Obesity surgery

OBESITY SURGERY

Obesity is no longer a symptom and especially morbid obesity is disease and if not tackled will lead to physical, psychological and medical problems.

Indications

BMI more than 32(Asian) with or without medical problems
People who fail to lose weight in spite of best efforts or rapidly gain weight after losing
People who suffer bad quality of life due to obesity related medical problems like Diabetes, Breathlessness (SOB), Knee pains, Hypertension, Sleep apnea, Gall stones and cosmetic reasons etc
Associated procedures like hysterectomy, hernia repair and other procedures can also be under taken during same sitting in eligible patients.

Procedures

All procedures are done laparoscopically (Key Hole) surgery.

Gastric Sleeve resection
Adjustable Gastric Band
Gastric Bypass

Mechanism of action of weight loss procedures

Less food intake, less appetite and early satiety due to reduced stomach capacity and hormonal changes
Decreased hunger hormone called Ghrelin.
Rapid transit of food, insulin sensitization , early rise of GLP and Leptin sensitization
Psychological well being and increased physical activity.

How much weight loss

Weight loss is gradual over period of 6 – 12 months
Weight loss ranges from 50 – 80% of excess weight.
Resolution of diabetes (type 2) occurs in 60 – 80% of persons

Hospitalization and back to work:

1 – 3 days
Most of the people go back to work in one week.

Gastric sleeve resection

Its restrictive, non reversible procedure where major part of gastric pouch is stapled and excised leaving small banana shaped stomach. It’s simple, safe does not have many long terms problems with good weight loss.

Adjustable Gastric Band

Adjustable gastric band applied around proximal stomach with control reservoir placed under skin which can be used to tighten or loosen band to have control on intake of food. It’s quite safe, reversible. Weight loss is less than sleeve or Bypass. Band can sometimes cause erosion or bleeding which requires its removal.

Gastric Bypass

Proximal stomach is stapled to make small pouch of 30cc capacity and small intestine is bypassed by 100 to 150 cm resulting in both restricted calorie intake and malabsorption. Results are good with more weight loss and diabetes control but require more nutritional management. Its standard procedure and can be reversed.

Post operative follow up

Kept nil orally for 24 hours
Initially with liquids in small quantity but frequently, later shifted to thick liquids to soft diet. After 4 weeks allowed taking normal diet.
Food consists of small meals with high protein, less fat and less carbohydrate diet.
Requires multivitamin, iron and calcium supplementation

Benefits of obesity surgery

When everything fails, obesity surgery helps
Helps to lose 50 – 80% of excess weight
50 – 60 % of total resolution of diabetes
50% of resolution of hypertension
Asthma. Breathing problems, knee pains, fatty liver, headaches etc are resolved
Infertility: it improves chances of pregnancy in obese infertile women
Psychological well being

Condition	Improvement
Excess Weight Loss	50-70%
Diabetes (type 2)	60-80%
Hypertension	60%
Sleep Apnea	70-90%
Hypercholestremia	63%
Migraine	57%
Depression	47%
Non Alcoholic Fatty Liver Disease	90%
Metabolic syndrome	80%
Gerd	72%
Osteoarthritis	41%
Urinary Stress Incontinence	44%
Quality of Life	95%

OBESITY SURGERY VIDEO

Obesity or weight loss surgery not only helps to lose weight, but also to regain confidence of individual in himself or herself. The procedures are much simpler than many assume, and you no longer need to hide yourself and can enjoy life and live life the way you want to live. As you are aware everyone has only one life, no one is sure of next life, make most of your life.