Who Needs Bariatric Surgery?

Monday 14 April 2014


An increase number of people who are overweight and obese makes the clinicians to work harder to prevent the occurrence of obesity-related diseases. Bariatric surgery helps extremely obese people to lose weight. But, it is not a guarantee of successful weight loss and maintenance. It is not cheap. The procedures need expertise and specialists from many areas that need to be paid. Having bariatric surgery is a serious decision and it should be decided wisely.  




Who is eligible for bariatric surgery? See 'Candidates for bariatric surgery' below. Commonly, patients who have a body mass index (BMI) greater than 40kg/m² or a BMI greater than 35 kg/m² with the presence of obesity-related diseases are encouraged to do bariatric surgery. The examples of obesity-related diseases are; congestive heart failure, coronary artery disease, hypertension, hyperlipidemia, type 2 diabetes, stroke and polycystic ovary syndrome. Most patients are in between 18 – 60 years old. Older adults also can do bariatric surgery, but more careful is needed because the healing process after surgery is not similar to younger. 




Before obese patients can proceed with bariatric surgery, they must follow non-surgical reducing weight treatment. There are multidisciplinary clinicians involve to help patients to reduce their weight. Such as, dietitians play a very important role to prescribe low calorie diet and physical activity. If it is not helpful, medical officers will prescribe reducing-weight drugs. Psychologists need to motivate and support patients not give up. If the low calorie diet and medical weight loss treatment are no longer effective, bariatric surgery can be the last choice.

Some patients cannot tolerate with anesthetic due to cardiac, pulmonary or hepatic problems. These patients cannot undergo bariatric surgery. For those who have mental illness or unstable psychiatric problems are categorized as poor candidates. Patients should know that bariatric surgery is not a quick fix. They should aware that their lives may change after the surgery. Patients may suffer with nutrient deficiency due to poor absorption. Examples, pellagra (lack of vitamin B3), beri-beri (lack of vitamin B1) and kwashiorkor (lack of protein). The most important, they should aware with the benefits and risks of surgery.

Bariatric surgery may lower death rates for patients with severe obesity. After the surgery, patients have to follow healthy lifestyle that includes well eating patterns and regular exercises. Bariatric surgery is not meant that patients can eat any food without control after surgery. Patients who undergo bariatric surgery, they must commit to lifestyle changes including diet, vitamin supplementation and follow up. The healthy habits can help patients to maintain weight loss after surgery.


 

References:
Bariatric Surgery for Severe Obesity. (2011). National Institute of Diabetes and Digestive and Kidney Diseases (NIH). U.S. Department of Health and Human Services. 
Brethauer, S. A., Chand, B., & Schauer, P. R. (2006). Risks and benefits of bariatric surgery: Current evidence. Cleveland Journal of Medicine, volume 73.

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