Everything you need to know about bariatric surgery to treat obesity
Obesity prevalence around the world is worrying. By 2025, the World Obesity Federation predicts that the global obesity prevalence will reach 18 percent for men and 21 percent for women. A third of obesity cases worldwide come from the US, China, Brazil, India and Russia.
Although the Philippines are not among the five countries, Filipinos are nowhere near spared the threat of this chronic relapsing disease. In fact, the World Obesity Federation has given the country a national obesity risk score of 6 out of 10, which indicates moderate risk.
Obese people are at higher risk of mortality, gallbladder problems, osteoarthritis, sleep apnea, cancer, coronary artery disease, diabetes, stroke, high blood pressure, and high levels of cholesterol, blood sugar, and triglycerides. In addition, obesity decreases the quality of life. It also affects mental and emotional health and causes pain throughout the body.
Obesity is caused by many factors – mainly an imbalance in energy intake and output. Put simply, if you ingest more calories from food than you are consuming from physical activity and all of the body’s energy production, you gain weight.
The next culprit comes from environmental factors. We live in an obese society, an environment that makes it easier for us to gain weight if we don’t take our lifestyle into our own hands. The portions are bigger than they were three decades ago. Technological progress and time pressure favor a sedentary lifestyle.
Genetics also play a role in increasing a person’s risk of obesity, but never use your genes as an excuse to simply accept your fate and not lift a finger to prevent it from happening. You can choose a healthier lifestyle to help you achieve and maintain a healthy weight range. After all, not everyone who has cancer genes will develop cancer. You won’t become obese overnight just because you unfortunately inherited more fat cells from your ancestors.
Proper diet and regular physical activity are the most important measures to combat obesity. However, there are only cases when these natural ways are insufficient for a person to lose weight efficiently in order to reduce the negative effects of obesity on their health.
Obese people are at higher risk of mortality, gallbladder problems, osteoarthritis, sleep apnea, cancer, coronary artery disease, diabetes, stroke, high blood pressure, and high levels of cholesterol, blood sugar, and triglycerides.
The National Institutes of Health (NIH) sets criteria for people who can undergo bariatric surgery to treat obesity. Bariatric surgery involves manipulating the digestive system to achieve weight loss. However, this procedure is not suitable for everyone with a simple desire to lose weight. The NIH criterion is suitable for patients with a body mass index (BMI) of 40 and above or patients with a BMI of 35 who suffer from comorbidities or pre-existing conditions.
There are several types of bariatric and weight loss surgery, but these are the most common.
The laparoscopic adjustable gastric band requires the placement of a foreign device (adjustable band) on the upper part of the stomach to create a very small gastric pouch. The patient now has a smaller reservoir of food, reducing total food intake to facilitate weight loss. A port is placed under the skin to act as a needle puncture site where the doctor can adjust the tape accordingly. Strict adherence to the diet is critical to preventing esophageal enlargement from overeating and gastroesophageal reflux (GERD), also known as acid reflux.
The most popular type is the sleeve gastrectomy. Approximately 80 percent of the stomach is removed, leaving only a small portion with a tubular structure. This type of surgery not only reduces food intake due to the size of the stomach. It also reduces the production of the appetite-stimulating hormone ghrelin, which leads to a significantly lower craving for food. Complications such as constipation, low blood sugar, malnutrition, nutritional deficiencies, GERD, hernia, and vomiting can occur.
Roux-en-Y gastric bypass results in greater weight loss and better comorbidity outcomes compared to the other two types. However, it has a higher risk of obstruction, adhesions, and ulcers. It can also make GERD worse. This procedure bypasses most of the stomach and the first section of the intestine, resulting in a complication called dumping syndrome.
Dumping syndrome is caused by the rapid “dumping” or deposition of undigested food in the intestines. A patient experiences palpitations, fainting, sweating, hunger, tremors, nausea, cramps, abdominal pain, dizziness, and diarrhea right after eating.
After the operation, the patient is given liquid as a nutritional supplement. Hydration is a priority. The diet will progress from clear to fully liquid by day two through day four. Soft and mixed foods from protein sources, well-cooked vegetables and soft fruits are introduced in the third week. In the fourth week, the patient may receive some complex carbohydrates and solid foods as tolerated.
Bariatric surgery holds promise for the long-term treatment of obesity, but it also brings many initial sacrifices for the patient. Are you considering going under the knife? Ask your doctor about your options when dealing with obesity.
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