Best Weight Loss Hospital in Hyderabad, India - Bariatric Surgery for Severe Obesity Treatment

Bariatrics is a speciality in medical science that deals with severe obesity and its related conditions. It also manages weight loss through different treatment modalities, including lifestyle modifications, pharmacotherapy, minimally invasive techniques, and surgical interventions. The main goal of bariatrics is to help individuals with severe obesity (BMI more than 30) maintain a healthy weight to rule out the risks and complications of obesity, which includes diseases like type 2 diabetes, hypertension, sleep apnea, and cardiovascular disease.

Bariatric surgery candidates include those with a BMI of 40 or more, a BMI of 35 or more and, severe obesity-related health issues, and those with a BMI of 30 or more and uncontrolled type 2 diabetes.

Bariatric surgery is also known as weight loss surgery. There are different types of surgical procedures in bariatric surgeries. They are:

• Roux-en-Y Gastric bypass (RYGB)
• Biliopancreatic diversion/ duodenal switch (BPD-DS)
• Endoscopic sleeve gastroplasty 
• Sleeve gastrectomy
• Laparoscopic gastric band
• Single-incision bariatric surgery
• Revisional bariatric surgery

Pre-surgery evaluations involve assessments by endocrinologists, dieticians, psychologists, anesthesiologists, cardiologists, and surgeons. Necessary tests include complete blood count, iron, vitamins, folate levels, coagulation and metabolic panel, and imaging studies.

• Psychological evaluation: Mental health, alcohol dependency, smoking
• Medical clearance: screening cardiac diseases and sleep apnea.
• Anesthetic considerations
• Nutritional evaluation 
• Weight loss plan 

The long-term success rate of bariatric surgery is between 68% and 74%. However, studies have shown decreases in mortality and obesity-related complications, along with improvements in quality of life and mental health.

Sleeve Gastrectomy, Gastric Bypass (Roux-en-Y) and Adjustable Gastric Banding are all common bariatric surgeries. The goal and mechanism of each procedure vary. Each procedure has its own benefits and considerations, and the selection of procedures depends on the individual's weight loss goal and condition.

In the Gastric Bypass (Roux-en-Y) surgery, a small pouch is made in the stomach, and a portion of the small intestine is rerouted to this pouch to reduce the stomach size and limit calorie and nutrient absorption. This procedure is complex and can lead to risks and nutritional deficiency. In contrast, in sleeve gastrectomy, a tube-like sleeve is created by removing approximately 80% of the stomach, intending to limit food intake and craving by controlling the hunger hormone ghrelin. This procedure is less complicated than Gastric Bypass. In Adjustable Gastric Banding, an adjustable silicone band is placed in the upper part of the stomach to create a small pouch to control the food intake. This procedure is less invasive and complicated but requires frequent follow-up for band adjustment.

Yes, there are non-surgical weight loss options, including procedures like a gastric balloon, aspire to assist, and the ROSE procedure. Other options are medication therapy, diet, and lifestyle changes.

Yes, various studies have reported an improvement after bariatric surgery in diabetes and other obesity-related conditions like sleep apnea and heart diseases. The effect of surgery will also vary depending on the type of surgery.

Bariatric surgery helps in improving ovulatory status and reducing androgenic (male) hormones which helps improve fertility. It is known to decrease follicular phase of menstrual cycle which can lead to improved ovulation.

Yes, research indicates bariatric surgery is safe for teenagers, similar to adults. Teenagers require careful attention to nutrition due to their ongoing growth and development.

Criteria for adolescent bariatric include:

• Failed at healthy weight reduction using a structured program for a 6-month period
• Reached tanner scale stage (a scale to access physical development of children
• Skeletal maturity of >95%
• Understanding of lifestyle changes and dietary requirement
• Good psychological well-being with strong social support 

Endoscopy is crucial before and after bariatric surgery. Pre-surgery, it detects hidden anatomical issues, helping with surgery selection. Post-surgery, it identifies anatomical changes like the size of the stomach and intestine.

The long-term success rate of bariatric surgery is between 68% and 74%. However, studies have shown decreases in mortality and obesity-related complications, along with improvements in quality of life and mental health.

