Basic Facts Regarding Weight Reduction Surgery

By Kathy Kaufman


Weight reduction surgery is stepwise procedure that is done to correct obesity in persons that are struggling with excess weight. It is also termed bariatric surgery. During the procedure, it is often necessary to reduce the size of the stomach as well through a number of techniques. This may be done either by use of sleeve gastrectomy or by use of a special gastric band. The former cuts off some portion whereas the latter only shrinks the volume. The bariatric procedure greatly benefits people struggling with conditions such as hypertension and diabetes.

The bariatric procedure is recommended for persons that have a minimum BMI of 40. It is also helpful in persons that have medical conditions that are exacerbated by excess weight. It is important to emphasize that this option should only be considered when all the conservative options have failed.

There are a number of advantages and disadvantages associated with this surgery. All these need to be taken into account before a decision is made on whether the procedure is necessary. Some of the possible complications that should be anticipated include malabsorption of nutrients and gall bladder disease. The risk of depression is also high and as such these persons should be counselled.

There are three surgical options that one may choose from. The common thing about them is that they are aimed at minimizing the recurrence of obesity and to encourage loss of weight. These are broadly classified into malabsorptive, restrictive and mixed type. In the malabsorptive procedure, the aim is to encourage malabsorption of some components in food. Such a procedure includes, for example, what is known as billiopancreatic diversion that is usually accompanied with a duodenal stitch (BDS/DS). The main downside is that some essential nutrients may not be absorbed and this often results in metabolic diseases.

Restrictive procedures are done to reduce the amount of food eaten by reducing the size of the stomach. The person that has had this surgery will usually experience earlier satiety than was the case in the previously. A common technique used to achieve this is the vertical banded gastroplasty. In this technique, permanent staples are put on the stomach and this effectively reduces the volume.

Another restrictive technique is known as sleeve gastrectomy. In the hands of a skilled surgeon, up to 15% of the original size of the stomach can be successfully removed. The greatest portion is taken from the greater curvature. The stomach shape is transformed into more of a tube. In advanced centers, laparoscopes are used so as to improve on the accuracy.

There is a need to make dietary changes after operation. The food types that should be taken include liquids such as broth, juices and sugar-free gelatin desserts. These should be maintained until full recovery of the gut takes place. As one recovers, the next foods to be introduced include blended substances that should also be sugar free.

Adverse effects of weight reduction surgery are common. Due to reduced calcium absorption, patients can develop metabolic bone disease in form of secondary hyperparathyroidism and osteopenia. Rapid weight loss can also result in gallstones. In addition, reduced absorption of nutrients such as thiamine, folate, iron and vitamin B12 can lead to nutritional derangements. Defective renal handling has also been reported.




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