Your doubts on Bariatrics answered

02 Nov 2018

1. Which is considered the ‘gold standard’ of a weight loss surgery?

a. Gastric Sleeve

b. Gastric Bypass

c. Lap band

d. All of the above

Correct Answer: Gastric Bypass

The gastric bypass surgery, also known as Roux-en-Y Gastric Bypass, is considered the ‘gold standard’ of weight loss surgery as it works by several mechanisms. Similar to most bariatric procedures, there is a smaller stomach pouch created. It is created by dividing the top of the stomach from the rest of the stomach. In gastric bypass, a portion of the small intestine is also divided, and the bottom end of the divided small intestine is brought up and connected to the newly created small stomach pouch.

This newly created stomach pouch and intestine system is considerably smaller and facilitates significantly smaller meals, which translates into less calories consumed. Also, as the smaller stomach pouch digests lesser food, and there is a segment of small intestine that would normally absorb calories as well as nutrients but no longer has food going through it — because of the gastric bypass procedure — there is, to some degree, less absorption of calories and nutrients.

The most significant change is that the rerouting of the food stream by the gastric bypass surgery causes changes in gut hormones that promote satiety, suppress hunger, and reverse one of the primary mechanisms which causes obesity-related Type 2 diabetes.


2. Who is qualified to undergo a obesity surgery?

a. A person whose BMI is > 35

b. A person who is more than 45 kg overweight

c. A person whose BMI is > 32.5 and suffers from any obesity related diseases such as diabetes, hypertension etc.,

d. All of the above

Correct Answer: All of the above

For most bariatric surgeries, there is an acceptable range. This means that there is a minimum and maximum Body Mass Index (BMI) qualification required. Procedures such as gastric sleeve, gastric bypass and lap banding require a BMI over 40 — which means the person should be more than 45 kg overweight that the prescribed healthy limit and should not have any obesity-related health condition. In other cases, a person with a BMI of 35 or over is also qualified but if only the person also suffers from some an obesity-related health condition, such as Type 2 diabetes, hypertension, sleep apnoea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease.

Apart from that the surgery itself should happen at a centre that has a multidisciplinary team of experts for follow-up care, such as at Aster CMI.

After an obesity surgery, most patients are able to return to work within in two weeks. They might feel low in energy for a while after the bariatric surgery but the bariatric surgeon will always give clear instructions that need to be followed to the. 


3. What procedure lets you get back to exercise right away?

a. Gastric Balloon

b. Gastric Bypass

c. Gastric Sleeve

d. All of the above

Correct Answer: All of the above

Any bariatric surgery is the first step to losing weight, not the last. The good thing about a minimally invasive bariatric surgery is that the patient can get to exercise right away. You can take gentle, short walks even while you are in the hospital — the important thing is to start slow and maintain the routine.

Listen to your body and your surgeon: if you used to lift weights or do sports — remember to stay “low impact” for the first two months. Build up your stamina slowly over several weeks. If you are a swimmer, all your incision wounds — even from the minimally invasive bariatric surgery — need to be healed completely before you get back in the water.

Many patients are worried about getting hernias at incisions. That is almost never a problem from work or lifting — however be careful about doing too much of it. Hernias are more often the result of infection, so keep it clean too. You will not feel well if you do too much too soon.


4. How many days will I stay in hospital for bariatric surgery?

a. Two Days

b. Three Days

c. Four Days

d. A week

Correct Answer: Three Days

More often than not, the patients are asked to be admitted to hospital the night before the surgery. After that, there will be two more days of hospital stay, including the day of the surgery. Like any other under-anaesthesia surgical procedure, you will feel groggy and lethargic when you wake up after the surgery.


5. What kind of a procedure is a bariatric surgery?

a. Keyhole

b. Op