Best Bariatric (Weight Loss) Surgery in Delhi, India

Bariatric surgery, or weight loss surgery that alters the digestive system to promote weight loss and improve overall health. It is a major procedure performed to help people, with severe obesity issues, achieve significant and lasting weight loss. Bariatric surgery is typically performed when traditional methods like diet and exercise are ineffective for individuals with severe obesity, and their excess weight contributes to serious health problems.

There are several types of bariatric surgery, each with its own approach to promoting weight loss and improving health. Here are some common types:

• Gastric Bypass Surgery: This procedure involves creating a small pouch at the top of the stomach and connecting it directly to the small intestine. By bypassing a portion of the stomach and the upper part of the small intestine, gastric bypass surgery restricts both food intake and the absorption of nutrients.
• Gastric Sleeve Surgery (Sleeve Gastrectomy): During this procedure, a large portion of the stomach is removed, leaving a smaller banana-shaped "sleeve" or tube-shaped stomach. This reduction in stomach size helps decrease appetite and food intake.
• Gastric Banding (Lap-Band Surgery): A band is placed around the upper part of the stomach to create a small pouch, limiting the amount of food that can be consumed at one time. The band can be adjusted by adding or removing saline solution through a port under the skin.
• Biliopancreatic Diversion with Duodenal Switch (BPD/DS): This complex surgery involves removing a large portion of the stomach and rerouting the small intestine to reduce the amount of food absorbed by the body. It combines both restrictive and malabsorptive elements to promote weight loss.

Each type of bariatric surgery has its own benefits, risks, and considerations, and the choice of procedure depends on factors such as the patient's medical history, BMI, and individual goals. It's essential for individuals considering bariatric surgery to undergo a comprehensive evaluation and discuss their options with a qualified healthcare provider.

Here’s how bariatric surgery can positively impact one’s health and lifestyle:

• Significant Weight Loss: Bariatric surgery can lead to substantial and sustained weight loss, helping individuals achieve a healthier weight and reduce obesity-related health risks.
• Improvement or Resolution of Health Conditions: Many individuals experience improvements or even complete resolution of obesity-related health conditions such as type 2 diabetes, high blood pressure, sleep apnea, high cholesterol, and joint pain following bariatric surgery.
• Enhanced Quality of Life: Losing excess weight can lead to improvements in overall quality of life, including increased mobility, improved self-esteem, and a reduced risk of developing obesity-related complications.
• Long-Term Weight Management: Bariatric surgery can provide a long-term solution for weight management when combined with lifestyle changes such as healthy eating habits and regular physical activity.

Here are some of the risks associated with bariatric surgery:

• Surgical Risks: Like any major surgery, bariatric surgery carries risks such as infection, bleeding, blood clots, and adverse reactions to anaesthesia.
• Nutritional Deficiencies: Restrictive or malabsorptive bariatric procedures can lead to nutritional deficiencies, including deficiencies in vitamins and minerals such as iron, vitamin B12, calcium, and vitamin D. These deficiencies may require lifelong supplementation.
• Gastrointestinal Issues: Some individuals may experience gastrointestinal complications after bariatric surgery, such as nausea, vomiting, diarrhoea, or dumping syndrome, which occurs when food moves too quickly through the digestive tract.
• Psychological and Emotional Challenges: Bariatric surgery can bring about significant changes in body image, self-esteem, and relationships, which may lead to psychological and emotional challenges such as depression, anxiety, or adjustment difficulties.

It's important for individuals considering bariatric surgery to carefully weigh the potential benefits against the risks and to undergo a thorough evaluation by a qualified healthcare provider to determine if they are suitable candidates for surgery. Additionally, post-operative follow-up care and adherence to dietary and lifestyle guidelines are crucial for maximising the benefits and minimising the risks of bariatric surgery.

Bariatric surgery is not a one-size-fits-all solution, and doctors carefully consider various factors to determine if someone is a good candidate.Here's a breakdown of who might be considered ideal for bariatric surgery:

• Body Mass Index (BMI): Generally, a BMI of 40 or higher is considered a strong indicator for bariatric surgery. In some cases, a BMI of 35 or more with serious obesity-related health problems might also be considered.
• Weight: Ideally, a patient should be at least 100 pounds overweight compared to their ideal body weight.
• Health Conditions: The presence of obesity-related health problems like type 2 diabetes, sleep apnea, severe high blood pressure, or joint problems can significantly increase the candidacy for surgery.
• Age: Most bariatric procedures are typically performed on adults between 18 and 65 years of age.
• Lifestyle Commitment: This is crucial. Bariatric surgery is a tool, but long-term success relies on a patient's commitment to significant lifestyle changes, including dietary modifications and exercise habits.
• Psychological Evaluation: Mental readiness and a good understanding of the surgery, risks, and lifestyle adjustments are essential.

Note: Here are some people who may not be ideal candidates for bariatric surgery.

• Pregnant women or those planning pregnancy soon
• Individuals with uncontrolled mental health conditions like active eating disorders
• People with severe uncontrolled medical conditions that could make surgery high-risk

Consulting a qualified healthcare professional is vital to determine candidacy for bariatric surgery. They assess the individual’s situation, medical history, and weight-loss efforts to make the best recommendation.

Preparing for Bariatric Surgery

• Comprehensive Evaluation: This includes a detailed medical history review, physical exam, blood tests, and psychological assessment. It helps determine candidacy, identify any underlying conditions, and ensure that the individual is mentally prepared for the lifestyle changes.
• Nutritional Counselling: Patients meet with a registered dietitian to discuss pre- and post-operative dietary modifications.This prepares them for the significant changes in how they eat after surgery, promoting healthy eating habits for long-term success.
• Weight Loss Education: This focuses on understanding the surgery, potential risks and benefits, and the crucial role of lifestyle changes (diet and exercise) in achieving success.
• Exercise Guidance: The individual might be encouraged to start or increase physical activity to improve overall health and prepare their body for surgery and recovery.
• Medication Adjustments: Some medications may need to be adjusted or discontinued preoperatively.
• Quitting Smoking: Smoking can significantly increase surgical risks. The doctors, therefore, strongly advise quitting smoking well before surgery.

