Surgery for Weight Loss (Obesity Surgery)

Frustrated with repeated failures in your weight loss endeavors- be it exercising, dieting, popping weight loss pills or experimenting with alternative medications? Weight loss Surgery can definitely be your savior, as is the case with the teeming obese milieu looking up to Obesity Surgery as the Last Resort, the only long-term option.

Critical cases of obesity can be ultra-chronic, causing you untold dilemma, as it can be a precursor to series of serious health problems. When all the traditional and current happening drugs fail you, leaving you high and dry, weight loss surgery can help by either restricting your food intake or disrupting your digestive process. A body mass index (BMI) over 40 may be an indication of a serious case of obesity that calls for surgery. Weight loss surgery may also be an option for a person with body mass index between 35 & 50, if he has acute heart related problems or diabetes.

Is Weight Loss Surgery for you?

Weight loss surgery may be your last option in your crusade against obesity; but remember, weight loss surgery may not turn out to be the healthiest way of losing weight.

You need a reality check before you consider yourself qualified for weight loss or obesity surgery.

Try answering some questions yourself before you take up the serious business of surgical weight loss:

• Are you a serious case of obesity with BMI of 40 or more?
• Do you have any critical cardiovascular problem, like sleep apnea, hypertension, with a BMI ranging anywhere from 35 to 39.9?
• Have all the traditional methods of weight loss like dieting, physical activities or drug therapy failed you time and again?
• Are you thorough with the entire procedure, risks, complications and effects of the surgery like dietary restrictions or occasional failures?
• Is your obesity a matter of grave concern, impairing the quality of your daily existence?
• Can you withstand the level of commitment and motivation required for the grind of surgical weight loss?
• Are you ready for the lifelong medical follow-up post-surgery?

Life after Surgery:

Lifestyle Adjustments: Lifelong use of nutritional supplements such as multivitamins, vitamin B12, vitamin D and calcium is necessary.

Surgical Follow-up: Physical, nutritional and metabolic counseling are needed to prevent nutritional deficiencies.

How does Surgery help Weight Loss?

The whole concept of weight loss surgery happened perchance in the course of surgical operations to remove cancer or severe ulcers. Patients rarely managed to achieve their pre-surgery BMI after certain parts of the stomach or small intestine are removed, giving light to a completely novel technique to combat obesity.

The new age weight loss gurus employ methods to attain weight loss by limiting the intake capacity of the stomach as well as by diminishing the calorie and nutrient absorption of the small intestine.

Surgery can help weight loss by:

• Restricting or decreasing the intake of food by removing or closing parts of the stomach thereby limiting the amount of food the stomach can hold. It can also delay the normal emptying of the stomach.
• Malabsorption or effecting poor digestion of food, as the food bypasses the duodenum and some jejunum, with a direct connection from the stomach to a lower segment of the small intestine.

Gearing Up for Weight Loss Surgery: Weight loss surgery is all about staying healthy like other major surgeries; it's not about making a fashion statement. Weight loss surgery definitely calls for intense mental preparedness to be successful. Comprehending the risk factors, potential benefits, and lifestyle changes post-weight loss surgery is highly called for, not bypassing or forgetting the doctor’s instructions.

Here are some simple strategies that can help your mentally ready:

• get a thorough knowledge of the entire surgical process
• converse with people who have gone through the grind (weight loss surgery)
• get emotional support from near and dear ones
• have only clear liquid diets 12 to 24 hours before surgery
• give up smoking at least a month before surgery
• take your doctor's advice if you are under medication for other health problems

Types of Weight Loss Surgery:Weight loss or obesity surgery can be broadly classified into: 1) restrictive and 2) combined restrictive and malabsorptive.  Many ways, generally called operative procedures have been developed. The surgeries and operative procedures are different from each other, with their own risks and side effects. Only your doctor can decide what is best taking your obesity in account.

1) Restrictive Weight Loss Surgery:Restrictive Surgery performs the weight loss function by restricting the intake of food in the stomach using bands or staples to create a small pouch (stomach pouch) which is surgically placed at the upper part of the stomach. The lower part of the stomach pouch has a tiny outlet, making the food stay longer in the stomach and giving you a feeling of being full.

