Bariatric Surgery is a surgical process to help morbidly obese people lose weight. The idea behind Bariatric surgery is to reduce the overall calorie intake of the body. There are two ways in which we can achieve this:
Induced malnutrition or Malabsorptive surgery: The process involves making changes to the digestive system so that the body can only absorb fewer calories from food.
Stomach volume reduction: The process of reducing the stomach volume so that it can hold low amounts of food.
Bariatric surgeries can leverage one of these methods, or both, to help the patient lose weight. The first-ever metabolic bariatric surgery was performed in 1954 by Dr. A K Kremen. In this surgery, Kremen went with Induced Malnutrition. He bypassed most of the patient’s intestine by connecting the upper part of the small intestine to the lower part of the small intestine.
Much of the nutrition absorption takes place in the middle of the small intestine. This way, the patient’s body can only absorb a few calories from the food they eat. However, Intestinal bypass had major downfalls as the side effects included severe diarrhea, vitamin deficiencies, and kidney stones. Over the last 50 years, bariatric surgeries have evolved, creating new techniques that have significantly reduced the complications associated with them.
Who should undergo Bariatric Surgery?
People gain weight when the body receives more calories than it can burn. Therefore, these additional calories get stored up as fat. In most cases, one can lower body fat with a combination of controlling food intake and exercise.
However, everyone may not be able to follow a strict and healthy lifestyle. Overeating and lack of exercise can quickly build up body fat, and after a certain point, it becomes increasingly hard to lose weight.
Bariatric Surgery is recommended as an option for people with morbid obesity. Morbid obesity can pose a serious threat to a person’s health and well-being. Checking your BMI is a great way to understand your body fat level. When you check your BMI, the number will fall between these ranges, here’s what they mean (for adults above the age of 20).
- BMI of less than 18.5 = Underweight
- BMI 18.5 to 24.9 = Normal weight
- BMI 25 to 29.9 = Overweight
- BMI 30 and 39.9 = Obese
- BMI 40 and above = Extreme obesity
As we discussed, when you are overweight, you can bring down your weight with food control and excursion. However, When your BMI tips beyond 30, it takes a lot of effort and dedication.
There are people whose BMI goes beyond 50, it just cases, bariatric surgery may be the only option because, at this stage, their body weight poses a real threat to their lives.
What are the different types of bariatric surgeries?
IN 2021, there are different variations of bariatric surgeries. Let us look at the most popular bariatric surgeries in the US.
Gastric Bypass Surgery or Roux-en-Y gastric bypass (RYGB): Gastric Bypass surgery is the most popular bariatric surgery performed in the US. Gastric Bypass surgery involves dividing the stomach into a small upper part and a larger lower part. This drastically reduced the volume of the upper part to just 3 ounces. This results in the patient feeling full with just a few bites of food.
Then the surgeon divides the small intestine into two – A larger upper part and a smaller lower part. The upper part of the stomach is then connected to the lower part of the small intestine. The upper part of the small intestine is then connected to the lower part of the small intestine.
Gastric Bypass achieves weight loss by combining the effects of restricting the amount of food that the stomach can hold and lower the number of calories that the body can absorb.
Sleeve Gastrectomy: Sleeve Gastrectomy involves removing around 80% of the stomach volume. Limiting stomach volume makes the patient feel full with less amount of food. With a considerable amount of stomach volume lost, the stomach can only hold a few ounces of food before the patient feels full.
Biliopancreatic Diversion with Duodenal Switch (BPD/DS): In BPD/DS, the surgery first performs a sleeve gastrectomy where a significant amount (about 2/3rds) of stomach volume is removed. The surgeon will then divides the upper part of the small intestine, the duodenum, leaving the pylorus (the valve that drains digested food from the stomach) intact to the stomach.
The duodenum is then connected to the lower part of the small intestine, bypassing the middle portion of the small intestine.
Sleeve Gastrectomy is performed on patients who have a body mass index of over 50. Patients who undergo sleeve gastrectomy must take vitamin and mineral supplements for life.
Mini Gastric Bypass (MGB), now renamed One Anastomosis Gastric Bypass (OAGB): As the name suggests, a Mini Gastric Bypass is a miniature version, a much simpler version of Gastric Bypass Surgery.
In One Anastomosis Gastric Bypass (OAGB) the top part of the stomach is stapled so that the stomach forms a tubular structure like that of ordinary Gastric Bypass surgery. The larger part of the stomach is completely separate from this new tubular structure. In the next step, the thin stomach is connected to the middle portion of the small intestine, creating an Omega loop.
When compared with Gastric Bypass Surgery, Mini Gastric Bypass surgery has only one Anastomosis or connections rather than two.
Is there a better alternative to bariatric surgery?
Innovation is an integral part of the medical industry. Today we have alternatives to surgeries that can provide similar or even better results when compared to bariatric surgery.
ESG or Endoscopic Sleeve Gastroplasty is an excellent example of surgery less bariatric procedure. It achieves the goal of reducing weight by modifying the digestive system without any incisions. Many do not approach bariatric surgeries as they fear the notion of surgery, no matter how critical their health conditions become.
Modern surgery-less bariatric procedures open up a world of possibilities that are safer, faster, and easier to recover. Visit Be Better Bariatrics to know more about Endoscopic Sleeve Gastroplasty and how you can benefit from it.