Popularly called "stomach reduction surgery" or "obesity surgery", bariatric surgery is one of the best known anti-obesity treatments in the world.
However, few people really know the particulars of surgery, its real indications and the risks it can offer. A very important point is to know that it is far from an aesthetic surgery.
The indication for bariatric surgery includes many factors and foresees the monitoring of a multidisciplinary team, in which each professional must approve or not whether the patient is fit for this type of treatment. Below, answer all your questions about the procedure!
Who is it for?
Bariatric surgery is indicated for patients with body mass index (BMI) equal to or greater than 40, or equal to or greater than 35, and who have comorbidities associated with obesity, such as:
- Diabetes;
- Arterial hypertension;
- Cholesterol problems;
- Sleep apnea;
- Reflux disease, among many others.
It is noteworthy that, even for patients who are indicated for bariatric surgery, dietary rehabilitation is necessary and is essential for postoperative success.
Read also: 22 Diabetes Myths and Truths Revealed
Main types of bariatric surgery
Ana Carolina C. Carvalho Fernandes? Alliance doctor Institute of Oncology, specialist in general surgery, certified in the field of bariatric surgery, and vice-president of the Brasilia chapter of the Brazilian Society of Bariatric and Metabolic Surgery (SBCBM)? points out that there are several types of bariatric surgery. ? However, today, worldwide, the two most common surgeries are Roux Y bypass and sleeve (or sleeve gastrectomy). Most patients can do any of them, but it is the patient test results that will determine the best technique, he says.
Roux Y Bypass: also called "gastric bypass", "Fobi-Capella" or "Capella" is the most commonly used type of surgery. Briefly, the stomach is reduced without having to remove any part of it or the intestines, as a diversion is made, thus reducing the space for food. In addition, food stops passing through the first part of the small intestine, which contributes to satiety and decreased hunger. These combined strategies, in addition to the required changes in habits, lead to weight loss and control associated diseases. The method is reversible.
Sleeve: also called "sleeve gastrectomy" or "vertical gastrectomy", this type of surgery consists of the removal of two thirds of the stomach in its vertical axis. In addition to naturally reducing the amount of food that can be eaten due to stomach reduction, the neglected part of the stomach is responsible for the production of the hormone ghrelin (which, in turn, is associated with appetite). The method is not reversible.
? In Brazil, the most used technique is bypass, with excellent results ?, explains the doctor Ana Carolina.
Risks of Bariatric Surgery
Ana Carolina explains that bariatric surgery, like any other surgery, can have complications. "However, with the evolution of the surgical technique in bariatric surgery, surgery is usually performed in just over an hour, and this has greatly reduced complications," he says.
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The doctor points out that the main risks are: "the patient has a thrombosis, pulmonary embolism and, even more serious, would be a fistula, which happens when there is an unwanted leak at some point of the surgery," she explains.
Everything you need to know about postoperative
Although bariatric surgery is successfully performed, it is worth remembering that postoperative requires special care (some even very specific to this type of surgery).
Back to activities
Ana Carolina points out that most patients return to work 15 to 30 days after surgery. "When they complete a month of surgery, most patients are released for physical activity," he says.
But, it is worth mentioning, each patient should strictly follow the guidelines given by the professionals involved in the treatment.
food
"In the first month, the patient feeds on liquids and soups, increasing the consistency of food until reaching the solid itself, the famous rice, beans and meat," explains Ana Carolina.
Read also: Obesity: Know Causes, Risks, Diagnosis and Treatments
Possible diseases
The doctor explains that surgery can lead to malnutrition if the patient does not make proper nutritional monitoring, which is done by daily intake of vitamins and supplements.
Propensity to develop addictions
This is one of the most commented points when it comes to the postoperative bariatric surgery.
When the patient is not emotionally prepared for surgery, he may develop some addictions. Therefore, psychological counseling is essential before, during and after surgery. In some cases, especially patients who already drink more alcohol, if they do not police themselves, can develop addiction to alcohol ?, explains Ana Carolina.
Weight regain
Weight regain happens when the patient gains a few pounds after reaching what is called a "plateau".
The plateau occurs when the patient stops losing weight and stabilizes at a certain value. The plateau happens about a year and a half after surgery. Weight regain, however, happens after two years. It can be light, ie a few pounds (2-5 kg), which is expected after bariatric surgery, or severe when the patient loses control ?, explains doctor Ana Carolina.
Also read: Weight Loss Medicine: Is It Worth It?
Plastic surgery
Another common question is: will all people who have had bariatric surgery have to have plastic surgery?
Ana Carolina points out that plastic surgery called "reparative" after surgery is indicated for patients who have excess skin after weight loss. Plastic surgery can also improve the hygiene of those patients whose excess skin disrupts cleansing and sometimes patient movement. It also helps a lot in improving self-esteem ?, explains.
It is worth stressing that the weight changes with the surgery, but "the patient's head must also change". It is critical that he be aware of what needs to be changed and not return to the harmful habits of before. For all these reasons, the importance of multidisciplinary follow-up is emphasized, involving physicians, nutritionists and psychologists.
Other Anti-obesity Alternatives
Ana Carolina points out that obesity treatment can be either clinical (with or without medication) for weight control, or surgical. "Surgery should be indicated for patients who have tried unsuccessful clinical treatment," he says.
Check out other known ways to combat obesity:
Dietary Rehabilitation and Physical Activity
Dietary rehabilitation associated with physical activity is indicated in all cases of overweight or obesity. It predicts that the person "relearn how to eat" by choosing healthier foods and eaten in adequate quantities, and that exercise becomes a habit. Thus, one reaches a caloric deficit, that is, the person spends more calories than he consumes, losing weight.
Often, in patients who have no other obesity-related illness, only this association (dietary reeducation + physical activity) can make the person lose all the necessary weight.
In other cases, drugs or bariatric surgery itself may be indicated, for example; However, dietary reeducation associated with physical activity is still necessary for the patient to reach his goals and be able to maintain his proper weight over time.
Pros and cons
This is undoubtedly the safest and recommended way to combat obesity. Food reeducation cannot be seen as a? Regime? (with a start and end date), but yes, as a new lifestyle? The idea is that the person, in fact, relearn how to eat and thus, after losing the necessary weight, will be able to maintain his proper weight for the rest of his life.
One thing that discourages most people is that the weight loss process requires patience. Some people take years to reach the desired weight. However, the best guarantee that dietary reeducation can offer is that, in fact, the patient has relearned how to eat and have good lifestyle habits, and thus will be able to maintain his or her proper weight.
Medicines
In some cases, the use of anti-obesity drugs may be indicated. Such medications can only be purchased with a prescription and all treatment should be accompanied by a trusted doctor.
In addition, even taking a certain medication, it is essential for the patient to acquire good lifestyle habits, so that after losing weight, maintain the proper weight.
Pros and cons
The biggest advantage of medicines is undoubtedly offering a much faster weight loss. However, this weight loss is not always safe and is often "transient": that is, the patient loses weight a lot and quickly, but, after a while, fattenes everything again because not? Relearned to eat? and / or did not create a habit of exercising.
In addition, highlights Ana Carolina, the use of anti-obesity medication can bring side effects, especially cardiac. "Its use should be done only with indication and specialized medical monitoring," he adds.
Finally, bariatric surgery is, in fact, one of the best known and most effective treatments to combat obesity (and other diseases associated with it). It offers risks as with other surgeries, but generally gives great results.
However, it is good to know that bariatric surgery actually integrates a broad and complex treatment that requires a multidisciplinary team and also a good preparation by the patient.
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