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Obesity / Bariatric Surgery

What is Obesity and how does BMI Calculator is one of the trusted indicators ?
Obesity is state when “Excessive fat gets accumulated in the body to the extent that health and well being are adversely affected and puts life at possible risks”.
• People are considered obese when their body mass index (BMI) exceeds 27.5 kg/m2.
• As per BMI index it is a stage prior to morbid obesity i.e. advancing towards high risk.
• Overweight, obesity and morbid obesity are the fifth leading health risk for global deaths. At least 2.8 million adults die each year as a result of being overweight or obese.
• In addition, according to WHO, 44% of the diabetics, 23% of the ischaemic heart disease and between 7% and 41% of certain cancer are attributable to overweight and obesity.

What is Obesity/weight loss surgery?
• Obesity can be treated both medically and surgically. Medical treatments for obesity are quite time taking and difficult as the amount of weight loss is small and patients gain back most of the weight within no time.
• Surgeries designed to deal with weight loss in patients who are severely overweight and obese are called obesity and weight loss surgeries.
• Post surgery it is imperative to have controlled diet regimen and healthy lifestyle should be followed for best results.

Types of Obesity Surgery
There are several types of restrictive, malabsorptive and combined procedures that can lead to sustained weight loss. Each one has its own benefits and risks. The top three procedures are:

Gastric Banding
A band is placed around the upper part of stomach to create a small pouch to hold food. The band limits the amount of food that the person eats by giving a feeling of fullness after eating small portions of food.

Gastric Bypass
It is a procedure which is both restrictive and malabsorptive. In this procedure a small pouch is created by using specially designed staplers.

Sleeve Gastrectomy
This is a restrictive procedure in which the stomach is stapled in such a way so as to create a long narrow sleeve.

Gastric Banding
• Gastric Banding is also known as the LAP-BAND procedure.
• In this procedure, a hollow band made of silicone rubber is placed around the stomach near its upper end, creating a small pouch and a narrow passage into the rest of the stomach.
• The band is then inflated with a salt solution through a tube that connects the band to an access port placed under the skin. It can be tightened or loosened over time to change the size of the passage by increasing or decreasing the amount of salt solution.

Benefits of Gastric Banding
• Simple and safe procedure
• Recovery period is short
• Rate of major complications that have been reported is low
• Does not require removal of any part of the stomach or intestines
• The natural anatomy of the abdominal region remains unchanged
• The width of the band can be adjusted from time to time
• The band can be removed any time if the patient desires
• Risks associated with Gastric Banding
• Minimal risks include about 5% chances of failure due to the following:
» Band erosion/migration
» Deep infection
• Patient’s inability to maintain proper dietary restriction and regular follow up

Gastric Bypass
• This is the most common and successful combined procedure for weight loss surgery.
• In this procedure, the surgeon creates a small stomach pouch to restrict food intake.
• Then a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach, the duodenum (the first segment of the small intestine), and the first portion of the jejunum (the second segment of the small intestine). This reduces the amount of calories and nutrients the body absorbs.

Benefits of Gastric Bypass
• Effectively controls food intake thus leads to rapid weight loss
• Controls the urge to take sweet foods
• It can be reversed in case of any medical emergencies but should be considered as a permanent weight loss surgery

Risks associated with Gastric Bypass
• Leak of staple line
• Hemorrhage
• Ulcers
• Blockage or undesired narrowing of the stoma
• Vomiting in case food is not properly chewed or is eaten too quickly
• Person can re-gain weight if dietary changes are not followed for a long time.

Sleeve Gastrectomy
• Sleeve Gastrectomy is also called vertical Sleeve Gastrectomy, Greater Curvature Gastrectomy, Parietal Gastrectomy, Gastric Reduction and even Vertical Gastroplasty.
• The size of the stomach is reduced to about 25% of its original size, by surgical removal of a large portion of stomach, creating a narrow sleeve or tube like structure

Benefits of Sleeve Gastrectomy
• Eliminates the portion of the stomach that produces the hormones that stimulates hunger (Ghrelin).
• No dumping syndrome because the pylorus is preserved.
• Minimizes the chance of an ulcer occurring.
• Very effective as a first stage procedure for high BMI patients (BMI >55 kg/m2).
• Ideal for people who are also suffering from Crohn’s disease and numerous other conditions that make them too high risk for intestinal bypass procedures.
• Risks associated with Sleeve Gastrectomy
• Patients with higher BMI may still need to have a second stage procedure at a later stage to help lose all of their excess weight. However, this is an active point of discussion for bariatric surgeons.
• Soft calories from ice cream, milk shakes, etc., can be absorbed and may slow weight loss.
• This procedure does involve stomach stapling and therefore leaks and other complications related to stapling may occur.
• Since the procedure involves stapling, it is an irreversible procedure

Cost of Obesity Surgery
Obesity surgery or Bariatric (Obesity) Surgery is a highly personalized treatment procedure. The cost of surgery depends on the patient condition; type of weight loss surgery performed and post operative recovery. An estimate can be given once the patients shares the medical history and current BMI parameters.