BARIATRIC SURGERY
Who is a candidate for bariatric surgery?
Bariatric surgery is a weight loss surgery that is recommended for individuals with a body mass index (BMI) of 35 or greater, regardless of the presence, absence, or severity of co-morbidities.
Additionally, bariatric surgery is recommended for patients with type 2 diabetes and BMI of 30 or greater.
Some insurance companies require that the surgery be performed at a facility that meets certain criteria.
The National Institutes of Health (NIH), the American College of Surgeons (ACS), and the American Society for Metabolic and Bariatric Surgery (ASMBS) recommend that surgery be performed by a board-certified surgeon with specialized experience/training in bariatric and metabolic surgery, and at a center that has a multidisciplinary team of experts for follow-up care.
The following are some of the qualifications for bariatric surgery:
· BMI of 40 or more
· BMI of 35 or more with a serious health problem linked to obesity, such as type 2 diabetes, heart disease, or sleep apnea
· BMI of 30 or more with type 2 diabetes that is difficult to control with medical treatments and lifestyle changes
· Body weight greater than 100 pounds or 45 kg above ideal weight
· BMI of 35 or greater with specific significant health problems like type 2 diabetes, sleep apnea, or high blood pressure
· BMI of 35 or greater, regardless of the presence, absence, or severity of co-morbidities
It is important to note that having surgery to lose weight is a serious decision, and patients should understand what the operation involves and its risks and benefits.
. Additionally, bariatric surgery is not recommended for everyone, and patients should consult with their healthcare provider to determine if it is a good option for them.
What are the qualifications for bariatric surgery?
To qualify for bariatric surgery, individuals generally need to meet certain criteria. The qualifications for bariatric surgery can vary slightly depending on the specific guidelines followed by different healthcare institutions. Here are the common qualifications for bariatric surgery based on the search results:
1. Body Mass Index (BMI): Bariatric surgery is typically recommended for individuals with a BMI of 35 or higher.
2. Some sources also mention a BMI of 30 or higher for individuals with specific obesity-related conditions, such as type 2 diabetes.
3. Obesity-Related Conditions: In addition to BMI, having obesity-related conditions can also be a qualification for bariatric surgery. These conditions may include heart disease, diabetes, high blood pressure, severe sleep apnea, or type 2 diabetes that is difficult to control with medical treatments and lifestyle changes.
4. Failed Nonsurgical Methods: Bariatric surgery may be considered for individuals with a BMI of 30-34.9 kg/m2 who have not achieved substantial or durable weight loss or improvement in co-morbidities through nonsurgical methods.
5. Commitment to Lifestyle Changes: Candidates for bariatric surgery are typically required to demonstrate a commitment to making permanent lifestyle changes, including changes in eating habits and physical activity.
It's important to note that these qualifications may vary depending on the specific healthcare institution and the guidelines they follow. Additionally, insurance coverage and other factors may also play a role in determining eligibility for bariatric surgery
.If you are considering bariatric surgery, it is recommended to consult with a healthcare professional or a bariatric surgeon who can evaluate your specific situation and provide personalized guidance based on your individual needs and health conditions.
What types of bariatric surgery procedures are available?
There are several types of bariatric surgery procedures available. Here is a list of the most common ones:
1. Roux-en-Y Gastric Bypass (RYGB): This procedure has been performed for more than 50 years. It involves creating a small pouch at the top of the stomach and connecting it directly to the small intestine, bypassing a large portion of the stomach and the first part of the small intestine.
2. Sleeve Gastrectomy: This procedure involves removing a large portion of the stomach, leaving behind a smaller, sleeve-shaped stomach. The reduced stomach size restricts the amount of food that can be eaten, leading to weight loss.
3. Adjustable Gastric Banding: In this procedure, a band is placed around the upper part of the stomach, creating a small pouch. The band can be adjusted to control the size of the opening between the pouch and the rest of the stomach, regulating the amount of food that can be consumed.
