Why should I undergo surgery for a problem which can be controlled with change in eating habits & exercise?
Overweight & obesity is an end
result of inherited genes, eating environment & lifestyle changes.
It is true that conventional measures like controlled eating, regular
exercises etc can help in weight loss. However, long term follow up
studies have shown that morbidly obese individuals regain their lost
weight within 1-3 years. Obesity is the cause of many associated
diseases & thus with the weight regain, associated illnesses also
come back.
Who can undergo this surgery?
Guidelines
are laid by International Federation for Surgery of Obesity for patient
selection. The criteria for patients from Asia Pacific Region is as
follows
|
| Height Candidates for Surgery(Kilos/Pounds)* |
| 5’ 79/174 |
| 5’2” 84/185 |
| 5’4” 90/198 |
| 5’6” 95/209 |
| 5’8” 101/223 |
| 5’10” 107/236 |
| 6’ 113/249 |
| *Especially if associated with co-morbid diseases like diabetes, hypertension etc. |
Surgery usually performed between 18-65 years age group in mentally stable, non alcoholic persons.
I need no surgery as I do not have many associated illnesses?Morbidly obese individuals (BMI>40 kg/sqm) are suitable candidates
for surgery irrespective of associated illnesses. If you have tried
various conventional measures & failed to maintain the weight loss,
then bariatric surgery is the only available option for significant,
sustained weight loss.
What is weight loss surgery?
Bariatric surgery is the surgical
intervention, mostly laparoscopic, to help patient lose weight. This
term includes various kinds of abdominal procedures which helps person
eat small quantity of food & feel satiated. Additionally, some
procedures prevent absorption of calorie dense food from intestines.
How much weight is lost on the day of surgery?
No spot weight loss happens. The
person loses 8-20kgs in the 1st month and 4-10 kgs thereafter depending
on initial weight. Weight loss continues for 1 1/2 to 2 years but slows
down gradually
How much weight loss is achievable?
Usually patients lose 50%-90% of excess weight after bariatric surgery. The excess weight is calculated by
(Actual weight – Ideal weight = Excess weight).
So if you are 100 kgs today & your ideal weight should be 65 kgs
then your excess weight is 35 Kgs. After bariatric surgery, it is
possible to lose 20-30 kgs, subject to regular follow up &
compliance.
I am diabetic & have blood pressure problem as well – Can I undergo this surgery?
If you are obese & diabetic & hypertensive, bariatric surgery
is all the more indicated as it resolves type II diabetes in 80%-90%
patients. Similarly, blood pressure is also controlled or resolved in
majority of patients.
It is
necessary that before surgery patient’s blood pressure & blood
sugar levels are brought to optimal level through adequate
pre-operative assessment & treatment.
Is it a cosmetic surgery?
Definitely not. Obesity is a life threatening disease & its
treatment helps in improving Quality of Life(QOL) & increasing life
span. It is also not performed by plastic/cosmetic surgeons.
What happens when I dine out?
You will be required to eat the starters/entree only – as your stomach
capacity is limited. It is advisable to eat slowly & let others eat
2-3 courses of meal. It is also advisable to inform your hosts your
specific requirement to save embarrassment, when you refuse to eat
their well crafted meal.
What about alcohol consumption?
Alcohol is liquid rich in calories. It is not held back by the new
stomach & also does not help in giving feeling of satiety. It
should be avoided esp after a gastric bypass procedure, where it can
give rise to abdominal cramps etc.
Will I have skin hangings over my arm, abdomen etc after weight loss?
Usually not. Skin has enough elasticity to regain shape after weight
loss. However, in some patients if the skin is unable to regain its
tone, cosmetic surgery may be desirable. It is advisable to wait for 2
years after bariatric surgery before making up your mind about cosmetic
procedure.
Can I become pregnant after bariatric surgery?
Usually, possibility of becoming pregnant increases after weight loss.
It is advisable to avoid pregnancy during the first 2 years after
weight loss surgery, but thereafter pregnancy is more safe as blood
pressure, blood sugar levels become normal & the baby’s weight also
is normal.
What about other medication – tablets etc?
Usually, it is possible to consume any size tablet/capsule. If you feel
the tablet is extra large, then you can break them in 2-3 pieces before
consumption.
Are these surgeries reversible?
Yes, technically most of these procedures except sleeve gastrectomy are
reversible, however, it is not advisable to contemplate reversal as
person can regain the lost weight, in addition, of morbidity of 2
surgeries.
Is it possible that I do not lose weight after surgery?
Surgery is an efficient tool to help you lose weight. If you follow
medical & dietary advice, then weight loss is imperative. Failures
do happen if the person defaults on supplement intake & inability
of long term follow up.
Will I be losing appetite or I will not be able to eat even if I am hungry?
Bariatric surgery works on the principal of satiety. Though your hunger
will be normal, you will feel satisfied/satiated with small amount of
food. Even today you eat till you are full. After surgery you will be
able to eat till you are full( with a small amount of food).
A foreign body like band can be rejected by the body?
The band manufacturer claim the band is made of pure silicon
& does not react with the body. The possibility of rejection
is unheard of, & no medication is prescribed, to reduce rejection.
What is the possibility of band slippage/erosion?
Band slippage incidence has reduced with the modified band placement
technique, improved band design & standardization of band
adjustment protocol. Band slippage, if it happens, can be corrected
laparoscopically & may not require removal of band/open surgeries.
Band erosion possibility is also substantially reduced with placement
of band away from gastric wall & gradual & deferred band
adjustment. Even if it happens then the corrective action can be taken
endoscopically / laparoscopically.
Which is the best procedure for me?
The choice of a procedure is taken after taking into consideration
various factors – dietary habits, associated diseases, desired weight
loss, initial weight, ability for follow on, age etc. It is recommended
that the decision be made in joint consultation with the operating
surgeon. The final decision will be of the patient & family.
How do I choose a surgeon?
Various factors should be considered prior to selecting a surgeon, including –
- Experience of surgeon
- Hospital set up
- Safety profile of surgeon
It is important to assess whether surgeon has performed similar
surgeries in past & how many of them had any major complication/s.
The best approach is to ask for few of the patient’s contact details.
Then you can contact them to find the required details.