Will you go under the knife to lose weight?

Published August 31, 2021, 8:35 AM

by Cheshire Que

Everything you need to know about bariatric surgery to treat obesity

Globally, the prevalence of obesity is worrisome. By 2025, The World Obesity Federation predicts the global obesity prevalence to reach 18 percent in male and 21 percent in female populations, respectively. One third of obesity cases around the world come from the US, China, Brazil, India, and Russia.

While the Philippines is not included among the five countries, the Filipinos are nowhere near spared from the threat of this chronic relapsing disease. In fact, the World Obesity Federation gave the country a national obesity risk score of 6 out of 10, indicating moderate risk.

Individuals with obesity have a greater risk of mortality, gallbladder problems, osteoarthritis, sleep apnea, cancer, coronary heart disease, diabetes, stroke, high blood pressure, and elevated values for cholesterol, blood glucose, triglycerides. In addition, obesity decreases one’s quality of life. It also affects the mental and emotional health, as well as causes aches and pains all over the body.

Obesity is caused by many factors—mainly an imbalance of energy intake and output. Simply put, if you consume more calories from food than what you expend through physical activity and overall energy production by the body, you gain weight.

The next culprit comes from environmental factors. We live in an obesogenic society, an environment that favors us to gain weight if we do not take control of our lifestyle. Food portions are larger compared to three decades ago. Technological advances and time pressures favor a sedentary lifestyle.

Genetics also play a role in increasing an individual’s risk for obesity but never use your genes as an excuse to just accept your fate and not lift a finger to prevent it from happening. You can choose a healthier lifestyle in order to help you achieve and maintain a healthy weight range. After all, not everyone who has cancer genes end up getting cancer. You won’t get obese overnight just because you unfortunately inherited a higher amount of fat cells from your ancestors.

A proper diet and regular physical activity will be the topmost intervention to combat obesity. There are just instances, however, when these natural ways are not enough to make a person lose weight efficiently to decrease adverse effects of obesity on their health.

Individuals with obesity have a greater risk of mortality, gallbladder problems, osteoarthritis, sleep apnea, cancer, coronary heart disease, diabetes, stroke, high blood pressure, and elevated values for cholesterol, blood glucose, triglycerides.

The National Institutes of Health (NIH) set criteria for individuals who can undergo bariatric surgery to treat obesity. Bariatric surgery involves the manipulation of digestive system to achieve weight loss. This procedure, however, is not for everyone who simply have the desire to lose weight. The NIH criterion is appropriate for patients with a body mass index (BMI) of 40 and above or patients with BMI 35 who have comorbidities or existing medical conditions.

There are various types of bariatric and weight loss surgeries but these are the most common.

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Laparoscopic Adjustable Gastric Banding requires the placement of a foreign device (adjustable band) at the top part of the stomach to create a very small stomach pouch. The patient will now have a smaller reservoir for food thus decreasing overall food intake to facilitate weight loss. A port is placed under the skin to serve as needle insertion site where the doctor can adjust the band accordingly. Strict adherence to diet is crucial to prevent enlargement of esophagus from overeating and Gastroesophageal Reflux (GERD) also known as acid reflux.

Sleeve Gastrectomy is the most popular type. About 80 percent of the stomach is removed, leaving only a small portion with tubelike structure. This type of surgery will not only reduce the amount of food intake due to stomach size. It also decreases the production of appetite-enhancing hormone ghrelin resulting in a significantly lessened desire to eat. Complications such as obstructions, low blood sugar, malnutrition, nutrient deficiencies, GERD, hernia, and vomiting may occur.

Roux-en-Y Gastric Bypass results in greater weight loss and better comorbidity outcomes compared to the two other types. It has, however, a higher risk for obstruction, adhesions, and ulcers. It can also make GERD worse. This procedure bypasses most of the stomach and first section of the intestine leading to a complication called Dumping Syndrome.

Dumping Syndrome is caused by the rapid “dumping” or deposition of undigested food into the intestine. A patient will experience palpitation, faintness, sweating, hunger, tremors, nausea, cramping, abdominal pain, dizziness, and diarrhea right after eating.

Post-surgery, a patient will be given fluids as sustenance. Hydration is a priority. Diet will progress from clear to full liquid from day two to 14. Soft and blended food from protein sources, well-cooked vegetables, and soft fruits will be introduced by the third week. On the fourth week, the patient can be given some complex carbohydrates and solid food as tolerated.

Bariatric surgery is promising for long-term obesity treatment but it also comes with a lot of sacrifice on the patient’s part initially. Will you consider going under the knife? Consult your doctor regarding your options if you are struggling with obesity.

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