4. Biliopancreatic Diversion with Duodenal Switch (BPD-DS): This procedure involves removing a large portion of the stomach and rerouting the small intestine to limit the absorption of calories and nutrients. It is usually recommended for individuals with severe obesity.
It's important to note that the choice of bariatric surgery procedure depends on various factors, including the patient's overall health, specific health needs, and personal preference. It is recommended to consult with a healthcare provider to determine the most suitable procedure for an individual's circumstances.
How does bariatric surgery work to help with weight loss?
Bariatric surgery, also known as weight loss surgery, works by making changes to the anatomy of the stomach and small intestines, which leads to changes in appetite, satiety (feeling full), and metabolism (how the body burns calories) .
The specific procedures involved in bariatric surgery, such as gastric bypass, sleeve gastrectomy, and duodenal switch, vary in their approach but ultimately aim to achieve weight loss by limiting the amount of food that can be eaten and reducing the body's ability to absorb nutrients.
Here is a breakdown of how some common bariatric surgery procedures work:
1. Gastric Bypass: This procedure involves creating a small pouch at the top of the stomach and connecting it directly to the small intestine, bypassing a large portion of the stomach and the first part of the small intestine. This restricts the volume of food that can be eaten and reduces the absorption of nutrients.
2. Gastric Sleeve: In this procedure, a large portion of the stomach is removed, leaving behind a sleeve-shaped tube. The smaller stomach size limits the amount of food that can be consumed, leading to weight loss.
3. Duodenal Switch: This procedure involves removing a portion of the stomach and rerouting the small intestine to create two separate pathways for food. One pathway carries food from the stomach to the lower part of the small intestine, bypassing the upper part. This reduces the absorption of calories and nutrients.
These surgeries not only help with weight loss but also have additional benefits. They can improve or resolve conditions such as diabetes, heart disease, high blood pressure, arthritis, and acid reflux.
However, it's important to note that bariatric surgery is not a standalone solution. It is a tool that, when combined with a healthy diet and exercise routine, can help treat obesity as a chronic disease.
Long-term success requires making permanent lifestyle changes and following a comprehensive post-surgery plan.
It's worth mentioning that bariatric surgery is a major procedure and carries risks and potential side effects. It should only be considered after other weight loss methods have been unsuccessful and when obesity poses significant health risks.
Consulting with a healthcare provider who specializes in bariatric surgery is essential to determine if it is the right option for an individual.
What conditions can bariatric surgery treat?
Bariatric surgery, also known as weight loss surgery, is a surgical procedure that involves making changes to the digestive system to help people lose weight.
Bariatric surgery can treat and prevent many metabolic diseases related to obesity, including diabetes and fatty liver disease.
The following are some of the conditions that bariatric surgery can treat:
· Obesity: Bariatric surgery is the most successful long-term treatment for class III obesity.
· According to the National Institutes of Health (NIH), it is nearly impossible for people with class III obesity to sustain weight loss through diet and exercise alone.
· Diabetes: Bariatric surgery can improve control of blood glucose levels and even reverse type 2 diabetes.
· High blood pressure: Bariatric surgery can reduce high blood pressure and the risk of stroke and heart attack.
· High cholesterol: Bariatric surgery can reduce high cholesterol levels.
· Sleep apnea: Bariatric surgery can improve sleep apnea.
· Arthritis: Bariatric surgery can improve arthritis
· Acid reflux: Bariatric surgery can treat acid reflux
· It is important to note that bariatric surgery is not for everyone who is severely overweight, and people may need to meet certain medical guidelines to qualify for weight-loss surgery.
· Additionally, people who undergo bariatric surgery must be willing to make permanent changes to lead a healthier lifestyle, and they may be required to participate in long-term follow-up plans that include monitoring their nutrition, lifestyle and behavior, and medical conditions.
Is bariatric surgery considered an "easy way out"?
