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Obesity is a growing health concern affecting millions of people worldwide. For those who struggle with severe obesity and have been unsuccessful in achieving lasting weight loss through conventional means, bariatric surgery can be a life-changing solution. This surgical intervention involves altering the digestive system to facilitate weight loss and improve overall health. If you or someone you know is considering bariatric surgery as an option, this guide will provide you with essential information to make an informed decision.

According to publication in 2000 in The Medical Journal of Australia, the incidence of being obese in Australia has surpassed twofold over the course of the last 20 years,

In the year 2005, the PubMed research has reported that being overweight currently impacts forty-eight percent of men and thirty percent of women in Australia, leading to an additional 19% of men and 22% of women suffering from obesity.

 

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What is Bariatric Surgery?

Bariatric surgery, also known as weight loss surgery, is a group of procedures aimed at reducing the size of the stomach or bypassing part of the digestive system. The primary goal of these surgeries is to restrict food intake and/or decrease nutrient absorption, resulting in significant and sustained weight loss.

According to NIH research in 2011, bariatric surgery patients should expect to shed around 16kg and 39kg following a year, with gastric bypass producing the greatest weight drop.

Types of Bariatric Surgery

Bariatric Surgery

Bariatric surgery comes in a variety of forms, each with advantages and drawbacks. The most common procedures include:

Gastric Bypass

This surgery involves creating a smaller stomach pouch and rerouting a portion of the small intestine, which reduces the amount of food you can eat and decreases calorie absorption.

Gastric bypass surgery is typically performed laparoscopically, using small incisions and a tiny camera for enhanced precision. The procedure is generally carried out under general anesthesia and typically takes about two to three hours to complete.

Creation of the Small Stomach Pouch – The surgeon divides the stomach into a small upper pouch, which will serve as the new stomach, and a larger lower pouch that is bypassed. This limits the amount of food the patient can consume, promoting earlier feelings of fullness.

Bypassing a Portion of the Small Intestine – The surgeon then attaches the lower part of the small intestine to the small stomach pouch, bypassing a section of the intestine where nutrient absorption occurs. This reduces calorie and nutrient absorption, aiding weight loss.

Sleeve Gastrectomy

In this procedure, a large portion of the stomach is removed, leaving a smaller, banana-shaped pouch, resulting in reduced food intake and hormonal changes that help control hunger. It is also a laparoscopic surgery. The procedure usually takes around one to two hours and is conducted under general anesthesia.

Reshaping the Stomach – The surgeon creates the sleeve by stapling and dividing the stomach vertically, removing approximately 80-85% of the stomach. The remaining stomach resembles a slender tube or sleeve, which significantly reduces its capacity.

Hormonal Changes – The removal of a portion of the stomach leads to changes in the production of hormones that regulate hunger and satiety. This hormonal shift aids in appetite control and contributes to weight loss.

Adjustable Gastric Banding (Lap-Band)

A band is placed around the upper part of the stomach, creating a small pouch, which can be adjusted to control the rate of food passage. The Adjustable Gastric Banding procedure is also a laparoscopic incision. The surgery typically follows these steps:

  • Anesthesia – The patient is given general anesthesia to ensure a painless and comfortable procedure.
  • Placement of the Lap-Band – The Lap-Band is then carefully positioned around the upper part of the stomach, creating a small pouch.
  • Connection to the Port – The Lap-Band is connected to a small port placed beneath the skin of the abdomen. This port serves as the access point for adjusting the band’s tightness by adding or removing saline solution.
  • Recovery and Follow-Up – After the procedure, the patient is taken to the recovery area to awaken from anesthesia. Most patients are discharged from the hospital within 24 hours, and they are closely monitored during their recovery period. Regular follow-up appointments are scheduled to assess progress, adjust the band, and provide support throughout the weight loss journey.

One of the foremost kinds of weight-loss surgery that is least traumatic is gastric band. In accordance to AFP (Australian family physician) review study from 2017, sleeve gastrectomy produce greater reduction in weight results than gastric band surgery.

