device.Sleeve Gastrectomy OR Vertical Sleeve Gastrectomy OR Partial Gastrectomy
This procedure involves surgery on the stomach only (it is only a restrictive procedure) and does not involve the intestine (which would make it malabsorptive). It basically consists of making a stomach that (before surgery) looks like a pouch into a long tube, or â€œsleeveâ€. The sleeve gastrectomy procedure removes approximately 2/3 of the stomach, which provides for quicker satiety (sense of fullness) and decreased appetite. The smaller stomach sleeve restricts food intake by allowing only a small amount of food to be consumed in a single sitting.
Surgical Procedure and Hospital Stay
Over 98% of sleeve gastrectomies are performed laparoscopically, with an average of 5 small incisions.They all require full general anesthesia and about 1 to 1 آ½ hours of surgical time. Most patients stay one or possibly two nights in the hospital.
How Much weight loss is achieved?
The vast majority of patients lose 50 to 80% of their excess weight in the first 12 months. . However,in the past, purely restrictive operations have led to LESS long term weight loss than the gastric bypass. The recent advances has advantage over the older procedures iin that it possibly eliminates most Ghrelin hormone production and helps to reduce the sensation of hunger that people have.
Advantages of the Vertical Gastrectomy Weight Loss Surgery
The stomach is reduced in volume but tends to function normally so most food items can be consumed, albeit in small amounts.
Eliminates the portion of the stomach that produces the hormones that stimulates hunger (Ghrelin).
No dumping syndrome
By avoiding the intestinal bypass, the chance of intestinal obstruction (blockage), anemia, osteoporosis, protein deficiency and vitamin deficiency are almost eliminated.
Very effective as a first stage procedure for high BMI patients (BMI>55 kg/m2).
Can be done laparoscopically in patients weighing over 500 pounds.
- Adjustable Gastric Banding
LapBand: Laparoscopic Adjustable Gastric Band
The Newest and Safest Surgical Weight-Loss Procedure
Approved by the FDA in 2001, Lap Bandآ® Surgery is the safest and least invasive bariatric surgery for weight-loss patients. The LapBandآ® is a small, inflatable belt placed around the upper portion of the patient’s stomach that functions to restrict the amount of food consumed, slow the emptying of food from the stomach, and provide a constant sensation of being “full.” Like our other weight-loss surgeries, Laparoscopic gastric banding surgery is a minimally invasive. Operating time is about 60 minutes and most patients are ready to leave the hospital the following day.
Gastric banding stomach reduction surgery functions by limiting the amount of food a patient can consume and delaying the emptying of the stomach to create the sensation of constantly being “full.”
On average, patients who undergo Lap Band surgery experience a 60% loss of excess weight.