Bariatric Surgery: What No One Tells You About an underused weight loss Option

Bariatric surgery can help an individual lose weight and maintain the progress in the long run, feel better physically and mentally, and live longer. This is what the experts say.

Obesity rate in the United States is remarkably increasing, and this phenomenon induces growing fear due the health problems that come with extra weight. People always encourage other people to summon the motivation and strength to lose weight, but let’s be honest about that. It is hard. Bariatric surgery could be a great option to avoid all the hardships of trying to lose weight and maintain the optimal progress. It is common that people are afraid of surgery. Given the outcome this one yields, the fear will not be necessary. This type of surgery is now safer and simpler than what it used to be in last decade of the 20^th century. It is just underused according to the experts.

Who Should Use Bariatric Surgery to Lose Weight?

Bariatric Surgery is not an option for all. According to Dr. Anne P. Ehlers, a bariatric surgeon-University of Michigan, less than 1% of people whose condition requires surgery actually do it. The cases which are eligible for bariatric surgery are people with high Body Mass Index (B.M.I) equal or higher than 40 as well as people with B.M.I between 30 and 35 who are struggling with other medical conditions that come with being overweight.

According to the 1991 guidelines, bariatric surgery should be recommended as an option only to people whose heath is heavily affected due to obesity. Recent medical research data indicates that not only obese adults are illegible for surgery but also obese teenagers. Obese teenagers are more likely to endure severe health complications as adults than adults who become overweight. There is a new trend now that recommends bariatric surgery for adolescent and teenagers with diabetes type 2 and could not overcome it through diet and exercise. 

Why Are People Reluctant to Go for Bariatric Surgery?

Bariatric surgery’s risk level is very low now. It has fallen from 11.7 % in 1998 to 1. 4% in 2016. The expertise of the surgeon is also important for the ultimate success of the operation. These are encouraging indicators, but people are still reluctant to choose it as an option for weight loss.

In an article titled “Long-term Outcomes Following Bariatric Surgery,” Shubeck et al. (2018) point out that bariatric surgery is underused because of the reluctance to accept its safety and long-term effectiveness. Besides, Dr. Ehlers adds in a separate interview that there is a psychological factor which discourages many to undergo this option. They are afraid to be judged by others for opting for an easy way to lose weight. They might also feel like they couldn’t try hard to win the challenge of losing weight through exercise and diet. Thus, many people wouldn’t lose weight to improve their physical and mental health because of social judgement.

Bariatric Surgery Techniques

There a few bariatric techniques, two of which are highly effective. The classic technique, which is the Roux-en-Y gastric bypass, works on the stomach by cutting down its size and limiting the absorption of calories at the level of the intestine. Recently, a newer technique, sleeve gastrectomy, has been developed and it has proved to yield great long-lasting outcomes.

The newer technique has less complications compared to the original one. The American Society of Metabolic and Bariatric surgery says that patients (7.7%) who underwent the traditional surgical surgery had to undergo again a reoperation due to complications compared to 1.5% of patients who underwent sleeve gastrectomy. Only a very small percentage of patients needed a band placed around their stomach to divide it into two parts.

Sleeve gastrectomy’s approach is to reduce hunger, appetite, and the food intake. Therefore, it reduces 85% of the stomach and removes the area in the stomach which is responsible for producing Ghrelin, an appetite hormone. The end result is a banana-shaped stomach which allows the patient to feel full after eating an amount of food regarded as adequate from a medical perspective.

Both bariatric approaches described above and other less effective ones involve laparoscopy. It is an operation performed in the abdomen or pelvis using small incisions with the aid of a camera. Good news: The patients would not be hospitalized over two days.

Life after Bariatric Surgery

There are a number of health conditions that can be reduced thanks to surgery including but not limited to heart disease, high blood pressure, type two diabetes, breast cancer, infertility, and elevated cholesterol. Longevity can be extended and death rates minimized by 50% among people 55 or older.

Courcoulas et al. (2020) reveal in a study involving 33, 560 adults undergoing either gastric bypass or sleeve gastrectomy that after following them five years after surgery, they have reached the conclusion that interventions as well as hospitalization are associated more with gastric bypass than sleeve gastrectomy. However, weight loss does not happen automatically after surgery. It follows a gradual process. The beginning of weight loss can be noticed by the end of the first month. People who underwent either of the effective bariatric surgical forms described above can notice loss of half of their excess weight within a year and up to 60% in 18 months.

Another study conducted by the University of Pittsburg of Graduate School of Public Health involved 2,2221 participants and followed them for 3 years after surgery to assess the long-term effects of the surgery. The follow-up concluded that the participants experienced less pain, and their ability to walked improved. Still, a healthy diet and regular exercise ought to be followed to manage weight, which is a fundamental requirement in any other weight-loss program out there.

Though the surgery’s success is optimal, it should be used in combination with other routines. The experts caution that eating habits should not be taken for granted after surgery. People should watch what they are eating and the amount of food they are eating. Big meals are not tolerated. That’s because surgery alone is not a magic pill. Certain nutrients such as iron, vitamin B12, and Vitamin D might be hard to absorb after surgery. Therefore, it is recommended that patients take these to supplement their diet. The data from the American Society of Bariatric Surgery shows that about 250000 were done in 2018, and 18 million with a B.M.I equal to 40 or higher underwent the surgery. The surgery costs between $17,000 and $30,000, which often covered by an insurance plan,while obesity that is not treated costs the country $1.72 trillion.

References:

Courcoulas A, Coley RY, Clark JM, et al. (2020). “Interventions and Operations 5 Years After Bariatric Surgery in a Cohort from the US National Patient-Centered Clinical Research Network Bariatric Study”. JAMA Surg. 155(3):194–204.

Shubeck S, Dimick JB, Telem DA. (2018). “Long-term Outcomes Following Bariatric Surgery”. JAMA. ;319(3):302–303.