Bariatric surgery is not considered an "easy way out" for weight loss. This perception is a misconception and can be stigmatizing for individuals who undergo this procedure.
Here are some reasons why bariatric surgery is not considered an easy solution:
1. Commitment and Lifestyle Changes: Bariatric surgery requires a significant commitment to long-term lifestyle changes. It is not a quick fix or a shortcut to weight loss. Patients must adhere to a strict diet, exercise regularly, and make permanent changes to their eating habits.
2. Medical Intervention for Severe Obesity: Bariatric surgery is typically recommended for individuals with severe obesity who have not been successful with other weight loss methods. It is a medically necessary intervention to improve health and quality of life.
3. Complexity and Risks: Bariatric surgery is a complex surgical procedure that carries risks and potential complications. It involves altering the anatomy of the digestive system to restrict food intake or limit nutrient absorption. Patients must undergo a thorough evaluation and meet specific criteria to ensure they are suitable candidates for the surgery.
4. Multidisciplinary Support: Bariatric surgery requires a comprehensive approach involving a multidisciplinary team of healthcare professionals, including surgeons, dietitians, psychologists, and exercise specialists. This support is crucial for long-term success and to address the underlying factors contributing to obesity.
It is important to recognize that bariatric surgery is a tool to assist individuals in achieving weight loss and improving their health. It is not a simple or easy solution, but rather a complex and life-changing journey that requires dedication, commitment, and ongoing support.
What is involved in the preparation for bariatric surgery?
Preparation for bariatric surgery involves several steps, which are outlined below:
1. Lifestyle Changes: Patients are advised to begin and maintain a workout routine to reach and keep their weight loss goals. They are also advised to lower their daily calorie intake to a range between 1200-1500 calories (or in a range discussed with their doctor) .
2. Presurgical Program: Many hospitals offer a presurgical lifestyle program that helps patients build lifestyle skills they can use before and after bariatric surgery. This program typically lasts for six months and includes meetings with a bariatric surgeon to review the weight loss procedure, discuss expectations about surgery, and learn about postoperative follow-up care.
3. Medical Tests: Certain basic tests are done prior to bariatric surgery, including a complete blood count (CBC), urinalysis, and a chemistry panel, which gives a readout of about 20 different blood tests.
4. Psychological Evaluation: Patients should be psychologically fit to undergo bariatric surgery. A psychological evaluation is typically done to assess the patient's mental health and readiness for surgery.
5. Nutritional Evaluation: Patients undergo a nutritional evaluation to assess their current dietary habits and to develop a weight loss plan.
6. Orientation and Consultation: Unlike candidates for other surgeries, bariatric patients begin preparing for surgery three to six months before the operation. During this time, they attend an orientation and consultation session to learn about the surgery, its risks and benefits, and what to expect during the recovery period.
7. Personal Care Items: Patients are advised to bring personal care items such as a bathrobe, slippers, shampoo, body lotion or hand cream, scented soap, toothbrush and toothpaste, lip balm, and hairbrush or comb to the hospital on the day of surgery.
It is important to note that the preparation process may vary depending on the hospital and the surgeon. Patients should talk to their doctor about how to prepare for their bariatric weight loss surgery and follow their specific instructions.
What are the risks of bariatric surgery?
Bariatric surgery is a major procedure that can pose serious risks and side effects.
While it can offer many benefits, it is important to make permanent healthy changes to your diet and get regular exercise to help ensure the long-term success of bariatric surgery.
Here are some of the risks and complications associated with bariatric surgery:
Short-term risks and side effects:
· Excessive bleeding
· Infection
· Adverse reactions to anesthesia
· Blood clots
· Lung or breathing problems
· Leaks in your gastrointestinal system
· Bowel obstruction
· Dumping syndrome, which leads to diarrhea, flushing, lightheadedness, nausea, or vomiting
· Gallstones
· Hernias
· Low blood sugar
· Malnutrition
· Vomiting
· Dilation of esophagus
· Inability to eat certain foods
· Skin separation
· Stricture
· Vitamin or iron deficiency
Long-term risks:
· Dumping syndrome, a condition that can lead to symptoms like nausea and dizziness
· Low blood sugar
· Malnutrition
· Vomiting
· Ulcers
· Bowel obstruction
· Hernias
It is important to note that all surgical procedures carry risks, and your surgeon will explain all potential bariatric surgery complications, both short and long term, and answer any questions.
