Explained: All You Need To Know About Bariatric Surgery And How Can It Lower Your Risk of Life-Threatening Diseases

Bariatric surgery can be a life-saving treatment option for people who are suffering from obesity-induced comorbidities. Obesity impacts more than 135 million people in India. It is calculated by using the Body Mass Index (BMI), dividing the weight in kilograms by height in meters square gives a number. If this number falls between 18-22, it denotes a healthy weight.

Anything less than that is considered underweight, and anything more is considered overweight. Above 30 signifies obesity, which is a critical condition that requires attention because of the many diseases it leads to.

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Bariatric surgery helps by changing the food breakdown process during digestion, which results in a reduction in calories and nutrients absorbed. The surgery can help with appetite and hunger cravings. Over time, this results in significant weight loss and a reduced risk of developing critical diseases. Bariatric surgery helps to reduce almost 70-90 % of the excess body weight.

How bariatric surgery helps overcome diseases

1. Reduce hypertension

In an obese person, the increased body mass puts excessive pressure on the heart to pump faster for the blood to reach all parts of the body. The body also requires more production of blood rich in oxygen and nutrients to maintain the same levels of bodily function, which in turn increases the blood pressure in the body. All of these changes can be difficult for the heart to handle and may have a permanent impact on its functioning. Bariatric surgery helps by reducing weight and lowering the pressure that falls on the heart. Psychologically, with reduced weight, patients feel more motivated and stress-free in their daily lives, leading to lowered blood pressure.

2. Helps in managing type 2 diabetes

Bariatric surgery helps with the chronic condition of type 2 diabetes, in which the excess weight in the body creates insulin resistance in the cells, resulting in early onset of diabetes and poor glycemic control. With bariatric surgery, it is possible to resolve or reverse diabetes in most patients. It brings a significant improvement in poorly controlled diabetics on high insulin dosage.

3. Prevents stroke and heart attack

It has been clearly noticed that the increased risk of stroke is directly proportional to increased weight. With bariatric surgery, complications of obesity including high blood pressure, cholesterol, blood sugar levels, atrial fibrillation, and sleep apnea can be controlled, and the progression to a state of stroke and heart disease can be prevented.

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4. Manages depression

Weight loss due to bariatric surgery can serve as a big motivation for the individual to continue the weight loss journey and fight obesity-induced body image issues.

5. Avoid the risk of kidney failure

Comorbidities like diabetes and hypertension affect kidney function. When this impact is not reduced or treated, it can develop into chronic kidney failure. Bariatric surgery prevents reaching that condition and helps promote good kidney function.

6. Prevents progression of fatty liver to liver failure

Obesity results in fat deposition in liver cells resulting in fatty liver. The progression of this condition to cirrhosis and liver failure is prevented and reversed after weight loss due to Bariatric procedure.

Bariatric surgery also improves PCOD and fertility in female patients. It improves arthritis, joiint pain and back pain. It significantly improves sleep apnoea condition in patients who are extremely obese

People have a few misconceptions about bariatric surgery. They believe that it removes excess flesh surgically, leading to almost instant weight loss, that it is to be used as the last treatment option, or that it is the easy way out of a weight loss journey. These myths are untrue, as bariatric surgery can be a great long-term solution to weight gain when combined with a healthy lifestyle and has a good success rate.

Bariatric surgery is not for everyone and is most preferred for people who are not able to lose weight with diet and exercise and are suffering from comorbidities that may risk their lives. To come to a well-informed decision about undergoing bariatric surgery, one must get a proper diagnosis done by their medical consultant. Earlier, only people who had a BMI over 40 or a BMI over 35 with comorbidities were allowed to get bariatric surgery. With the new guidelines, this cut off value has been modified to 37.5 or 32.5 with comorbidities.

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Here are some checkpoints to consider before deciding whether to get bariatric surgery or not:

1. The individual has a BMI of over 35

2. Other alternatives for weight loss have failed due to medical reasons

3. The lost weight keeps coming back again and again

4. There is a presence of critical comorbidity in the body that is progressively getting worse

If a person checks one or more of the above-mentioned points, then they may consider getting bariatric surgery.

The surgery although is not risk-free as these patient are usually high risk candidates for anaesthesia because of the multiple comorbidities they have. So patient¡¯s need proper pre-operative evaluation, counselling and care in tertiary care centres with dedicated team of Bariatric surgeon, dietician , anaesthetist and ICU care. Post operatively, regular follow up is recommended to achieve and maintain good desired weight loss and avoid long term nutritional issues.

About the author: Dr. Arun Bhardwaj is a Consultant Minimal Access and Bariatric Surgery, HCMCT Manipal Hospitals, Dwarka. All views/opinions expressed in the article are of the author.