Bariatric surgery: the whole truth
Bariatric surgery is a type of surgical procedure that can help weight loss in people with severe obesity and indirectly reduce body fat. Such surgical interventions are performed on the stomach and within the small intestine: as a result, the amount of food intake or absorption of nutrients decreases, which ultimately leads to a decrease in body weight. However, bariatric surgery affects not only the function of the gastrointestinal tract – their action is more global: virtually all types of weight reduction operations are aimed at restoring metabolism, that is – the normalization of metabolism.
Nevertheless, despite the seeming simplicity of this method of treating obesity, bariatric surgeries are overgrown with myths and misconceptions: from surgery for weight loss, they are expected to be magically transformed, then, on the contrary, they are accused of terrible consequences. Let us, step by step, find out the truth about bariatric operations.
The principle of bariatric operations
Bariatric surgery stimulates weight loss by limiting the amount of food that enters the stomach (after the operation it decreases its volume), as well as by interfering with the small intestine, resulting in impaired absorption of nutrients (in medicine this is called malabsorption). Sometimes a combination of these two principles can be used – reducing the volume of the stomach and limiting and removing part of the small intestine. Anyway, after surgical interventions, this type of organism receives fewer calories, which leads to systematic and long-term weight loss. Bariatric surgery also often leads to hormonal changes, which after a while normalize the metabolism – and it is in obese people in almost 100% of cases is broken. Besides
However, the most important thing is that the change in the route of the nutrient flow provokes positive changes in the activity of the intestinal hormones, in particular, ghrelin and leptin. These local hormones contribute to the formation of a sense of satiety (feelings of the fullness of the stomach), help to suppress hunger, and reverse one of the main mechanisms by which overweight and obesity induce the development of the metabolic syndrome, and later – and type 2 diabetes.
Types of bariatric operations
The most common techniques that are used in the framework of bariatric surgery are gastric banding, stomach plication, gastric bypass surgery with gastro jejunoanastomosis, laparoscopic gastrectomy (gastrectomy), gastric resection and biliopancreatic diversion with duodenal ulceration. Each of the types of bariatric operations has its advantages and disadvantages.
The “golden standard” of bariatric surgery is gastric bypass surgery with gastrojejunoanastomosis – this is the most studied and demanded type of weight loss operations. For today, gastric bypass surgery is the most commonly performed bariatric surgery in the world.
Benefits of bariatric surgery
- Bariatric surgery guarantees significant and long-term results – weight loss after such interventions can be from 60 to 80% of excess weight (depending on the type of surgery and individual characteristics of the patient). So, in some cases, a person loses up to 50% of the total body weight.
- To date, most of the patriotic operations are performed using minimally invasive methods (laparoscopic techniques), and this, of course, also should be attributed to their advantages.
- Bariatric surgery not only limits the amount of food consumed – due to the normalization of metabolism, but they can also create conditions in the patient’s body that increase energy consumption.
- Stimulate favorable changes in the activity of hormones in the intestines, which ultimately reduces appetite and provides an earlier onset of a feeling of satiety.
Disadvantages of bariatric surgery
- Technically, these are more complex procedures that can potentially lead to higher risks of complications, ranging from infections to severe gastroenterological and metabolic disorders. Therefore, it is extremely important to seriously approach the choice of a surgeon and a clinic for a weight loss operation. By the way, conscientious experts do not undertake to carry out bariatric operations without evidence. That is, if a person is diagnosed with obesity, he should choose alternative weight loss methods: diet and exercise.
- Among the most common potential risks of bariatric surgery are vitamin-mineral deficiencies, in particular, vitamin B12 deficiency. Also in the long term, iron, calcium, and folic acid may be deficient. Vitamin-mineral deficiencies can develop not immediately, but after a while, so often patients do not notice such complications, exacerbating the lack of nutrients.
- The disadvantages of weight loss surgery can be attributed to staying in the hospital, the length of hospitalization depends on the type of operation, while after surgery on the small intestine it is the longest.
- After such procedures, strict and lifelong observance of fairly strict dietary recommendations, regular intake of vitamins and mineral supplements is required.
Bariatric operations: myths and reality
Myth 1. Most people who have done a bariatric surgery, after a while, return their excess weight. True. According to statistics, up to 50% of patients undergoing different types of bariatric surgeries gain weight after a year or two, but this is a small indicator (about 5% of the total body weight). However, most such patients are able to maintain weight loss results in the long term and maintain an improvement in the quality of life. In any case, a significant and sustained weight loss after “slimming surgery” is in sharp contrast to the effect of most non-surgical treatments.
Myth 2. The risk of dying from metabolic abnormalities after bariatric surgery is higher than the risk of dying from the effects of obesity. True. As the body weight increases, the life expectancy decreases – this is medical statistics. People with severe obesity suffer from many life-threatening pathologies that significantly increase the risk of premature death. Among them – diabetes mellitus type 2, hypertension, etc. At the same time, despite the poor health of patients with obesity before surgery, the likelihood of dying after surgery is very low. The advantages of bariatric surgery far outweigh the risks. Associated with excess body weight.
Myth 3. “Slimming Surgery” is an excuse for lazy people: to lose weight and support, people suffering from severe obesity simply have to adhere to a strict diet and follow a program of physical exercises. Really. People suffering from severe obesity tend to be resistant to long-term weight loss, which with normal body weight is achieved through diet and exercise. Bariatric surgery is much more effective in maintaining long-term weight loss, in part because they help to normalize the metabolism, which is significantly impaired in obese people. Diets, as a rule, negatively affect metabolism (for example, many people have the effect of “yo-yo”). It is worth recalling that this is not about people with normal BMI: “slimming surgery” is only indicated for obesity.
Myth 4. Many of the patients become alcoholics after bariatric surgery. Really. In fact, some of the patients confess that they have problems with alcohol after the operation – but they are few. Most of them abused alcohol at some time and before the operation. At the same time, the susceptibility to ethanol really increases after the surgical treatment of obesity – especially if alcohol is consumed during a period of rapid weight loss. Therefore, such patients are advised to avoid drinking alcoholic beverages, at least during a rapid reduction in body weight: during this period even small doses of alcohol cause intoxication.