Bariatric Surgery

Bariatric Surgery

Bariatric surgery (also known as metabolic surgery, weight loss surgery) is a surgical treatment involving the gastrointestinal tract; the purpose of which is to increase weight reduction in obese patients, as well as provide alleviation or remission of diseases associated with obesity. Bariatric surgery is performed in a situation when diet and exercise have not achieved the desired results of significant weight loss or when it remains the only form of treatment for diseases such as type 2 diabetes, high cholesterol, etc. As a result of the surgery patients experience less hunger, which results in less food consumed and a decrease in calories absorbed normalization of blood pressure, and an increase in life expectancy and quality of life.

Bariatric surgery certainly has many benefits; however, like any form of surgery, weight loss surgeries are serious procedures that can have serious risks and side effects which need to be recovered from. In addition, patients must make positive changes to their lifestyles including increasing regular exercise in order to consolidate the success gained from the surgery.

Bariatric Surgery - When Should You Consider This Treatment?

Bariatric surgery is performed to help patients lose weight and reduce the risk of potentially life-threatening weight-related health problems, including:

• cardiovascular diseases and strokes,
• high blood pressure,
• non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH),
• high cholesterol,
• joint diseases,
• sleep apnea syndrome,
• PCOS,
• type 2 diabetes.

Bariatric surgery is generally recommended for patients who have not been able to lose weight through diet and exercise.

Bariatric surgery can be one of the best ways to solve the problem of obesity in patients:

• with a body mass index (BMI) of 40 or higher,
• with a body mass index between 35 and 39.9, and if they have health problems associated with being overweight, such as type 2 diabetes, high blood pressure, or severe sleep apnea,
• who may have been offered certain types of weight loss surgery, if their BMI is between 30 and 34 and if they have serious health problems associated with being overweight.

However, bariatric surgery is not a magic wand for anyone and everyone who is overweight. In order to begin this treatment for weight loss, patients need to undergo diagnostics and certain examinations. Moreover, patients must be psychologically ready to introduce permanent changes in their diet and lifestyle, without which it is impossible to sustain the positive results of treatment.

Depending on the chosen program and clinic, patients may need to take part in specially designed programs that include observation (control) of dietary habits and lifestyle, as well as health monitoring after surgery.

Like any surgical treatment, bariatric surgery is associated with certain risks and complications in both the short and long term.

Risks associated with a surgical procedure may include the following:

• heavy bleeding,
• infection,
• adverse reactions to anesthesia,
• lung problems and breathing issues.

The long-term risks and complications of weight loss surgery depend on the type of surgery and may include:

• intestinal obstruction,
• dumping syndrome, which can lead to diarrhea, redness, dizziness, nausea or vomiting,
• gallstones,
• hernia,
• low blood sugar,
• ulcers,
• vomiting,
• acid reflux,
• the need for a repeat operation, or an additional procedure.

Types of Bariatric Surgery

Each type of bariatric surgery has its own pros and cons, which should be discussed with a doctor who knows your medical condition, medical history, and associated medical conditions. Some of the most common types of bariatric surgery are:

• Roux-en-Y Gastric Bypass is one of the most common weight loss methods; as a result of this operation, the amount of food intake decreases and it is usually irreversible. The advantages of this procedure are quality control of type 2 diabetes and the absence of foreign bodies in the body. The disadvantages include the need for postoperative health monitoring, strict adherence to a customized diet (doctor's recommendations), the constant use of vitamin-mineral complexes. After bypass surgery, patients usually lose up to 80% of their excess weight, however, return to the pre-op body weight is possible.
• Gastric sleeve is a procedure that removes about 80% of the stomach. A smaller stomach cannot hold the same amount of food, as it produces less of the appetite-regulating hormone ghrelin, reducing hunger. The advantages of this type of treatment include the following: low probability of vitamin deficiency after surgery, possible remission of diseases associated with obesity, quality control of type 2 diabetes, no foreign bodies remain in the patient's body, and a short hospital stay. However, some patients have a risk of regaining weight, heartburn, and less excess weight loss compared to other types of bariatric surgery.

Depending on the clinic and the country of treatment, patients may be offered other types of bariatric surgery, such as double (bipartite) transit, laparoscopic gastric banding, or a biliopancreatic bypass (BPD). Therefore, when deciding which procedure you plan to undergo, it is necessary to study the possibilities of local clinics, as well as foreign ones, focusing on the benefits and risks associated with each treatment. Since some bariatric surgery procedures are costly, it is worth taking the time to explore each one in detail. In some situations, surgery in clinics abroad will be more reasonable; explore the cost of the procedure, the experience of doctors involved, and whether the equipment is good quality and up to date. In other situations, you will have to make a choice about which clinic to undergo treatment based on several components all guaranteeing the effectiveness of treatment at a similar level.

