Bariatrics is a branch of medicine dealing with the causes, prevention, and treatment of obesity. The word ‘Bariatrics’ is derived from the Greek word ‘baro’, which means ‘weight’. The suffix ‘iatrics’ means ‘a branch of medicine’.
Bariatric Surgery is a weight loss surgery and it refers to the different procedures followed to treat obesity via the modification of the gastrointestinal tract, so as to reduce the intake of nutrients and to reduce the amount of absorption within the body. It is different from the surgical procedures of removal of fat from the body using methods such as, liposuction or abdominoplasty.
Who Can Opt
Bariatric surgery is conducted for those individuals, who are unable to achieve any significant weight loss through diet modifications and exercise programs. There are other also other factors, which have to be considered before going for this surgery:
- The body mass index (BMI) must be 40 or more, or the individual should be at least 100 pounds overweight, compared to his normal weight. The calculation of BMI is based on the height and weight of the individual. The average BMI is between 18.5 and 25.
- An individual, who has a BMI of 35 and above, and at the same time, is suffering from life-threatening illnesses (like Diabetes Type II, Heart Disease, Sleep Apnea etc.), which can be cured by reducing the weight of the person.
However, this is not an easy option for weight loss. The follow-up procedures for this surgery are equally important. Only those people, who are committed are considered eligible for the operation. Towards that end, often, a psychological evaluation of the patient is also conducted along with an evaluation of his lifestyle, in order to qualify for the surgery. The patient also receives extensive counseling about nutrition before the surgery.
Procedure and Process
The procedure for a bariatric surgery is quite straightforward in theory. In this procedure, the stomach is made smaller by dividing the upper and lower section of the stomach into two parts by using staples (which are similar to stitches). Now, the top part of the stomach will hold all the food which is eaten by the person.
Then, the surgeon connects the top part of the stomach to a section of the small intestine. This, thus, bypasses the lower portion of the stomach. The new connection is known as the ‘Roux Limb’.
The base of this Roux Limb is then connected to the remaining part of the small intestine (from the bottom of the stomach), thus forming a ‘Y’ shape.
This Y-shaped connection lets the pancreatic fluids and bile to mix with the food, which now travels directly from the top part of the stomach to the small intestine.
Medical innovation has now improved this process and this kind of gastric bypass surgery can now be conducted via a laparoscopic procedure.
In this method, small incisions are made in the abdomen and surgical instruments including a small camera, are passed through these incisions.
This technique is good because, it reduces the size of incisions made, lowers the risk of scars and hernias after the procedure.
However, this process is not recommended for people, who have gone through some sort of abdominal surgery before, or those, who weigh more than 350 pounds. The same procedure, which was mentioned prior to the laparoscopic procedure, is followed for such patients.
Nowadays, that procedure has also become quite refined with the advent of adjustable gastric bands, which are tied around the stomach to divide it into two parts. This is used instead of staples or stitches.
After the Surgery
This kind of surgery is not easy to live with, simply because, it is irreversible and because of the changes one has to undergo after the surgery. The patient needs to be very committed to these changes. For several weeks, the patient will be on a liquid diet after the operation. He can then begin to take in, small quantities of solid food.
However, some patients often experience vomiting and nausea because of the large amount of food being present in the stomach. Some patients also experience diarrhea, dizziness, sweating, and bloating.
Ideally, patients need to take vitamin supplements and follow, what is now called, a ‘gastric bypass diet’. They also need to exercise regularly in order to stay fit.
In effect, the surgery reduces the amount of food absorption in the body by reducing the intake of food, reducing the time that the food remains in the body during the digestion process. This often causes less amounts of nutrition to be absorbed in the body. Also, the amount of food consumed has to be reduced significantly, because the stomach pouch has been reduced. Furthermore, the patients would not be able to handle large amounts of alcohol, sugar, fatty foods, and products such as fries, cakes, or candies. Food intake has to be separated by the fluid intake by about 30 minutes. Also, one can only sip what one is drinking.
Risks and Complications
- Inflammation of the stomach lining or gastritis
- Follow-up surgeries for the correction of complications or removal of excess skin
- Iron and / or vitamin deficiencies
- Calcium deficiency, which can lead to osteoporosis and similar bone disorders
- Vomiting due to excessive consumption of food
The weight loss, which is the aim of the gastric bypass surgery occurs quite well, if all the instructions of the doctor are properly followed. Most patients end up losing about 10 pounds per month (on an average) and they reach stable weight within 18 to 24 months of this surgery.