Weight loss/ Bariatric surgery

Bariatric surgery is indicated for patients having a BMI of more than 40 kg/m2 or those with BMI more than 35 kg/m2 along with two or more obesity related comorbities.

Liposuction is a cosmetic procedure for body shaping in which the subcutaneous fat is sucked out with the help of a long and narrow cannula. It target specific areas of the body, gives a cosmetic result but doesn’t result in weight loss.

Bariatric surgery on the other hand is a metabolic surgery which is done by laparoscopy which decreases the size of the stomach and intestines leading to long term weight loss. The overall weight of the individual decrease by 30-40% over a period of 6-12 months along with remission of obesity related diseases.

Bariatric surgery results in gradual but sustained weight loss. During surgery, no fat is removed but only the stomach capacity is reduced so there is noe weight loss at the time of the procedure itself. However, after the surgery, the patient loses 1-1.5 kg of weight every week and 4-6 kgs/months for the next 6-12 months. This translated into an absolute weight loss of 30-40 kgs and sometimes even more depending upon the initial weight of the individual. The weight stabilises after a period of 12-18 months and doesn’t increase after that.

Bariatric surgeries are grouped into two different types of procedures – Restrictive and Malabsorptive. Restrictive procedures are those which reduce the stomach capacity either by placing a band, staples or stitches and include gastric banding, sleeve gastrectomy and gastric plication. On the other hand, malabsorptive/combined procedures decrease the capacity of stomach and shorten the length of the small intestines thereby restricting both the intake of food as well as its absorption. The procedures include gastric bypass and bilio pancreatic diversion.

Bariatric surgery is done by laparoscopy and most procedures are completed within 90-120 minutes. They require hospitalisation for 2-3 days and patients are discharged soon after.

The surgery is done under general anaesthesia so the patient is completely unaware during the procedure. Postoperatively, there is minor pain which is usually managed with the help of painkiller injections and tablets.

Bariatric surgery causes caloric restriction in the body which leads to a gradual and sustained weight loss. The portion size is very small so the person has to take numerous small meals throughout the day to meet the daily energy demands. Along with the restricted calories, the intake of multivitamins, minerals and proteins also becomes less which increases the chances of their deficiency. To avoid this, these nutrients and proteins are supplemented early in the postoperative period and may continue for up to 1 year after bariatric surgery.

A lady can plan her pregnancy post bariatric surgery after her weight has stabilised, i.e. 12 -18 months after the procedure. During this time, the diet of the lady would have increased so that it can support the developing baby without any chances of deficiency or side effects.

A person is required to stay in the hospital for 2-3 days following a bariatric procedure. After discharge from the hospital, the person can resume their normal activities within 5-7 days.

The patient is advised a strict diet schedule for period of 6-8 weeks after bariatric surgery. Initially, the diet is composed of liquids only which is gradually progressed to semi solid and then a soft diet. A normal diet is resumed after 2 months but the portion size stays small and 6-8 portions may be taken throughout the day.