Which Weight Loss Surgery Should You Choose?

The type of weight loss surgery that suits you best depends on your specific situation. Your surgeon will take many factors into account, including body mass index, eating habits, associated health problems, previous surgeries, and the risks associated with each subsequent procedure.

Most surgeons prefer less invasive surgery, which will make it possible to recover faster shortening the rehabilitation period. Minor risks associated with postoperative complications include infections, tissue integrity disorders, individual reactions to anesthesia, etc. Laparoscopic bariatric surgery is not effective in every case. Independent factors such as the choice of a clinic or even the doctor's experience are crucial when making a decision about whether to go ahead with this type of surgery.

That is why a detailed and honest discussion with one’s doctor, weighing all the risks and benefits, is the best way to choose the type of bariatric surgery.

How to prepare for bariatric surgery and what results can you expect?

If you are referred for bariatric treatment, you will be advised on how to properly prepare for a particular type of surgery. Before the operation, patients should undergo a certain type of examination and pass the relevant laboratory tests. In some cases, patients may be restricted from eating certain foods and drinks and taking certain medications. Patients may also be required to start exercising and quit or significantly limit smoking.

Of course, one of the most important factors is patients demonstrating the correct psychological approach; this Involves a clear desire to actively participate in the process and self-discipline throughout, as well as a willingness to follow doctors’ recommendations.

Patients should also understand that the greater the preoperative body weight, the higher the risk of various complications after surgery. For those wishing to reduce risks, doctors recommend introducing a diet during the preoperative period, which involves drinking more water and a reduction in the amount of carbohydrates consumed. Patients who smoke are advised to quit smoking at least 6 weeks before surgery; cessation of smoking reduces risks associated with the cardiovascular system (heart attack, stroke) as well as other vital organs (infections, risk of thrombosis, pneumonia, etc.). By quitting smoking, patients help improve the activity of the cardiovascular system and the lungs; the body as a whole receives a significant increase in oxygen.

Exercise before surgery improves physical and psychological well-being. Patients are advised to devote at least 30 minutes daily to walking, swimming, or cycling. Being in good or excellent physical shape significantly shortens the duration of the recovery period allowing patients to quickly return to their lives.

Bariatric surgery is performed in a clinic (hospital) under general anesthesia and lasts several hours. Depending on the type of bariatric surgery, patients stay in the clinic for several days.

The duration of the recovery period depends on the specific situation of each patient. Patients must eat right and adhere to the following rules during the postoperative period.

• include protein and sufficient water in their diets,
• control their blood sugar levels,
• limit the intake of sweets,
• limit the intake of carbonated, very cold or hot drinks, and drink juice only if diluted with water,
• switch to solid food intake only after the complete restoration of the gastrointestinal tract.

Patients should not only adhere to correct and frequent food intake in the postoperative period, but also take care of other essentials, for example:

• correct and regular care of the postoperative wound, it is necessary to maintain cleanliness, correctly and hygienically changing plasters. If a wound does not heal, there is redness or other sensations that are bothersome, you should contact the clinic or your family doctor.
• if you experience negative emotions, anxiety, or you are not satisfied with the appearance of your skin, if your mood often changes and you feel that you are suffering from depression, you should seek help from a professional psychologist or psychiatrist. During the postoperative period, patients should pay special attention to their shifting emotional and psychological states, as some conditions may worsen. With most patients, their emotional and psychological state improves; self-esteem rises as well as sex drive, and their relationship with their partner improves.
• When new medications are introduced, your stomach may react in a negative way to their intake. Discuss your situation with your doctor and select optimal medications that are best for you. Taking birth control pills after bariatric surgery may also be problematic. Make an appointment with your doctor and select a more suitable method for preventing pregnancy.
• Remember to take vitamin and mineral complexes to reduce the risk of postoperative complications, achieve the correct bodyweight and ensure your body’s optimal functionality.
• Remember to receive obligatory consultation when it comes to additional complexes, especially during pregnancy.
• regular physical activity, which is one of the main elements of successful preparation for the procedure, as well as achieving optimal weight after surgery. It is recommended to exercise regularly (walking, swimming, etc.) at least 3 times a week.

Weight Loss and Bariatric Surgery

Most overweight patients would like to instantly change their situation and are ready to make the decision to receive surgical treatment. However, in the matter of achieving optimal weight, an integrated approach is required.

After weight loss surgery patients must adhere to all the planned follow-ups. If you notice that you are not losing weight or you have any complications, immediately consult your doctor. Patients are advised to track weight loss and evaluate factors that have a potentially negative impact on the process.