Operative Procedures:

Vertical Banded Gastroplasty (VBG) - is generally referred to as "pure" restrictive surgery as it only involves the surgical creation of a stomach pouch using bands and staples.

Laparoscopic Gastric Banding (Lap-Band) - is a less invasive alternative of surgery approved by the FDA in June 2001 where smaller incisions are made to apply the band. In Gastric Banding, inflatable bands that can be adjusted over time are used to create the stomach pouch.

2) Combined Restrictive Malabsorptive surgery: - is an amalgamation of restrictive surgery (stomach pouch) with bypass (malabsorptive surgery). It involves connecting the stomach to the jejunum or ileum of the small intestine, bypassing the duodenum.

Operative Procedures:

Roux-en-Y Gastric Bypass (RGB) - is the most commonly performed gastric bypass procedure where a direct Y- shaped connection is made from the stomach pouch (for restrictive surgery) to the ileum or jejunum for malabsorption. The length of the bypassed segment of the small intestine is directly proportional to the amount of weight loss. Gastric bypass with an extensive segment of small bowel bypassed is termed "Long Limb Gastric Bypass."

Biliopancreatic Diversion (BPD) - is the most complex and complicated among the current crops of procedures for weight loss surgery, as it involves the removal of a portion of the stomach. The remaining part of the stomach is connected to the ileum for malabsorption. It is generally recommended for obese people with BMI of 50 or more.

3) Other Procedures: Restrictive and gastric bypass weight loss surgeries are safe and effective in the long-term.

Here is a list of some weight loss surgery procedures that are not recommended generally:

Intestinal Bypass: was a common practice that involved bypassing or reducing parts of the small intestine.

Jaw Wiring - is an effective short-term procedure of food intake reduction for weight loss in patients without respiratory problems.

Liposuction - is the most popular and frequent cosmetic operation for weight loss in the United States, where fat tissue (relatively small amounts) is removed, resulting in very little weight loss.

Know Risks & Benefits of Weight Loss Surgery:

Weight loss surgery is a serious undertaking. Every individual willing to undergo obesity surgery should evaluate his cardiovascular or endocrine systems. A careful psychological assessment should make sure that the person is not led by overriding motivation for self-image or self-esteem as a result of the weight loss surgery. Along with nutritional counseling, you need to consider the following benefits and risks of weight loss surgery;

• You would lose weight at a rapid pace and would continue to do so for up to 18 to 20 months after the procedure.
• The surgery may help you get rid of your other obesity related problems. Your diabetes may become normal as the surgery can lower your blood sugar level.

Risks and side effects: (edit)

• A common risk of restrictive operations is vomiting caused by the small stomach being overly stretched by food particles that have not been chewed well.
• Gastric bypass operations also may cause "dumping syndrome," whereby stomach contents move too rapidly through the small intestine. Symptoms include nausea, weakness, sweating, faintness, and, occasionally, diarrhea after eating, as well as the inability to eat sweets without becoming so weak and sweaty that the patient must lie down until the symptoms pass.
• The more extensive the bypass operation, the greater is the risk for complications and nutritional deficiencies. Patients with extensive bypasses of the normal digestive process require not only close monitoring, but also life-long use of special foods and medications.
• Ten to 20 percent of patients who have weight-loss operations require follow-up operations to correct complications. Abdominal hernias (ruptures) are the most common complications requiring follow-up surgery. Less common complications include breakdown of the staple line and stretched stomach outlets.
• More than one-third of obese patients who have gastric surgery develop gallstones. Gallstones are clumps of cholesterol and other matter that form in the gallbladder. During rapid or substantial weight loss a person's risk of developing gallstones is increased. Gallstones can be prevented with supplemental bile salts taken for the first 6 months after surgery.
• Nearly 30 percent of patients who have weight-loss surgery develop nutritional deficiencies such as anemia, osteoporosis, and metabolic bone disease. These deficiencies can be avoided if vitamin and mineral intakes are maintained.
• Women of childbearing age should avoid pregnancy until their weight becomes stable because rapid weight loss and nutritional deficiencies can harm a developing fetus.
• Common side effects/discomforts include: nausea, vomiting, bloating, diarrhea, excessive sweating, increased gas and dizziness.