Q. Why should someone consider bariatric surgery?

Current research suggests that one in three Indian is obese. In this country alone, about 300,000 deaths per year can be linked to obesity. Obesity is associated with serious health conditions, including high blood pressure, heart disease, sleep apnea (serious sleep disorder), heartburn or reflux, cerebral artery disease (stroke), diabetes mellitus (sugar diabetes), asthma, osteoarthritis, infertility, and cancer of the breast, colon, prostate and uterus. Usually within the first six months after weight-loss surgery, patients may no longer need to take medications for these conditions.

Q: Who is eligible for weight-loss surgery?

A: A person may be a candidate for bariatric surgery if he or she is having BMI greater than 32 or BMI greater than 30 with comorbidities like diabetes, hypertension, arthritis, sleep apnoea etc and traditional weight-loss methods have failed.

Q: What is involved in a gastric bypass procedure?

A: Gastric bypass is the most commonly performed bariatric procedure. This method makes the stomach smaller and alters digestion. It is referred to as a combined restrictive and malabsorptive procedure because less food can be eaten and fewer calories can be absorbed.

Q: What is the recovery time following gastric bypass surgery?

A: Most patients recover from surgery without complications. Patients are encouraged to get out of bed and start walking by the next day. The hospital stay for patients who undergo the procedure is usually two to four days. Most individuals return to work in two to three weeks.

Q. When is bariatric surgery considered successful?

A. Weight-loss surgery is considered successful when a person loses 50 percent of his or her excess weight. Although few people lose all of their excess weight, they do gain numerous health benefits, which may be lifesaving. It’s important to remember that there are no guarantees with any method of weight loss, even surgery. Success hinges on your ability to become part of the plan to support the surgical tool you've chosen and make lifestyle changes with exercise and dietary adjustments.

Q. Are there activity restrictions following bariatric surgery?

A. Yes, strenuous activity should be avoided until you are healed. Walking, however, is a required activity at this stage of recovery.   At your first follow-up visit, your doctor will determine when you can return to work, but most people return to work three to six weeks after surgery.


Q: What are the dietary restrictions following weight loss surgery?

A: Following surgery, you will need to follow specific eating guidelines. Registered dietitians work directly with bariatric surgery patients to provide dietary education before and after surgery.

Q. What about exercise after surgery?

A. Light exercise, such as walking, should begin immediately after surgery. Vigorous exercise will be gradually introduced in six to eight weeks. Exercise will not only keep you feeling well and energized, but it also helps burn fat and calories. For many people, returning to physical exercise is an important step toward feeling better.

Q: How long will it take to lose excess weight after weight-loss surgery?

A: Excess weight loss begins right after surgery and continues for 18-24 months after surgery.

Q: Is it possible to gain the weight back after bariatric surgery?

A: Bariatric surgery has an excellent long-term track record for helping morbidly obese individuals maintain weight loss. If you are committed to making permanent dietary and lifestyle changes, your chance of weight re-gain is minimized.

Q: What are the risks of bariatric surgery?

A: All surgical procedures have risks, particularly when the patient is morbidly obese. Depending upon your individual circumstances, your risks may be higher or lower than average. It’s also important to know that surgeons with more experience performing bariatric surgery techniques have fewer complications. Potential risks of surgery should be discussed with your surgeon so you can make an informed choice.


Q: What is Sleeve Gastrectomy?

Sleeve gastrectomy is a surgical weight-loss procedure generally done by laparoscopy where the stomach is reduced to about 25% of their original size. By laparoscopic surgery removal of a large area of the stomach is done, following a major curve. Outer edges stomach are then attached together often with surgical staples to create a sleeve or tube having a banana shape. The process permanently reduces the size of the stomach. The procedure is performed laparoscopically and isn't reversible.

Q: How the sleeve gastrectomy procedure is done?

The majority of weight loss sleeve gastrectomies performed today use a laparoscopic technique, which is considered minimally invasive. Laparoscopic surgery usually produces a shorter stay in hospital, faster recovery, smaller scars, and less pain than open surgical treatments. Patients usually go back to normal activities in 2 weeks and are fully recovered in 30 days.

Q: What is the main benefit of the sleeve gastrectomy over gastric bypass?

There is two benefits of the sleeve over a gastric bypass:

(1) There is no malabsorption of nutrients or vitamins, unlike with gastric bypass. The risk of developing malnutrition or a vitamin deficiency thus remains really low.

(2) The chance of a sleeve gastrectomy is slightly lower than a gastric bypass in most studies, the rate of weight reduction is about the same.

Q: What is the main advantage of the sleeve gastrectomy over gastric banding?

There is two advantages to the sleeve over gastric banding:

(1) The rate of weight reduction is all about 2-3x faster with a sleeve than a band.
(2) There isn't any implantable device, so slips and erosions are not an issue.

Sleeve gastrectomy patients have been shown to experience significant weight loss and improvements in their health. Patients have been shown to lose an average of 55% of their excess weight.

Q: Is removing the stomach safe in Sleeve Gastrectomy Procedure?

This kind of stomach removal has been performed with the Duodenal Switch procedure since the mid 1980’s. It does involve stapling, just like within the gastric bypass and it has similar risks. Interestingly, patients do not ever return requesting their stomach back however, many do wonder if it is easy to reduce the size it again.

Q: Will I need to take vitamins and minerals like calcium after Sleeve Gastrectomy?

Vitamin and mineral deficiencies are rare with this procedure since there is no intestinal bypass. However, the procedure is very restrictive so most surgeons recommend that patients have a multivitamin, calcium and possibly a B12 vitamin after surgery.

Q: Will I regain weight after Sleeve Gastrectomy?

All patients undergoing bariatric surgery are in risk for weight regain. None of the operations can prevent this. Those patients who maintain good dietary habits and use patterns of exercise may keep your weight off than those who don't exercise and who snack frequently.

Q: What's going to my diet end up like after Sleeve Gastrectomy surgery?

The diet will progress over the first year. It usually begins with 2-4 weeks of liquid protein drinks and water. Patients gradually progress to thicker food items and by 8 weeks are able to eat seafood, eggs, cheese along with other regular foods. The diet generally recommended is low-calorie roughly 500 Kcal per day, high protein 70gm daily, low fat 30 gm daily and low carbohydrates as 40 gm daily. The calorie consumption increases over the newbie by twelve months many patients have achieved their goal weight reduction and consume between 900 and 1500 calories daily. This final calorie consumption depends upon level of activity, age and gender men usually can consume more calories and keep their weight normal.

Q: Is there any reduction in cravings for sweets after Sleeve Gastrectomy?

A clinical study showed that 50% of patients who had a sleeve gastrectomy procedure lost their craving for sweets after 12 months, and after Three years 23% still experienced a loss of revenue of cravings for sweets. Additionally, the amount of a hormone called ghrelin, which has been referred to as a hunger-regulating hormone, was found to become significantly reduced after sleeve gastrectomy surgery.

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