Wednesday, June 26, 2013

Opting for Bariatric surgery ??

This question has been posted to me by many of my clients. Bariatric Surgery (BS) should be in my opinion, the last in the list of options in the treatment plan for obesity. As a weight management specialist my advice would be to first rule out a metabolic cause that may be related to obesity and treat it under medical supervision.

Next make lifestyle modifications, adopt a regimen of regular physical exercise and eat a healthy nutritious diet. This approach is minus
shortcuts but will result in not just weight loss but also improved cardio vascular functioning, improved lung efficiency, stronger bones, increased lean body mass (muscle mass) , improved absorption & utilization of nutrients  and numerous other physiological benefits.

BS can be considered as an option for those with uncontrolled metabolic disorders & for those who are unable to adapt a lifestyle
modification program due to extremely high body weight or due to a physical handicap.Hence, persons with a BMI of over 40 and those with a BMI of between 35 to 40 who suffer with obesity related disorders such as diabetes, sleep apnea, heart disease would be considered as ideal candidates.

 According to certain recent guidelines for a person above BMI of 30 with atleast one 
complication of obesity, BS can be considered as an option. It is also important to note that BS is NOT a cosmetic procedure & hence
should not be misused in order to bring about rapid weight loss.

Advantages of BS:

1) Rapid weight loss immediately post surgery & most people also continue to lose weight in the following 12  to 24 months

2) Improvement in metabolic conditions & sleep apnea with certain studies suggesting a complete recovery from the associated
disease.

Disadvantages of BS

1) Most patients complain of nausea, vomiting, weakness, faintness and also diarrhea

2) Unless adequate supplementation is maintained patients of BS develop anemia, osteoporosis & other forms of nutritional
deficiencies.

3) Complications such as abdominal hernias, infections, breakdown of the staple line and stretched stomach outlets may call for follow up surgeries.

4) Certain studies have reported that almost one third of the patients who undergo BS develop gall stones.

A question I asked at a recent BS seminar to a group of people who had undergone the procedure was " Have any one of you tried to loose weight by sticking to a weight loss programme for at least six months under the guidance of a qualified professional ?" ....The answer was "No"