Follow-up interventions, surgery, and hospitalizations are relatively common within 5 years of weight-loss surgery, affecting about one-third of patients.
Laparoscopic surgery, which uses punctures to enter the abdomen, can lead to injury, bleeding, and death.
Therefore, it is important to discuss the risks and benefits of bariatric surgery with your doctor before making a decision.
What are the advantages and disadvantages of each type of bariatric surgery?
There are several different types of bariatric surgery, each with its own advantages and disadvantages.
Here are some of the pros and cons of each type:
1. Sleeve Gastrectomy
· Advantages:
· Promotes excessive weight loss
· Technically simple and shorter surgery time
· No need to cut the stomach or bypassing the intestines
· Disadvantages:
· May cause acid reflux
· Non-reversible
2. Gastric Bypass
· Advantages:
· Greater overall weight loss due to the tighter dietary restrictions and less caloric absorption
· Faster initial weight loss
· Reduces the risk of cardiovascular disease, diabetes, high blood pressure, and stroke
· Disadvantages:
· Longer hospital stay
· Higher risk of complications
· Requires a longer recovery time
3. Adjustable Gastric Band
· Advantages:
· Adjustable and reversible
· Lower risk of complications
· Disadvantages:
· Slower weight loss
· Requires frequent adjustments
· May cause nausea and vomiting
4. Biliopancreatic Diversion with Duodenal Switch
· Advantages:
· Promotes excessive weight loss
· Effective in treating diabetes, high blood pressure, sleep apnea, and high cholesterol
· Disadvantages:
· Higher risk of complications
· Longer recovery time
· May cause malabsorption of nutrients
It's important to note that the long-term success of bariatric surgery depends on the patient's ability to make permanent changes in their diet, behavior, and exercise.
The type of bariatric surgery that works best for a patient will depend on several factors, including their general health, health needs, and personal preference.
A bariatric surgeon will review a patient's health history and work with them to determine which surgery is best for them.
How long does it take to recover from bariatric surgery?
Recovery time after bariatric surgery can vary depending on the procedure and the individual patient. However, most weight loss surgeries today are minimally invasive laparoscopic procedures which promise speedier recovery and fewer complications.
Here are some general guidelines for recovery after bariatric surgery:
· Hospital Stay: Patients generally spend one to two days in the hospital following minimally invasive bariatric surgery.
· Early Days and Weeks: In the early days and weeks after surgery, it's normal to experience fatigue, nausea and vomiting, difficulty sleeping, postsurgical pain, weakness, light-headedness, loss of appetite, flatulence and gas pain, loose stools, and emotional ups and downs.
· Patients experience these to varying degrees, so it's important to discuss any particular concerns with the bariatric surgery team.
· Activity Restrictions: Patients may need to avoid lifting anything heavier than 15 to 20 pounds for the first six weeks.
· Depending on the procedure, patients may be able to return to normal activities within 3 to 5 weeks.
· Pain Control: Pain control is important after surgery, and patients should follow their doctor's instructions for taking pain medication.
· Follow-up Appointments: Patients should stay in communication with their bariatric surgery team, so they can do their best to help the recovery go smoothly.
· Diet and Supplements: After surgery, patients need to take vitamins and supplements regularly, ingest high-quality nutrients, attend follow-up appointments, and follow a healthy diet and exercise plan to maintain weight loss.
Overall, recovery from bariatric surgery takes about three to six weeks.
However, it's important to remember that each person recovers at a different pace, and patients should follow their doctor's instructions for a safe and successful recovery.