What is Bariatric Surgery, weight loss surgery demystified?

Bariatric surgery comprises of a group of surgeries which involve making surgical adjustments to the digestive tract, in order to help the patient lose weight. The procedure employs a laparoscopic method, whereby a small camera is inserted into the abdomen through tiny holes and is subsequently used to conduct the operation. The various types of bariatric surgery include:

• Laparoscopic sleeve gastrectomy,

• Laparoscopic Roux-Y gastric bypass,

• Laparoscopic mini gastric bypass.

These surgeries may involve a reduction in the size of the stomach, or bypass a portion of the intestines. The end result is a decreased intake and absorption of food following the surgery, which causes decreased hunger and increased satiety (fullness following a meal), and ultimately helps patients lose weight.

Advantages of laparoscopic bariatric surgery

Being a laparoscopic procedure, bariatric surgery has the advantage of being minimally invasive, which means that there are no unsightly surgical scars. In addition, the procedure is less painful, promotes better cosmetic and surgical healing in patients undergoing the surgery, and carries a fewer risk of complications than its more invasive counterparts.

The number of bariatric surgeries has risen consistently over the past few decades [1], which is a testament to their safety and effectiveness.

Obesity and associated problems

The main indication for bariatric surgery is for the reduction of weight in morbidly obese patients, and owing to its impact in these patients, the procedure is often referred to as ‘weight loss surgery’ [2]. Obesity is a well-established cause of a number of serious medical problems, such as coronary heart disease, heart failure, fatty liver disease, renal failure, and diabetes. In addition, obese males are also reported to have lower sperm counts and higher rates of erectile dysfunction, while obese females suffer from decreased fertility and higher rates of pregnancy loss [3]. A person may be categorized as obese if their BMI exceeds 30, while the term ‘morbidly obese’ is used for those with a BMI of over 40.

Benefits of bariatric surgery in obese patients

The current general consensus is that bariatric surgery is the predominant treatment option for individuals who are clinically obese, and are at the risk of obesity-induced complications. Research has shown that while bariatric surgery can help reduce weight, it can also lead to a decline in obesity-related complications [4]. Accordingly, bariatric surgery has been shown to reduce the risk of heart disease by impacting blood cholesterol levels and blood pressure, and has also been documented to aid in treatment of type 2 diabetes mellitus [2]. Furthermore, research on obesity-related infertility revealed that the fertility status of a patient can improve following bariatric surgery [5].

Therefore, bariatric surgery exists as a viable, minimally invasive option for overweight/obese individuals, who wish to lose weight, reduce the risk of obesity related problems, and enjoy a better quality and standard of life.

References

1. Davis MM, Slish K, Chao C, Cabana MD. National trends in bariatric surgery, 1996-2002. Archives of Surgery. 2006 Jan 1;141(1):71-4.

2. Public Education Committee. Bariatric Surgery Procedures. American Society for Metabolic and Bariatric Surgery. 2021 May. https://asmbs.org/patients/bariatric-surgery-procedures

3. Kinlen D, Cody D, O’Shea D. Complications of obesity. QJM: An International Journal of Medicine. 2018 Jul 1;111(7):437-43.

4. Angrisani L, Santonicola A, Iovino P, Formisano G, Buchwald H, Scopinaro N. Bariatric surgery worldwide 2013. Obesity surgery. 2015 Oct;25(10):1822-32.

5. Musella M, Milone M, Bellini M, Fernandez LM, Leongito M, Milone F. Effect of bariatric surgery on obesity-related infertility. Surgery for obesity and related diseases. 2012 Jul 1;8(4):445-9.