Bariatric surgery and obesity: Everything you need to know

by Dr Vidhya Sharada Bhat

Bariatric surgery refers to surgeries that help in losing weight. It’s done in morbid obesity. Obesity is a medical condition in which there is an excess accumulation of fat in our bodies. It’s a very common condition which we see around us but to categorically tell whether a person is obese or not we need to calculate something called BMI which stands for Body mass index. BMI is calculated by weight in kilograms divided by height in meters square.

If this value is more than 40kg/m2 or >35kg/m2 with the obesity-related comorbid condition then he or she becomes a candidate for bariatric surgery. There are various medical conditions associated with obesity like hypertension, Myocardial infarction, Diabetes (Insulin resistance), Hypothyroidism, PCOS, joint pains and arthritis, Obstructive sleep apnea syndrome, GERD and finally last but not the least obesity is associated with social discrimination leading to depression. So when once weight cannot be reduced by diet or exercise surgery plays a role.

The bariatric procedure requires a multidisciplinary team which includes Surgeon, nutritionist, Anaesthesiologist, Psychiatrist, Psychologist and medical specialist. A thorough preoperative evaluation and counseling of the patient have to be done. The patient and the family have to be educated regarding preoperative, operative and postoperative care.

There are different types of bariatric surgery like LAPAROSCOPIC SLEEVE GASTRECTOMY (SLEEVE OPERATION), Mini Gastric bypass, RY Gastric bypass, BANDED SLEEVE GASTRECTOMY, Biliopancreatic diversion etc. These surgeries can either decrease the quantity of food intake or decrease the absorptive capacity of the bowel.

It is a completely safe surgical procedure following which there is gradual weight loss and also improvement in the cardiovascular and other disorders associated with it like REDUCING BLOOD PRESSURE, CURE DIABETES, CURE SLEEP APNEA, LOSE BELLY FAT etc. Bariatric procedures also help in CONTROLLING SUGARS IN DIABETIC PATIENTS. These surgeries are done Laparoscopically and are completely safe. The post-surgery patient will be educated regarding the dietary changes which have to be done. The patient usually gets discharged in 3-4 days. Post-surgery weight loss has to be documented.

Over time, some people regain weight despite bariatric surgery. Some eat high-calorie or high-fat foods instead of healthy foods — and eat them too often. Some people rely on “soft meals” such as ice cream and milkshakes. The body itself may change over time, too, leading to weight gain. The digestive tract might begin absorbing more calories. Even the size of your surgical stomach can gradually expand over time. To keep the weight off, you need to work at it. Here are some tips such as eating very small meals, making nutrition a priority, exercise regularly. After gastric bypass surgery, most people can expect to lose between 66% and 80% of their extra body weight. Most of this is lost within the first two years.

After some weight loss surgery, the body has difficulty absorbing certain important nutrients, including Iron, Vitamin B-12, Folate, Calcium, and Vitamin D. However, taking a daily multivitamin, plus other supplements can prevent or reduce these deficiencies.

(The author is a Consultant in Surgical Gastroenterology Department, KMC Hospital, Mangalore. Views expressed are personal and do not reflect the official position or policy of


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