During Bariatric Surgery

• Administering Anaesthesia: General anaesthesia is typically used to ensure comfort throughout the procedure.
• Surgical Approach: There are several types of bariatric surgery, each with its own technique. Common procedures include:
• Laparoscopic Roux-en-Y Gastric Bypass: Creates a small stomach pouch, rerouting food flow to bypass most of the small intestine.
• Laparoscopic Sleeve Gastrectomy: Restricts stomach size by removing a significant portion.
• Laparoscopic Adjustable Gastric Band: An adjustable band is placed around the upper stomach to create a smaller pouch and restrict food intake.

Post Bariatric Surgery Care

• Hospital Stay: The patient will likely stay in the hospital for a few days for monitoring and initial recovery.
• Dietary Restrictions: Initially, the patient needs to follow a strict liquid diet, gradually progressing to soft foods and then a balanced regular diet as their body adjusts.
• Nutritional Support: Vitamin and mineral supplements may be recommended to ensure the patient meets their nutritional needs with the reduced food intake.
• Pain Management: Medication will be prescribed to manage discomfort.
• Wound Care: Follow instructions on cleaning and caring for the incision sites.
• Physical Activity: Gradually increase physical activity as tolerated, following the doctor's guidance.
• Support Groups: Connecting with others who have undergone bariatric surgery can be a valuable source of motivation and support.
• Regular Follow-up Appointments: These are crucial to monitor progress, address any concerns, and ensure long-term success.
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By following preoperative guidelines, understanding the procedure, and diligently following post-operative care instructions, one can maximise their chances of successful and sustainable weight loss.

What preoperative tests are required before undergoing bariatric surgery?

Preoperative tests typically include blood tests, a complete physical exam, nutritional and psychological evaluations, and sometimes imaging tests like an EKG or chest X-ray. These tests ensure you are a good candidate for the surgery and help plan the best approach.

Is it possible to reverse bariatric surgery?

Some types of bariatric surgery, such as adjustable gastric banding, are more easily reversible than others. However, procedures like gastric bypass are much more complex to reverse and come with higher risks.

Does bariatric surgery increase the risk of developing cancer?

There is no evidence to suggest that bariatric surgery increases the risk of developing cancer. In fact, it may reduce the risk of obesity-related cancers by promoting significant weight loss and improving metabolic health.

Can bariatric surgery improve fatty liver disease?

Yes, bariatric surgery can significantly improve or even resolve fatty liver disease by reducing body weight, improving insulin sensitivity, and decreasing liver inflammation.

Does bariatric surgery have any benefits for kidney health?

Bariatric surgery can benefit kidney health, particularly by improving or resolving obesity-related conditions such as diabetes and hypertension, which are major risk factors for chronic kidney disease.

Does one need to follow a specific diet prior to bariatric surgery?

Yes, doctors usually recommended a specific diet before surgery. This preoperative diet helps reduce liver size, making the surgery safer and easier to perform. It often includes high-protein, low-calorie foods and avoids sugars and fats.

What is the typical duration of a bariatric surgery procedure?

The duration of bariatric surgery varies depending on the type of procedure, but it typically ranges from 1 to 3 hours.

Is it safe to consume alcohol after bariatric surgery?

Alcohol consumption is generally discouraged after bariatric surgery, especially in the early stages. Alcohol is absorbed more quickly after surgery, which can lead to intoxication and other health issues. Long-term, it should be consumed in moderation, if at all.

How does bariatric surgery impact pregnancy?

Bariatric surgery can positively impact pregnancy by reducing obesity-related risks and improving fertility. However, it is generally recommended to wait 12-18 months after surgery before becoming pregnant to ensure your body has adjusted and nutritional deficiencies are managed.

What are the long-term health benefits of bariatric surgery?

Long-term health benefits of bariatric surgery include sustained weight loss, improvement or resolution of obesity-related conditions (such as type 2 diabetes, hypertension, and sleep apnea), improved quality of life, and increased life expectancy.

Can bariatric surgery affect mental health?

Bariatric surgery can positively impact mental health by improving self-esteem and reducing symptoms of depression and anxiety associated with obesity. However, some patients may experience emotional challenges post-surgery, so ongoing psychological support is important.

Are there any lifestyle changes required after bariatric surgery?

Yes, significant lifestyle changes are required after bariatric surgery. These include adhering to a healthy diet, regular physical activity, and routine follow-ups with healthcare providers to monitor nutritional status and overall health.

How does bariatric surgery influence diabetes management?

Bariatric surgery is highly effective in improving and often resolving type 2 diabetes. The weight loss and hormonal changes after surgery enhance insulin sensitivity and can lead to remission of diabetes.

Can bariatric surgery lead to nutritional deficiencies?

Yes, bariatric surgery can lead to nutritional deficiencies due to reduced food intake and absorption. Common deficiencies include vitamins B12, D, iron, calcium, and protein. Lifelong supplementation and monitoring are essential.

Are there any restrictions on physical activities after bariatric surgery?

Initially, physical activities are restricted to allow healing. Gradually, patients are encouraged to incorporate regular exercise into their routine. Long-term, there are generally no specific restrictions, and patients are encouraged to stay active for optimal health outcomes.

Reviewed By Dr Ashish Gautam - Senior Director – General, Laparoscopic & Robotic Surgery on 30 Oct 2024.