Bariatric Surgery for Morbid Obesity

What is Bariatric Surgery?

Bariatric Surgery is considered as a treatment option for patients with a BMI of 32.5 kg/m² for asian population with comorbidities or 35 kg/m2 without comorbidities or greater who instituted but failed an adequate exercise and diet program (with or without adjunctive drug therapy) or for people who are suffering from Morbid Obesity and want to go for weight loss and also who are present with obesity-related comorbid conditions, such as hypertension, impaired glucose tolerance, diabetes mellitus, hyperlipidemia, and obstructive sleep apnea. A doctor–patient discussion of surgical options should include the long-term side effects, such as possible need for reoperation, gallbladder disease, and malabsorption.

Animated Bariatric Surgery Video : (Made Easy to understand the Concept)

What is Morbid Obesity?

Obesity is considered a health "condition". A person is considered "obese" when he or she weighs 20% or more than his or her ideal body weight. At that point, the person's weight poses a real health risk. Obesity becomes "morbid" when it significantly increased the risk of one or more obesity related health conditions or serious diseases. Morbid obesity - sometimes called "clinically severe obesity" - is defined as having a Body Mass Index (BMI) or 35 or higher.

What is BMI ?

To understand Morbid Obesity we have to know the Body Mass Index (BMI). Body Mass Index is a simple and widely used method for estimating body fat mass. It calculates body fat based on the relationship of weight and height.

The formula for calculating Obesity Body Mass Index (BMI) is :

BMI = Weight (in Kgs) / Height² (in Metres)

A Healthy BMI is about 18-25.

• BMI Less than 19 indicates you are Under Weight.
• BMI between 20 and 24 is usually considered Normal.
• BMI of 25 to 29 is considered Over Weight.
• BMI of 30 or above is considered Obese.

How to calculate Normal Weight ?

Weight = Height (in cms) - 100 [example : 176cms - 100 = 76 Kg] where 76 Kg is the normal weight required for a person whose height is 176cms.

How does obesity differ from being overweight ?

A person may appear fat, but may not be clinically obese. An overweight person has a BMI of 23-27.5. An obese person is one whose BMI exceeds 27.5.

The Body mechanisms of Obese biologically set in such a manner that the patients gain weight easily.

Even small amounts of weight loss are difficult to achieve and very difficult to sustain in patients of clinical obesity.

Type of Bariatric Surgeries?

1. Roux-en-Y Gastric Bypass
2. Gastric Sleeve
3. Gastric Sleeve with Duodenal Switch
4. Gastric Band (Lap Band)
5. Mini Gastric Byepass

Surgery Comparision Table

Benefit's of Bariatric Surgery :

Diabetes Mellitus
Over 90 percent of Type II diabetics obtain excellent results, usually within a few days after surgery. These results often include: normal blood sugar levels, normal Hemoglobin A₁C values, and freedom from all their medications including insulin injections.

Heart Disease
Although we can not say definitively that heart disease is reduced, the improvement in problems such as high blood pressure, high blood cholesterol, and diabetes certainly suggests that reduction of risk is very likely.

High Blood Pressure
At least 70 percent of patients who have high blood pressure and who are taking medications to control it are able to stop taking these medications and watch their blood pressure return to normal.

High Blood Cholesterol
Over 80 percent of patients will develop normal cholesterol levels within 2-3 months after their operation.

Asthma
Most asthmatics find that they have fewer and less severe attacks, or sometimes none at all.

Respiratory Insufficiency
Improvement of exercise tolerance and breathing ability usually occurs within the first few months after surgery. Often patients who find themselves barely able to walk find that they are able to participate in family activities.

Sleep Apnea Syndrome
Dramatic relief of sleep apnea occurs as our patients lose weight. Many report that within a year after surgery their symptoms were completely gone and they had even stopped snoring completely.

Gastroesophageal Reflux Disease
Relief of all symptoms of reflux usually occurs within a few days of surgery for all patients.

Gallbladder Disease
When gallbladder disease is present at the time of the surgery it is "cured" by removing the gallbladder during the operation.

Stress Urinary Incontinence
This condition responds dramatically to weight loss, usually becoming completely controlled.

Low Back Pain, Degenerative Disk Disease & Degenerative Joint Disease
Patients usually experience considerable relief of pain and disability from degenerative arthritis and from the pain in weight-bearing joints.