Biliopancreatic Diversion with Duodenal Switch (BPD/DS)

This complex surgery involves a combination of a sleeve gastrectomy and intestinal rerouting to limit food intake and reduce nutrient absorption. A duodenal switch aims to lower calorie consumption and speed up the process of weight loss. However, the hazards associated with this kind of weight loss procedure are the highest. Biliopancreatic Diversion with Duodenal Switch is performed under general anesthesia and typically follows these steps:

1st step – The surgeon starts by performing a sleeve gastrectomy, where a significant portion of the stomach is removed, leaving behind a banana-shaped pouch. This reduction in stomach size restricts the amount of food that can be consumed, leading to early satiety.

2nd step – The second part of the procedure involves rerouting the small intestine to reduce nutrient absorption. The surgeon connects the end of the small intestine directly to the duodenum, bypassing a significant portion of the small intestine where nutrient absorption typically occurs.

Eligibility specifications

Bariatric surgery is typically reserved for individuals who meet specific criteria:

  • Substantial overweight, measured by a Body Mass Index (BMI) of forty or above.
  • BMI of 35-39.9 with obesity-related health issues (e.g., type 2 diabetes, hypertension).
  • A history of unsuccessful attempts at sustained weight loss through non-surgical methods.
  • A commitment to adopting a healthier lifestyle post-surgery, including diet and exercise.

A physician might urge you to think about this operation in particular if you are experiencing significant, unrelated health issues, like the following:

  • diabetes with type 2
  • arterial hypertension
  • metabolism syndrome

Preparing for Surgery

Preparing for bariatric surgery requires careful planning and adherence to specific conditions to ensure the best possible outcome and minimize the risk of complications. The conditions may vary depending on the type of bariatric surgery (e.g., gastric bypass, sleeve gastrectomy, adjustable gastric banding) and the guidelines set by the surgeon and medical team. However, here are some common conditions you may need to follow for bariatric surgery preparation:

  • Medical Evaluation – undergoing a comprehensive medical evaluation to assess your overall health, identify any pre-existing medical conditions, and determine your eligibility for surgery.
  • Psychological Evaluation – A psychological assessment may be conducted to evaluate your mental health, emotional well-being, and readiness for the significant lifestyle changes required after surgery.
  • Nutritional Counseling – You may be required to attend nutritional counseling sessions to understand dietary changes, portion control, and proper nutrition before and after surgery.
  • Weight Loss Attempts – Some surgeons may require documentation of previous attempts to lose weight through diet, exercise, or medical weight loss programs.
  • Smoking Cessation – If you are a smoker, you may be asked to quit smoking for a specified period before surgery to reduce the risk of post-operative complications.
  • Lifestyle Changes – Committing to adopting healthier lifestyle habits, including regular exercise, can be crucial for successful bariatric surgery outcomes.
  • Education and Support – Attend educational classes and support group meetings to learn about the surgical procedure, recovery process, and long-term lifestyle changes.
  • Pre-Operative Diet – You may be placed on a pre-operative diet plan to reduce the size of the liver, making the surgery technically easier and safer.
  • Medication Management – Inform your medical team about all medications and supplements you are taking, and follow their instructions regarding their use before and after surgery.
  • Alcohol and Substance Use – Abstain from alcohol and recreational drug use advised by your medical team because these can interfere with anesthesia and the recovery process.

It is essential to work closely with the medical team to ensure that you meet all the necessary conditions for bariatric surgery preparation. Each patient’s case is unique, and your surgeon will tailor the preparation process to suit your individual needs and health status. Following these conditions diligently will increase the likelihood of a successful surgery and pave the way for a healthier, more fulfilling life after bariatric surgery.

Risks related to bariatric surgery

As with any surgical procedure, bariatric surgery carries both risks and benefits. Potential risks include infection, blood clots, and complications related to anesthesia.

