What Are Your Bariatric Surgery Options?
Bariatric surgery is a type of surgery that restricts food intake, in fact decreasing the daily caloric intake in order to fight obesity.
They are rather complicated operations, reserved for the most to cases known as “morbid obesity” characterized by a body mass index above 40, which have failed to be controlled by various diet attempts.
The effectiveness on weight loss is almost constant and significantly decreases mortality and morbidity of obese patients. The lost weight can sometimes reach 40% of the initial weight of the patient. This weight reduction is accompanied by an improvement in levels of hypertension, fat levels and even curing pre-existing diabetes in more than three-quarters of cases. The improvement in blood sugar levels is almost immediated, even before any weight loss. Psychological monitoring and evaluation are needed along the way.
A set of techniques exist that can be classified into two main types of interventions.
- The first aimed at reducing stomach capacity, ie the volume of the stomach and to reduce the rate of emptying of the stomach to get a feeling of fullness faster (gastric banding surgery).
- The second, mixed procedures, combine gastric restriction with the creation of a bypass system in the digestive tract to reduce absorption of nutrients by the intestine. These techniques are performed by incision of the abdominal wall (laparotomy) and, in recent years, almost all can be done laparoscopically.
Comparative efficiency techniques
The analysis of available data indicates that the different bariatric surgery techniques are effective.
In general, the mixed procedures, combining gastric restriction and intestinal malabsorption, are more effective than interventions that only reduce stomach capacity.
Laparoscopic techniques, provide you with many benefits, including reduced duration of hospitalization, although they are not free of complications. Only two laparoscopic approaches are fairly well developed and their effects known enough not to be regarded as experimental.
The Importance of follow-ups
Patients that undergo weight-loss procedures should be monitored annually by a multidisciplinary team, in addition to the surgical team (especially attentive to the early and late terms), including nutritionists, psychologists and medical specialists. Plastic surgery is often necessary. Recurrence of obesity can be seen in just under one in 10 in long term studies.
In general, bariatric surgery is a costly intervention.
However, its costs are largely offset by the decrease in the prevalence of diseases associated with obesity (heart disease and diabetes, for example) and by reducing their impact the health system and productivity losses caused by disability, as well as improving the patient’s life quality.