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Weight loss surgery always remains hot in the news. In my line of work, I often field questions from patients, neighbours, concerned relatives and strangers, and it never ceases to amaze me how little people understand about bariatric (weight loss) surgery. In this column, I have busted the common misconceptions about this type of surgery
Weight loss surgery helps people shed those extra 20 kilos
Many people don’t realise that gastric banding, sleeve gastrectomy and gastric bypass are not cosmetic procedures to be taken as lightly or performed as frequently as Botox or a nose job. Weight loss surgery is a definitive and final step for people weighing at least 40Kgs over their ideal body weight. These people have a BMI of 32.5 to 37 or higher, and have unsuccessfully tried many a fad diets, taken so called “weight reducing pills” and attempted other means of weight loss. There is consideration, conversation and qualification before a procedure. After the operation, patients must keep to a rigorous follow-up schedule. People who are 10-15 kilos overweight have a host of tools and approaches available to them that can assist them in regaining health, managing their appetite and keeping weight off.
Obese people have to undergo surgery because they are lazy.
On a personal level, this misperception annoys me the most. By the time these people come to my outpatient clinic, they have tried every diet available. They have suffered immense social, emotional and psychological stress, and they want nothing more than to rid themselves of the excess body weight they carry. Due to an individualised interplay among genetics, environment and behaviour, these patients have realised that their best chance of living a normal life is to resort to a band, sleeve or bypass.
As part of my job, I literally get inside of people and either reroute their digestive tracts or slip a lap band over the top of their stomachs. Sounds dangerous, right? As with any surgery, weight loss surgery carries risks. But modern technology has made bariatric procedures relatively safer. In a study of 66,000 obese people over five years, those who chose to have a bariatric surgery lived longer than those who did nothing. It has been shown repeatedly that it’s far more dangerous to live life morbidly obese than to undergo a bariatric procedure. I’ll put it in perspective: In most programmes, the risk of a bariatric surgery is in line with the risk of having one’s gallbladder removed.
You can’t get pregnant after weight loss surgery.
Many patients have trouble getting pregnant prior to surgery and find that they’re very fertile following the surgery. This is good news if you want to have children — or it may be bad news if you don’t! Contrary to popular belief, pregnancy following weight loss surgery is very much possible. Patients are much less at risk during pregnancy because their other health problems have lessened or disappeared. After your weight is back to normal, and assuming you don’t have any other health problems, you can expect to have a normal delivery. If you’re a woman of childbearing age, use two forms of birth control for one year following surgery. During that first year, you aren’t eating enough to nourish yourself, not to mention a growing foetus, so you don’t want to get pregnant then. Besides, you want to concentrate on your own weight loss during that first year. Better safe than sorry.
You’ll never be able to enjoy a real meal again OR Now you can eat everything you want!
Patients who undergo bariatric surgery can, in fact, celebrate their birthday with a little cake, they just can’t eat the whole thing anymore! People learn new, reasonable, healthy eating behaviours. Trying to eat too much at one time would make it hard to keep the food down. With those caveats, a person can live an unrestricted life following surgery. They can go out to restaurants, take a cooking class and host a family dinner!
Bariatric patients undergoing surgery have a very restricted lifestyle.
Bariatric surgery has a significant impact on the patient’s personal life. Men and women who are morbidly obese deal every single day with deep, core issues of self-esteem and pride. For example, there are physical repercussions of being so overweight (like, inability to control the bladder) that can be embarrassing, if not humiliating. Bariatric surgery can help restore dignity. About sixty percent of my patients are women. Many obese women have suffered not only emotional abuse because of their weight, but actual physical abuse as well, perpetrated by our society that didn’t respect them and convinced them that they were unworthy of love and affection. Dramatic weight loss over time often brings these women a new self-confidence and a new beginning to a more fruitful life.
What is the difference between bariatric & metabolic surgery?
Though, there is a large amount of overlapping between Bariatric and Metabolic surgery, however, all Bariatric procedures can also be called Metabolic procedures because the word metabolic says that it changes your metabolism. So, what happens in a Bariatric surgery? It can be divided primarily into three limbs— One, Surgery done for morbidly obese patients who do not have any associated co-morbidities such as diabetes, hypertension, etc. The second limb would consist of patients who have obesity which is related with diabetes, and other co-morbidities like hypertension, heart problems, kidney problems, etc. And the third limb would consist of patients who have diabetes only, without any associated obesity. So Bariatric surgery is primarily done for patients who are obese or have related diseases like diabetes and hypertension. Whereas, Metabolic surgery for diabetics would encompass purely surgery done for patients with diabetes without associated obesity.
Does it mean that all Diabetic patients should go under the knife and get the surgery done?
Absolutely NOT! There have been strict guidelines and criteria to choose a patient who would benefit from this surgery. So, based on individual cases, we decide which patient will benefit from it. However, broadly speaking, patients who have Diabetes for less than a duration of 10 years, or those who have not been Insulin dependent for a long time or those who do not have involvement of more than 2 organs have a much better chance of getting a resolution in terms of Diabetes. But an individual study of cases can speak best.