Bariatric Surgery

Bariatric Surgery

What is Bariatric Surgery?
Bariatric surgery is a surgical treatment for obesity. It not only reduces weight, but also adjusts eating and nutrient absorption for sustainable weight loss. It is suitable for those who have not been successful with conventional weight management.

Working Principles:
1. Reduces stomach size → Reduces appetite
2. Partially redirects the digestive tract → Reduces energy and nutrient absorption
3. Stimulates appetite-regulating hormones, such as GLP-1, → Reduces hunger

Causes/Reasons for Treatment
- Severe obesity: BMI ≥ 40
- Obesity with comorbidities: BMI ≥ 35 + comorbidities such as:
- Type 2 diabetes
- High blood pressure
- High cholesterol
- Obstructive sleep apnea
- Osteoarthritis, cardiovascular disease
- Failure of other weight management methods

Common symptoms/problems in obese patients:
- Difficulty breathing or fatigue
- Joint pain or osteoarthritis
- Difficult-to-control diabetes
- High blood pressure or abnormal cholesterol
- Sleep apnea

Preoperative assessment/diagnosis
1. History and physical examination: Weight, height, BMI, comorbidities, eating behaviors, and mental health.
2. Blood and hormone tests: sugar, fat, liver, kidney, thyroid hormones.
3. Nutritional assessment: Check for readiness to change behaviors.
4. Psychological assessment: Screen for depression and eating disorders.
5. Additional tests: such as a gastroscopy or X-ray in some cases.

Advantages of surgery:
- Lose 50–70% of excess weight within 1–2 years.
- Control or resolve comorbidities such as diabetes, hypertension, and high cholesterol.
- Reduce the risk of cardiovascular disease.
- Improved quality of life, such as easier walking and activities.

Risks/Complications:
- Complications from surgery: Bleeding, infection, blood clots.
- Malnutrition: Vitamin B12, iron, calcium, vitamin D.
- Gastrointestinal problems: Diarrhea, nausea, wound separation.
- Psychological problems or eating disorders.

Should or should not be considered?
- Persons with severe obesity and comorbidities.
- Other weight loss methods have not been effective. -Ready to adjust eating habits and follow up with a doctor.
Do not attempt:
*Pregnant or planning to become pregnant early
*Experience uncontrolled mental illness
*Alcohol or drug addiction
*Failure to comply with post-operative care



Summary
Bariatric surgery is a highly effective treatment for obesity, effectively reducing weight and comorbidities. However, it requires thorough evaluation and a commitment to lifelong behavioral adjustments.