Bariatric surgeries are an increasingly common option for those who struggle with chronic obesity. Although it is effective in promoting significant weight loss, this procedure also involves some risks. Therefore, anyone interested in the procedure needs to arm themselves with information before deciding on surgery.
In this article, we will show some points to consider before opting for bariatric surgery, including possible risks, types of bariatric surgeries, and indications.
What is bariatric surgery and how is it performed?
Bariatric surgery is an increasingly performed procedure, aimed at weight loss. It is indicated for people who cannot lose weight through conventional methods, such as diets and exercises. In bariatric surgeries, the surgeon alters the anatomy of the stomach and intestine to induce weight loss, and currently, there are two main types of procedures.
Vertical gastroplasty or sleeve
This method removes part of the stomach, leaving it in a tube shape, reducing its volume, without causing changes in the intestine. It is a type of surgery that leads to a decrease in the volume of food that the patient can ingest, leading to weight loss. Because of this mechanism, this type of surgery is called restrictive.
Gastric bypass or Reducing gastroplasty (Capella Surgery)
In this method, the stomach is separated by staples into two parts, leaving a small part connected to the esophagus (gastric reservoir), and the larger part separated from the rest. An anastomosis (junction) is also performed between the small intestine and this small part that remained of the stomach, causing the ingested food to end up “skipping an initial part of the intestine, decreasing its absorption. Thus the amount of food ingested is small (restrictive surgery), and its absorption decreased (disabsorptive surgery), being therefore the mechanism of weight loss of this type of surgery called mixed.
What to evaluate before the surgical procedure?
Bariatric surgery can be an effective way to treat obesity, but it is important to understand the risks and limitations before making this important decision. Therefore, patients should know all the facts about bariatric surgery, so that they can consciously decide if this is the best.
It is recommended to seek guidance from the doctor so that he can explain the risks involved. It is also important to remember that there will be a lifestyle change after the procedure. That is, the patient will need to follow a controlled diet and it will also be necessary to abandon sedentary lifestyle.
Bariatric surgery has different options, which should be discussed with the doctor to determine which one best suits the patient and their goals. In addition, the procedure also requires physical and mental preparation, so that the body and mind can cope well with the effects of the operation.
Evaluate your BMI
Bariatric surgery is an important option for weight loss, but before any decision, it is important to remember that it is vital to evaluate the patient’s BMI (Body Mass Index). This index is used to assess weight in relation to the patient’s height, and determine the nutritional status and diagnose obesity.
The BMI is calculated by dividing body weight by height squared. If the result of the BMI is between 25 and 30 the patient is overweight, if between 30 to 35 is considered with obesity grade I, between 35 and 40 obesity grade II and above 40 obesity grade III.
Bariatric surgeries today are indicated for patients with BMI between 35 and 40 who have comorbidities (diseases related to obesity) such as diabetes and arthrosis, and for everyone above BMI 40.
Important: For the patient to be considered fit to undergo surgery, the BMI needs to have been stable for at least 2 years.
Which surgery to choose?
This decision is based on BMI, patient characteristics, and surgeon’s choice. In general, vertical gastrectomy is the choice for patients who need less weight loss, and because it does not have anastomoses, it has a lower surgical risk. Reducing gastroplasty, on the other hand, is reserved for patients who need greater weight loss, but has risks of complications greater than vertical gastrectomy.
Before opting for the surgical procedure you need to have constant multidisciplinary team (doctors, nutritionists, physical education professionals and others) follow-up to ensure that the results of bariatric surgery are satisfactory.
Understand the limitations resulting from surgery
Bariatric surgery should not be considered as the miraculous cure for obesity. It is just the first step of the patient in the weight loss journey. It will be necessary to have determination and strength, as it will need to carry out a restrictive diet, physical exercises, and constant health evaluations. Thus, without the total determination and support of the patient, the weight loss result cannot be achieved.
Consider the risks of bariatric surgery
Studies suggest that the main risk factor for complications is extreme obesity, but factors such as general health and smoking should also be considered when assessing the risk of developing complications. However, with technological advances and dedicated patient care, the risks of bariatric surgery are reduced, allowing more and more people to benefit from surgery.
Complications can be different for each type of surgery, but the most common are
- Postoperative pain;
- Bleeding;
- Infections;
- Fistula;
- Pulmonary embolism.
It is worth remembering that all these complications have treatment, therefore, bariatric surgeries are considered safe procedures.
Before the patient agrees to undergo a surgical procedure, he needs to understand that the postoperative period will have a very different reality. Normally, the body receives fewer nutrients, and therefore the patient may have anemia, hair loss and even dental problems.
Conclusion
Deciding on bariatric surgery for weight loss is not a simple choice. As we have seen, there are prerequisites that will assess whether the patient fits the profile of this type of procedure, and which is the best for him. The interested party also needs to evaluate the risks and postoperative care.
Before opting for bariatric surgery, pay attention to our content on the subject. Here on Gastroblog, we bring complete and detailed information about this surgery, so that you make the best decision and transform your life, without any doubt about the procedure.
In addition, it is very important that you always talk to your doctor if bariatric surgery is the best option for you.
Doutor em Gastroenterologia pela FM-USP.
Especialista em Cirurgia do Aparelho Digestivo (HCFMUSP), Endoscopia Digestiva (SOBED) e Gastroenterologia (FBG).
Professor do curso de Medicina da Fundação Educacional do Município de Assis - FEMA.
Médico da clínica Gastrosaúde de Marília.