Reducing obesity-related risk factors can decrease the incidence of heart disease. Obese patients experience elevated cardiac output to meet the metabolic demand caused by excess fatty tissue. Bariatric surgery patients are 49% less likely to develop major cardiovascular events, such as heart attacks and heart failure.

Lowering obesity can reduce the risk of stroke. Obesity contributes to the advancement of atherosclerosis and the development of thromboembolism, potentially resulting in arterial blockage. Bariatric surgery patients have a 71% decrease in risk of developing stroke.

Know more about Cardiac arrest and Heart attack

Weight loss can improve liver function and has been proven to reduce liver fat. Various studies have shown reduced liver fat on a 3-5% decrease in whole body weight.

Read more about NAFLD & NASH

Weight loss can improve symptoms and increase fertility. Weight loss in overweight women with PCOS has been known to improve insulin sensitivity, metabolic health, reproductive function, and hyperandrogenic features. Based on several studies, the incidence of PCOS has decreased from 45.6% to 6.8% in a year due to bariatric surgery.

Know more about PCOD and PCOS

Bariatric surgery can improve or resolve conditions associated with metabolic syndrome, such as insulin resistance, dyslipidemia, and hypertension.

Obese patients are often associated with diabetes. The outcomes of clinical trials show that bariatric surgery improves diabetes in 33–90% of patients one year after treatment, compared to 0–39% of those who received medical management. Although the improvement rates decrease over time, they are still higher in patients who underwent surgical treatment.

Know more about Type 2 Diabetes

Bariatric surgery significantly improves the lipid-lipoprotein profile and metabolism through various mechanisms. Potential causes for the remission of dyslipidemia following bariatric surgery may include alterations in adipose tissue distribution and function, enhanced insulin sensitivity, and a beneficial impact on liver fat levels.

Bariatric surgery is a very successful therapy for hypertension associated with obesity, leading to the remission of hypertension in over 50% of patients. However, a higher requirement for antihypertensive medication before bariatric surgery and a smaller amount of weight loss during the follow-up period are both potential obstacles to achieving complete remission of hypertension. The Hypertension remission rate is 43-83% within one year of surgery. 

Know more about Hypertension

Bariatric surgery leads to a notable decrease in the apnea-hypopnea index. Nevertheless, the average apnea-hypopnea index following weight loss surgery indicated the presence of moderately severe OSA. These individuals will probably require ongoing OSA treatment to reduce its potential complications.

Bariatric surgery has effectively improved joint pain in the early postoperative period. However, the degree of improvement in osteoarthritis after surgery is not as remarkable as that in other obesity-related comorbidities. When bariatric surgery is combined with changes in diet and exercise, significant results are seen in weight loss, knee pain, and function.

Know more about Osteoarthritis

Weight loss can improve kidney function, as obesity is one of the risk factors for kidney disease. Chronic kidney disease (CKD) linked to obesity is believed to be caused by the buildup of fat within the kidneys and changes in kidney function involving increased filtration, reduced glomerular filtration rate, and the presence of albumin in the urine. It is reported that bariatric surgery has decreased the development of CKD by 54%.

Know more about Chronic kidney disease (CKD)

Weight loss can improve venous circulation and reduce symptoms. It is reported that 95% of gastric bypass patients have significantly reported complete recovery of venous stasis disease.

In women, obesity can cause infertility, which can be improved with weight loss. Obesity can induce insulin resistance and alter sex hormones, which is linked to the failure of a woman to produce an egg from each ovary each month.

Most women experienced an improvement in stress urinary incontinence symptoms and a reduction in its impact on quality of life after losing weight through bariatric surgery. After undergoing bariatric surgery, nearly half of women and over one-fifth of men with severe obesity reported prevalent incontinence in the past three months. Three years post-surgery, significant enhancements in incontinence were observed, leading to remission for most women and men.

Know more about Urinary Incontinence

The development of cancer due to obesity is strongly linked to metabolic syndrome, high levels of insulin, and dysfunctional visceral fat. Bariatric surgery in severely obese patients significantly improves the symptoms of metabolic syndrome and hormonal imbalances and considerably decreases the risk of overall cancer-related deaths and cancer occurrence.