Who are the candidates for weight loss surgery?
To qualify for surgery patients one must weigh 30 kgs more than their ideal body weight, or have a Body Mass Index greater than 37 without associated Diabetes / Hypertension or more than 32 with associated co morbidities. However, patients who weigh less than this may be considered for surgery as per new IDF (International Diabetes Federation) guidelines for Asians.
Who are the candidates for metabolic surgery or surgery for diabetes?
Candidate must have diagnosed type II Diabetes Mellitus which is not controlled with medicines and lifestyle changes, there is evidence of organ damage in the form of neuropathy or kidney disease, there must be sufficient insulin reserves on Investigations.
Why should I lose weight?
Today pre mature death rates are increased by 200% for men and women who are significantly overweight. Obesity causes or increases the risks of many diseases e.g. Diabetes, high BP, heart disease, joint pains etc
What are the options available to me?
Mild form of obesity can be treated with Diet, Exercise & Medication, however for people who are severely obese after conventional approaches to weight loss such as diet and exercise – have failed, or for patients who have obesity – related disease, surgery may be the best treatment option.
What are the long term results?
The Results of bariatric surgery are long term, studies performed at various bariatric surgical centers concluded that after Bariatric surgery most of the individuals suffering from morbid obesity can maintain more than 50 % of the excess weight loss and among these individuals almost 80 % of those who are suffering from super super morbid obesity are able to achieve more than 50 % of the excess weight loss.
After surgery, when can I resume work?
You could start your office/desk work after 3 days of surgery. If your job involves heavy lifting you may need to wait longer, possibly a week, though different patients behave differently post operatively.
Can I get pregnant after weight loss surgery?
It is strongly recommended that women wait at least one year after the surgery before a pregnancy. Approximately one year post-operatively, your body will be fairly stable (from a weight and nutrition standpoint) and you should be able to carry a normally nourished foetus. You should consult your surgeon as you plan for pregnancy.
Can Weight Loss Surgery prolong my life?
Various research papers published found that those who are affected by morbid obesity and have undergone bariatric surgery are at a lower risk of death then those who do not have surgery. There are proven evidences that after bariatric surgery there is a significant reduction in mortality from diabetes and heart diseases in individuals suffering from morbid obesity. The mortality rate for bariatric surgery (3 out of 1000) is similar to that of gall bladder removal and considerably less than that of hip replacement. The exceptionally low mortality rate with bariatric surgery is quite remarkable.
Can weight loss surgery help other physical conditions?
In addition to improvements in health and longevity, surgical weight-loss improves overall quality of life. Measures of quality of life that are positively affected by bariatric surgery include physical functions such as mobility, self-esteem, work, social interactions, and sexual function. Singlehood is significantly reduced, as is unemployment and disability. Furthermore, depression and anxiety are significantly reduced following bariatric surgery.
How soon will I be able to walk?
Almost immediately after surgery doctors will require you to get up and move about. Patients are asked to walk or stand at the bedside on the night of surgery, take several walks the next day and thereafter. On leaving the hospital, you may be able to care for all your personal needs, but will need help with shopping, lifting and with transportation.
How soon can I drive?
You could start driving from third day of surgery if you feel upto it. However, it is recommended that you don’t take a long drive as it increases the chances of DVT (Deep Vein Thrombosis).
How is bariatric surgery different form liposuction?
Bariatric surgery is a major surgery involving the gastrointestinal tract. The stomach and intestines are modified so that less food can be consumed or absorbed, which leads to a substantial loss of weight that can be maintained for years. Liposuction is a from of cosmetic surgery in which areas of the body are reshaped or resculpted by removing excess amounts of fat in those areas. The purpose of liposuction is not to produce weight loss.
Why not just lose the weight through diet and exercise and skip the serious complications that could result from surgery?
If you can lose the necessary amount of weight (and keep it off) through diet and exercise- more power to you! Ninety-five percent of people considering weight loss surgery have tried (sometimes numerous times) and failed. I like to use this analogy: If someone asks, "If I can buy a lottery ticket and win the lottery, why do I have to work for a living?" my answer would be, "You don't. If it is easier and less painful to win the lottery and you can do it, then go for it." For a morbidly obese individual, losing a significant amount of weight is comparable to winning the lottery.
Is it unhealthy to lose weight rapidly after weight loss surgery ?
I like to answer this question by asking another question: "is it healthy to be 45 kgs overweight?" The rapid weight loss experienced after weight loss surgery is extremely gratifying psychologically and physically. If you eat properly, making sure you get enough protein, there should be no ill effects from it.
I smoke, I would like to quit-but I haven't. How will smoking affect me?
In addition to the well-known ill effects of smoking, it can complicate surgery by increasing the incidence of pneumonia and pulmonary problems immediately after surgery. I recommend that patients stop smoking at least several weeks before surgery.
Will my gallbladder be removed at the same time?
It depends - may be yes, may be no. There is a strong relationship between obesity and gallstones and a high incidence of cholecystitis (gallbladder attacks) during rapid weight loss in patients with gallstones. For this reason, it is customary for patients to be screened for gallstones before surgery. Patients with documented gallstones should have their gallbladders removed at the time of surgery.
If I'm not happy with the results, can the operation be reversed?
The operation maybe reversed only in an emergency. Any weight loss procedure should be thought of as a permanent solution, because if it is reversed, the weight will be regained. Although technically feasible, re-operative surgery is much more difficult and complex and the result will NOT, in all likelihood, restore the individual to the exact same state as before surgery. The impact of weight loss on a person's life is so immense that it is highly unlikely that one would ever demand for reversing the procedure.
Can you gain the weight back?
Long-term results after sleeve gastrectomy and Roux-en-Y gastric bypass have shown that patients usually regain less than 15 percent of the weight they lost after ten years. However, if you go back to your old eating habits and don't exercise at all, you might gain more than that.
I'm sixteen years old. Can someone be too young to be a candidate for this surgery?
Yes. People can be too young. You need to have stopped growing and you must have a mature bone age. In addition, you must understand the surgery and want it. You can't have an operation because your friends or your parents want you to. You need to be able to give informed consent, which means you make an educated decision and then give your permission for the procedure. It is also necessary that your parents are supportive of your decision and understand the role they will need to play in your case and recovery.