According to findings published in Journal of Clinical Nursing 2020, some patients who undergo bariatric surgery might struggle socially and psychologically as they adjust to their new “normal.” One might think of discussing additional medical treatment, involving possible assistance teams, with an expert in the field of mental health.

Surgical Risks

Bariatric surgery, like any major operation, carries inherent surgical risks, including infection, bleeding, blood clots, and adverse reactions to anesthesia. These risks are generally low but should be carefully considered.

Nutritional Deficiencies

Certain bariatric procedures, such as gastric bypass and duodenal switch, can lead to malabsorption of essential nutrients, resulting in nutritional deficiencies. Patients are required to take vitamin and mineral supplements to prevent these deficiencies.

Dumping Syndrome

This condition can occur after some bariatric surgeries when food moves too quickly through the digestive system, causing symptoms such as nausea, vomiting, dizziness, and diarrhea.

Gallstones

Rapid weight loss after bariatric surgery can increase the risk of developing gallstones, which may require additional treatment.

Psychological and Emotional Challenges

Some individuals may experience psychological and emotional difficulties post-surgery, including body image issues, changes in relationships, and adjustments to new eating habits.

Benefits

However, the benefits of bariatric surgery can significantly outweigh the risks for eligible candidates. Some of them are given below:

  • Significant Weight Loss – Bariatric surgery can lead to substantial weight loss, helping patients shed a significant amount of excess body weight. This reduction in weight can alleviate pressure on joints, improve mobility, and reduce the risk of obesity-related health conditions.
  • Resolution of Obesity-Related Health Issues – Many individuals with obesity suffer from health problems such as type 2 diabetes, hypertension, sleep apnea, and high cholesterol. Bariatric surgery has been shown to improve or even resolve these conditions, leading to a reduced need for medications and an improved overall quality of life.
  • Enhanced Quality of Life – Weight loss resulting from bariatric surgery can lead to increased energy levels, improved self-esteem, and better physical and emotional well-being. Patients often report enhanced social interactions and participation in activities they once found challenging.
  • Long-Term Success – When combined with lifestyle changes such as healthier eating habits and regular exercise, bariatric surgery can provide long-term weight loss success for many individuals.

The Post-Surgery Journey

The post-journey of bariatric surgery is just as crucial as the procedure itself, as it requires commitment, dedication, and a willingness to embrace profound lifestyle changes.

Researchers proved that laparoscopic procedure is thought to be less invasive, more secure, and efficient than open surgical procedures. It’s linked to quicker healing times, less discomfort, fewer problems, and a lower mortality risk.

In 2018, the findings of a study from Australian Journal of General Practice explained the rate of complications following a month of their operations were 5% of patients who had gastric bypass surgery, 2.9% of those who had gastric band surgery, and 2.6% of those who had gastric sleeve surgery.

Lifestyle changes play a crucial role in achieving and maintaining successful outcomes after bariatric surgery. The surgery provides a tool for weight loss, but it is the post-surgery lifestyle adjustments that contribute to long-term success and improved overall health. Here are some essential lifestyle changes that should be adapted after bariatric surgery:

Phase 1- Recovery and Healing

The immediate post-operative period is critical for recovery and healing. Patients will spend a few days in the hospital under medical supervision. During this time, they will be gradually introduced to a liquid diet, and any surgical incisions will be monitored for proper healing. Pain management, wound care, and mobility are essential aspects of this phase, with patients encouraged to follow the medical team’s guidelines for a smooth recovery.

Phase 2- Transitioning to Solid Foods

As the body heals, patients will progress to a soft diet and eventually transition to solid foods. This phase is a learning process, as patients must adapt to the new capacity of their smaller stomachs and discover which foods work best for their bodies. It is crucial to eat slowly, chew food thoroughly, and avoid high-calorie, sugary, and fatty foods to prevent discomfort and promote weight loss.

Phase 3 – Embracing a New Lifestyle

Bariatric surgery is not a quick fix for weight loss; it is a tool that requires patients to adopt a new lifestyle to sustain their progress. Daily workout is essential for maintaining weight loss, building muscle, and supporting overall health. Patients are encouraged to engage in activities they enjoy, whether it’s walking, swimming, cycling, or participating in group fitness classes.

