The double-edged sword of technology has made possible many advancements in the field of surgery but at the same time, it has caused lifestyle diseases that warrant the need for such complicated surgical treatments. One such surgical treatment made possible is bariatric surgery. But, like all other technological changes, there are disadvantages of bariatric surgery, in addition to the advantages. Obesity and type II diabetes fall into the category of aforementioned non-communicable, lifestyle diseases which also include cardiovascular diseases and cancer.
Body Mass Index (BMI), which is a measure of body size, is used as a screening tool for obesity. The healthy BMI range for adults is between 18.5-24.9. Individuals with a BMI between 25-29.9 are considered overweight, and those with a BMI of 30 and above and considered obese. The further a person’s BMI is from the healthy range, the greater are the health risks and threats. Type 2 diabetes, high blood pressure, and cardiovascular problems are common health concerns among obese people.
Society today is a lot more body-positive than it used to be, and we continue to make strides towards acceptance of all body types. Earlier, in addition to health risks, people might have opted for weight loss techniques and surgeries simply to adhere to societal norms of a perfect body type.
Today, however, weight loss is either a voluntary choice or medically necessitated. Even then, surgery is always the last resort, when weight loss is not possible through rigorous physical exercises and dietary changes, or the individual keep gaining back the lost weight rapidly.
Also read: Weight Loss And Health Can Move Hand In Hand
What is Bariatric Surgery? Who is eligible for it?
WHO guidelines state that a BMI greater than 35 in adults suggests morbid obesity. The life-threatening consequences of morbid obesity warrant bariatric surgery. Also known as weight-loss surgery, bariatric surgery comprises a group of processes that alter the digestive system.
Some processes reduce the size of the stomach, others remove some part of the small intestine. The idea is to reduce the person’s appetite and calorie consumption, which would in turn prevent weight gain. These processes affect hormones and gut bacteria, which changes the process of fat metabolism and insulin usage in the body.
Bariatric Surgery procedures
The most common bariatric surgeries are gastric bypass, sleeve gastrectomy, and adjustable gastric band. Each has its own advantages and disadvantages.
This is the gold standard of bariatric surgeries. It involves the reduction of stomach volume as well as the size of the small intestine. A shortcut is created for food by bypassing part of the stomach and small intestine. This leads to lesser calorie absorption by the body.
It produces a significant, long-term weight loss, produces favorable changes in gut hormones that reduce appetite, and leads to maintenance of greater than 50% excess weight loss. However, the disadvantages of bariatric surgery include long-term vitamin/mineral deficiencies. It also requires prolonged hospitalization and can lead to greater complication rates.
Laparoscopic Sleeve Gastrectomy
This operative procedure removes 75% of the stomach. A narrow tube of the stomach remains which is connected to the intestines. By restricting the amount of food held by the stomach, it induces rapid and significant weight loss. It requires a shorter hospital stay (2 days) and causes favorable changes in gut bacteria to suppress hunger.
However, it’s a non-reversible procedure and can cause long-term vitamin deficiencies. Gastric sleeve complications include blood clots, hernia, internal bleeding, gallstones, leakage, perforation, skin separation, etc.
Adjustable Gastric Band
Also known as ‘the band’, the procedure involves an inflatable band around the stomach, which divides the stomach into a smaller upper pouch and a larger lower section. It leaves a small hole in between the two sections through which food passes very slowly, thus increasing satiety.
This is the safest procedure as it involves no cutting of the stomach or intestines. It is reversible and adjustable, with the lowest rate of postoperative complications. It requires a much shorter hospital stay (often less than 24 hours) and has the lowest risk of vitamin deficiencies.
However, weight loss is slower and lesser than other procedures. The individual is required to strictly adhere to the postoperative diet. Also, since a foreign object is inserted into the body, there could be band slippage or erosion, or still other mechanical problems. It has the highest rate of re-operation.
Bariatric Surgery side effects
The most commonly reported side effects of bariatric surgery include:
- Acid reflux
- Anesthesia risks since general anesthesia are administered to people undergoing the surgery
- Chronic nausea and vomiting
- Dilation of the esophagus (especially in adjustable gastric banding)
- Inability to eat certain foods due to postoperative dietary restrictions
- Obstruction of stomach
- Weight gain or failure to lose weight
- Internal bleeding
- Blood clots
- Leaking from sites where the stomach and/or intestine are altered
How dangerous is Bariatric Surgery?
As mentioned at the beginning of this article, technology is a double-edged sword. As a result, all modern surgeries are riddled with risks and advantages and it is normal to have concerns about its potential dangers. Bariatric surgery is among one of the safest surgeries to undergo.
The laparoscopic approach used these days reduces the complications as it is minimally invasive, and causes limited scarring and pain. Make sure you do some research and consult an expert in the field of bariatric surgery (a licensed professional who has performed a large volume of such surgeries). Being well-informed and in good hands also adds to your safety.
Prevention is better than cure
Finally, it is important to thoroughly weigh the cost and benefits of the surgery before deciding to get it done. It is only advisable if you’re unable to successfully reduce weight through exercise and diet. Prevention is always better than cure. Maintaining a healthy routine becomes a difficult task in today’s busy, competitive world.
But, it is better to make some effort in that direction than undergoing the risks of altering your natural body through surgical equipment. There are also economic considerations before you decide to get bariatric surgery. It costs anywhere between Rs. 2.5-5 lakh in India and $15,000-$20,000 abroad. Medical insurance has now begun to include bariatric surgery costs only if:
- It has been advised by a doctor
- If the patient is older than 18 years
- The BMI of the patient is 40 or above, or 35-39.9 with diabetes or heart disease
- The surgery has been conducted with proper clinical protocols
Your health must be your priority. Make an informed choice in the right direction!