The surgical way to a smaller stomach

Last Updated : 07 May 2010, 10:53 IST
Last Updated : 07 May 2010, 10:53 IST

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What is bariatric surgery or obesity surgery?

Bariatric surgery or weight-loss surgery is a type of medical procedure performed on people who are dangerously obese, for the purpose of reducing their weight which translates to longevity of life.

Whom is the surgery for?

The surgery is usually for men who are at least 100 pounds overweight and women who are at least 80 pounds overweight.

Is it a cosmetic procedure?

No. This procedure is designed for weight loss in morbidly obese people to prevent multiple problems that arise due to excess weight. To make people beautiful is not the purpose of surgery.

What are the risks involved?

Any surgical procedure has its own risks. As in any surgery, it has risk of anaesthesia and bleeding. Since the intestines are cut and joined, they may not heal and result in leakage, necessitating re-operation. After the operation one may develop blood clotting in veins in the lower limbs, which can migrate to the heart. In addition to these risks, as majority of obese patients have diabetes, blood pressure and heart disease, there may be complications due to surgical stress. Death may occur only in 0.6 per cent of surgeries. But this is much lower than death rate due to obesity.

Who is considered a suitable candidate for surgery?

Individuals with BMI of 40 or more (more than 45 kg or 100 pounds overweight); or BMI of 35, with serious obesity-related illness such as diabetes, heart disease, sleep apnea, pain in weight-bearing joints interfering with work or lifestyle usually seek surgical intervention. Individuals between 19 years and 65 years with the above symptoms seek medical help.

The procedure can be broadly divided into two categories
* Restrictive
* Mal-absorptive surgeries.

Restrictive surgeries are the ones where we reduce the size of stomach. Mal-absorptive surgeries also have restrictive component but in addition a significant segment of small intestine is kept away from digestive and absorptive function.

Restrictive surgeries commonly practiced are gastric banding and gastric sleeve resection.
Gastric banding is a procedure where a silicon band is put around the upper part of stomach, so that capacity of stomach reduces. This is a simple surgery where less cutting is involved and it is a reversible procedure. But this is expensive and found to have problems in the long-term due to the foreign body nature of the band, which can erode the stomach, migrate or get infected.

Gastric sleeve resection is more popular today. The stomach is cut longitudinally around a tube to reduce the size. We recommend women of childbearing age not to become pregnant for two years after surgery.

Though surgery may seem inevitable in some cases, it is always better to follow a healthy diet and exercise regularly to avoid surgery.

Published 07 May 2010, 10:53 IST

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