Weight Loss Surgery: What is Bariatric Surgery, How Does it Help in Reducing Weight, And Is it Safe?

Bariatric surgery refers to a gamut of weight-loss surgeries often recommended to people suffering from chronic obesity and obesity-related health problems such as diabetes, hypertension.

For most people losing weight is a herculean task. Even today, a lot of people think that obesity is just a cosmetic issue. But people who are obese or overweight are at risk of various ailments such as type 2 diabetes mellitus, high blood pressure, high cholesterol, joint pains, cardiovascular diseases, obstructive sleep apnoea, breathing problems, fatty liver disease, gall bladder disease, stroke, osteoarthritis, PCOD, infertility, gout and so on.

Most people go through a cycle of weight loss and weight gain for many years before they contemplate bariatric surgery. Bariatric surgery is the only effective option that leads to sustained weight loss in patients who suffer from morbid obesity.

“Unfortunately, today obesity has reached epidemic levels. It is a silent killer and more people are dying of obesity and related diseases than any other non-communicable disease. When it comes to treatment, there are many myths and it is important to understand that just like any other disease, obesity needs to be treated according to the stage and severity of the disease,” says Dr Aparna Govil Bhasker, Laparoscopic and bariatric surgeon, Saifee Hospital, Apollo Spectra, Namaha and Currae Hospitals, Mumbai.

What is Bariatric Surgery? 

Bariatric surgery refers to a gamut of weight-loss surgeries often recommended to people suffering from chronic obesity and obesity-related health problems such as diabetes, hypertension, high cholesterol level, and sleep apnea.

There are many kinds of weight loss operations such as sleeve gastrectomy, gastric bypass operations, banded weight loss procedures, and so on. When combined with diet and lifestyle modification these can help you provide a much more sustained long-term weight loss. But is it safe?

Recently, director and choreographer Remo D’Souza’s wife Lizelle D’Souza recently spoke about her weight loss journey and bariatric surgery. “I have a target to lose another 10 kilos by December, post that, I plan to go for a tummy tuck and Remo is supporting me, my kids are supporting me,” Lizelle told Times of India.

Bariatric surgery for weight loss

“Bariatric surgery leads to weight loss through multiple mechanisms. Restriction of food intake, a feeling of fullness after smaller meals, reduced appetite, mal-absorption of nutrients, hormonal changes, changes in the gut bacteria etc is some of the mechanisms that will help you to cut down on those excess kilos, ” says Dr. Aparna Govil Bhasker, Bariatric & Laparoscopic Surgeon, Saifee, Apollo Spectra, Namaha and Currae Hospitals, Mumbai.

Your bariatric surgeon will recommend the most suitable operation for you after a clinical evaluation. Undergoing bariatric surgery will slash down your risk of fatal conditions like stroke and heart disease, sleep apnoea, type 2 diabetes, high blood pressure, and non-alcoholic fatty liver disease (NAFLD). It also leads to improvement in joint pains, gout, PCOS, infertility and decreases the risk of many cancers associated with obesity.

Who should opt for it?

As per the guidelines of the Obesity and Metabolic Surgery Society of India (OSSI) an individual with a BMI ≥ of 35 Kg/m2 is eligible for bariatric surgery.

• An individual with a BMI ≥ of 30 Kg/m2 is also eligible for bariatric/metabolic surgery in the presence of two associated diseases such as type 2 diabetes, high blood pressure, high cholesterol, etc.
• Eligibility for bariatric/metabolic surgery is assessed after a complete clinical evaluation by the bariatric surgery team.

How you must prepare for a weight loss surgery

• After your clinical assessment, you will be advised to undergo medical investigations and your medical fitness will be assessed by concerned specialists.
• You will be asked to adhere to a few vital instructions related to diet prior to your surgery. This may be for 7 to 15 days depending on your clinical profile and weight.
• You will be asked to avoid foods rich in carbohydrates and encouraged to take foods rich in protein. Sugars are best avoided. Smoking and alcohol intake must be stopped prior to surgery.
• If your tests reveal any nutritional deficiencies for vitamins, iron, or calcium, supplementation for the same will be started prior to surgery.
• It is also very important to clear all your doubts and be stress-free before the operation. Hence the more rounds of consultation you have with your bariatric surgery team, the better it is.

What to expect after bariatric surgery?

• Once you undergo bariatric surgery then you will be fasting for 24 hours. During this period you will be kept on intravenous fluids.
• You will be on liquids for the first 15 days after the surgery. In stage 2 you will be on pureed foods for another 2 weeks. It is advisable to chew your food well, eat slowly and in small portions. Eating too fast or in large portions may lead to pain in the chest or vomiting in some cases.
• After a month, you will be started on a normal diet. However, it will be very restricted in portion size. You will be able to eat only 3 or 4 portions at one go. You will need to eat very slowly and will need to give at least 30 mins to every meal. It is also recommended to eat something every 2 to 3 hours as you will not be able to eat much at one go.
• It is advisable to avoid foods high in sugar and carbohydrates. Avoid fried foods and junk food right from the beginning. As time passes by you will be able to eat more quantities and if you continue to eat the wrong kind of foods, then you may start regaining weight. Focus on high protein food like chicken, eggs, meat and paneer, tofu and sprouts etc if you are a vegetarian,
• You must opt for low-impact exercises like walking, yoga, stretching, and swimming after 2 to 3 months of surgery. After 6 months, slowly you may resume strength training, cardio workouts and weight training. It is important to exercise as it helps to tone up and minimizes skin sagging after weight loss.

Bariatric/metabolic surgery is life-changing surgery. It transforms a person beautifully. However, individuals who embrace lifestyle modification and a healthy diet after their surgery, get better results and maintain their weight loss for a much longer period, according to Dr. Bhasker.

Unfortunately, today obesity has reached epidemic levels. It is a silent killer and more people are dying of obesity and related diseases than any other non-communicable disease.