For patients who do not observe a more positive lifestyle including an optimal diet, the operation itself will not lead to the desired weight loss.

Patients also need to remember that in the long term they can gain minimal additional weight, and this is a natural process, and the risk of weight gain will accompany them throughout their lives. If the recommendations below are not followed, your weight will quickly return to how it was before the pre-op period.

• follow all of your doctor’s recommendations,
• monitor your health at all times for the first two years, preferably with a bariatric surgeon,
• eat right and avoid bad habits from the preoperative period,
• exercise regularly,
• identify medications that cause weight gain and discuss them with your doctor,
• avoid drinking beverages containing sugar and alcohol,
• include enough vegetables and fruit in your diet.

Bariatric Surgery - Other Recommendations

Patients planning a pregnancy are advised to delay for at least 1.5 years after surgery since the body needs time to recover and adjust to a new lifestyle. During pregnancy, patients should inform their doctor about bariatric surgery and discuss taking vitamin and mineral complexes.

After bariatric treatment, patients may experience hair loss lasting up to 6 months; hair loss is associated with the body's adaptation to the implementation of a new nutrition method. This particular side effect usually stabilizes, therefore, patients are advised to avoid being nervous or upset; it is crucial to remember to take additional vitamin-mineral complexes while experiencing hair loss.

As stated earlier, patients are advised to start exercising before bariatric treatment; exercise is proven to positively affect the condition of the skin in the aftermath of the procedure. Due to weight loss patients develop excessive skin, which can become aesthetically problematic. If you decide to undergo plastic surgery, it can be performed no earlier than 1.5 years after bariatric surgery.

Bariatric Surgery - FAQ

What operations are performed by your specialists and how much do they cost?

As we wrote earlier the choice of the appropriate type of surgery depends on the individual situation of the patient. In order to provide detailed information based on your situation, please contact us and we will offer a solution that best fits your circumstances.

How Safe Is Bariatric Surgery?

Like any type of surgery, bariatrics is associated with certain risks. However, when compared to other types of surgery, weight loss surgeries are among the safest generally speaking.

Does bariatric surgery shorten life?

For most obese diabetic patients, bariatric surgery is believed to increase life expectancy. However, surgery can shorten life expectancy for people with a BMI over 62 kg / m2.

How quickly will I lose weight after bariatric surgery?

During the first 30 days after bariatric surgery, the average weight loss is 2 to 6 kg per week. Men tend to lose weight faster than women. After 2 months, most patients on average lose 20% of their excess weight.

How Painful is Bariatric Surgery?

Patients may feel pain at the incision site, and some patients also experience neck and shoulder pain after laparoscopic bariatric surgery.

Can I drink coffee after bariatric surgery?

It is recommended to avoid consuming drinks with caffeine and carbonated drinks. Caffeine causes dehydration and acts as an appetite stimulant, and soft drinks can cause bloating and discomfort, especially after surgery.

How long does it take to recover from bariatric surgery?

Most operations are laparoscopic, which means that the surgeon makes small incisions, which shortens the recovery time. Most patients stay in the hospital for 2 to 3 days and return to normal life 3-5 weeks after surgery.

How to psychologically prepare for bariatric surgery?

5 tips to help you psychologically prepare for bariatric surgery:

• define realistic expectations after surgery,
• do not try to go through this process alone, the support of loved ones or friends is very important,
• understand the nature of food addiction and the importance of physical activity. Implement positive changes before surgery accordingly,
• if you notice symptoms of moodiness or depression, seek professional help immediately,
• Be aware of and work on your other addictions, such as alcohol consumption or smoking.

Can I Drive After Bariatric Surgery??

For your own safety, you should not drive until you stop taking medication; prescription drugs can impair one’s ability to think clearly and react quickly. Patients can drive again on average 7-14 days after surgery.

What is the purpose of a liquid diet before bariatric surgery?

All patients should start a liquid diet 2 weeks before the date of surgery. Adhering to this diet will not only accelerate weight loss but will also help to reduce the size of the liver, which simplifies surgery and positively affects the effectiveness of treatment.

How to prevent hair loss after surgery?

Take vitamin supplements two weeks before surgery to prevent hair loss and fatigue associated with low nutrient levels. Check your blood iron levels if you are still losing hair seven months after your surgery.

How to support a person after bariatric surgery?

Talk to the person who is receiving the surgery about your concerns in a diplomatic way without judgment or criticism. Encourage other acquaintances or friends to attend follow-up visits after surgery.

What exercise is recommended after undergoing bariatric treatment?

The most optimal low-stress physical activities are swimming, cycling, walking, yoga, dancing, jogging, or aerobics.