Phase 4 – Nutritional Changes and Supplementation

Post-bariatric surgery, patients may be required to take vitamin and mineral supplements to prevent nutritional deficiencies. These supplements help compensate for reduced nutrient absorption due to the surgery. Nutritional counseling and regular follow-up appointments with healthcare professionals are essential to monitor nutrient levels and ensure patients are meeting their dietary needs.

Phase 5 – Psychological and Emotional Support

Bariatric surgery not only impacts the body but also the mind. Patients may experience psychological and emotional challenges, such as body image issues, changes in self-esteem, and adjustments to a new eating routine. Support groups and counseling can provide invaluable support during this phase, allowing patients to share experiences, receive encouragement, and learn coping strategies.

Phase 6 – Focus on Sleep

Prioritize sufficient and restful sleep to support overall health, energy levels, and weight management.

Phase 7 – Avoid Smoking and Limit Alcohol

If you smoke, quitting smoking is essential for better healing and overall health. Limit alcohol consumption, as it provides empty calories and can affect nutrient absorption.

Phase 8 – Practice Stress Management

Utilize stress-relieving practices like meditative practices, yoga, concentration, or pastimes to control anxiety and eating disorders.

Phase 9 – Long-Term Follow-Up

Long-term success after bariatric surgery hinges on consistent follow-up care. Regular appointments with the medical team are vital for monitoring progress, addressing any concerns, and making adjustments as needed. Weight loss progress, nutritional status, and overall health will be evaluated during these visits.

Key Takeaway

Bariatric surgery can be a life-changing solution for those struggling with severe obesity and related health issues. However, it is essential to carefully weigh the risks and benefits and understand the commitment required to maintain long-term success. Always prioritize your physical and emotional well-being, and don’t hesitate to seek assistance when needed.  Adapting to a balanced and nutrient-dense diet, practicing mindful eating, engaging in regular physical activity, and attending regular follow-up appointments are integral components of sustaining weight loss and improved health after surgery. The journey towards weight loss and improved health after bariatric surgery is undoubtedly challenging, but it is a path that offers tremendous rewards. From resolution of obesity-related health conditions to enhanced quality of life, bariatric surgery empowers individuals to lead healthier, happier lives.

SmoothiePROTEIN SMOOTHIE

PREP TIME: 5 minutes

COOK TIME: N/A

TOTAL TIME: 5 minutes

SERVING: 1 serving

INGREDIENTS:

  • 1 cup unsweetened almond milk or any milk of your choice
  • 1 scoop protein powder (your preferred flavor)
  • 1 ripe banana, frozen
  • 1/2 cup frozen berries (such as blueberries, strawberries, or mixed berries)
  • 1 tablespoon nut butter (e.g., almond butter or peanut butter)
  • 1 tablespoon chia seeds or flax seeds (optional)
  • Ice cubes (optional, for desired thickness)
  • Honey or sweetener of your choice (optional, for added sweetness)

PREPARATION:

  • In a blender, combine the almond milk, protein powder, frozen banana, frozen berries, nut butter, and chia seeds or flax seeds (if using).
  • Blend the ingredients on high speed until smooth and creamy. If desired, add a few ice cubes to thicken the smoothie.
  • Taste the smoothie and adjust the sweetness by adding honey or sweetener if desired.
  • Pour the Protein Smoothie into a glass and enjoy immediately.

NUTRITIONAL FACTS:

The nutritional composition of the Protein Smoothie may vary depending on the specific ingredients and brands used.

Here’s a general breakdown of the approximate values:

  • Calories: 350-400
  • Fat: 10-15g
  • Carbohydrates: 35-45g
  • Protein: 25-30g
  • Fiber: 7-10g
  • Sugar: 15-20g
  • Sodium: 200-300mg

Learn more about our Bariatric Nutrition Services!

References

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