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Bariatric surgery criteria include 40 or more BMIs (or over 100 kg)

Surgeries reduce the amount of food և Hormonal changes that reduce hunger



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Do you have a pound to lose weight, but do not have a plan to lose weight? If you are seriously considering how to lose weight, there are three proven levels of intervention depending on your individual needs.

Intervention 1. Lifestyle changes

Intervention 2. Medications

Intervention 3. Surgery

If you are overweight, have not been able to lose weight with lifestyle changes or weight loss medications, or if you have serious health problems related to obesity, bariatric (or weight loss) surgery is a potential option.

“You think about surgery when other obesity treatments fail,” says Sue Cummings, a registered nutritionist who has been the clinical program coordinator at the Massachusetts General Hospital Weight Center for the past 20 years. “The man has gone through everything, now he has diabetes, hypertension, sleep apnea, arthritis. “Then you would really start thinking about surgery.”

In the United States, weight loss surgeries include gastric bypass surgery, or gastrectomy (also known as gastric bypass surgery), a procedure called biliopancreatic diversion with a duodenal switch. The latter has the best results in terms of forgiveness of many medical conditions associated with weight loss and obesity, according to Cummings. However, it also carries the maximum risks.

Cummings said the adjustable gastric band is another option, although the long-term risks associated with the band have led to a significant reduction in surgeons.

Bariatric surgery criteria include a body mass index (BMI) of 40 or higher (or over 100 pounds) or a BMI of 35 or higher for health problems, including type 2 diabetes, high blood pressure, heart disease, or sleep apnea. : (A BMI of more than 30 ունեցող with a serious health problem is only indicated for the stomach area).

Surgeries lead to weight loss for two reasons. They reduce the amount of food: cause changes in the hormones produced in the intestines, which help reduce hunger, increase satiety և regulate blood sugar. For a detailed description of the various weight loss surgeries, see the online guide to the American Society for Metabolic արի Bariatric Surgery.

In fact, most bariatric surgeries are so effective at creating long-term weight loss that they greatly affect the physiological regulation of body weight by interfering with the signals that protect against hunger and weight loss. This ultimately changes the point or level at which a person seeks to stabilize their weight.

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“Surgery literally changes the way your body regulates body weight,” he said.

For example, the base or upper part of the stomach is the main place where ghrelin, the appetite-stimulating hormone, is produced. The production of ghrelin is significantly reduced after the removal of the fundus in the stomach. Bypassing the stomach to a lesser extent accelerates the supply of nutrients to the area of ​​the small intestine known as the buttocks, which causes an increase in the secretion of appetite-suppressing hormones, according to Cummings.

An individual’s response to weight loss surgery varies, although on average people undergoing bariatric surgery lose 15% to 35% of their original weight. Gastric bypass tends to lose more weight than the waist or abdomen, Cummings said, although “each bariatric procedure shown shows such wide variations in patient outcomes.”

As a result of weight loss, bariatric surgery can improve many health conditions associated with obesity, including type 2 diabetes, sleep apnea, high blood pressure, high cholesterol, acid reflux, and arthritis. In the case of gastric bypass, the improvement in diabetes occurs within a few days after surgery, regardless of weight loss. The reason is due to hormonal changes that enhance the response of insulin to nutrients, Cummings explained.

The benefits of weight loss surgery, however, do not come without risks և Long-term considerations. “About 10% to 20% of patients are unable to lose significant weight, while others experience significant or premature weight gain,” says Cummings.

Complications of surgery may include infection, bleeding, poor nutrient absorption, or early dehydration, such as ulcers and hernias. The side effect of gastric bypass, known as “dumping syndrome”, can occur immediately after eating and can lead to nausea, dizziness, weakness, cold sweats, spasms, diarrhea.

Long-term results are also different. According to a 12-year study of people who underwent gastric bypass surgery, one in three experienced tape erosion, and almost half of patients needed to have their belts removed.

You may realize that lifestyle changes after surgery are extremely important. This includes avoiding the many temptations of the food around you, such as fast food french fries and local coffee shop cookies.

“Surgery will not change the environment. “Therefore, combining lifestyle changes with surgery will give the best results,” Cummings said. These changes include eating more whole foods, avoiding processed foods, and increasing daily physical activity.

In addition, lifelong vitamins and minerals are needed, including iron, calcium, folic acid, and vitamins B12 և B1 և D. “The risk of defects increases when a patient leaves surgery, so all patients must constantly monitor their food laboratories for life,” Cummings said.

Deciding to have weight loss surgery is not easy. Each patient should be fully aware of the risks ուտ benefits և assessed by a multidisciplinary team, including a surgeon, physician (their primary care physician և and / or obesity specialist), a registered dietitian և a mental health professional. , – explained Cummings.

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In addition, a full benefit-risk analysis should be performed.

“Do the benefits outweigh the risks?” “If that’s the case, surgery is the most effective therapy,” Cummings said. type diabetes, heart disease, sleep. apnea, high blood pressure, kidney failure, etc.

Lisa Dreyer is a nutritionist and author of CNN Health և Nutrition Investor.

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