• Bariatric surgery is a term used for any procedure that involves changes in the digestive system to induce weight loss.
  • The most common bariatric surgery procedures include saline gastrectomy, gastric bypass, and adjustable gastric bands.
  • Doctors usually recommend bariatric surgery for people who are extremely obese and have not been able to lose weight through diet, exercise or medication.
  • This article was reviewed by Dr. Abraham Krikheli, Minimally Invasive Bariatric և General Surgeon նախագահ Chair of the Robotic Surgery Committee at Columbia University Irving Medical Center.
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By changing the stomach, sometimes the large intestine, bariatric surgery can help people who are struggling with obesity lose a significant amount of weight and maintain it. Doctors recommend it to patients who have tried unsuccessfully


to lose weight

by other means, including diet, exercise, and medication.

“Many people think this is an easy way out. That’s not true, “said Fatima Cody Stanford, an obesity doctor at the Massachusetts General Hospital Weight Center. “It is a tool that we know, based on evidence, can help people with moderate to severe obesity achieve and maintain a healthy weight.”

How does bariatrics help with weight loss?

It is widely believed that a person’s weight is determined by the number of calories burned, but the reality is much more complicated, says Stanford.

The body’s metabolism is very complex, it will change if you lose weight, either as a result of diet or bariatric surgery, which can make long-term weight loss difficult. One theory as to why weight gain is so difficult suggests that our body և brain is struggling to keep our weight close to a certain point by changing the rate at which our metabolism burns calories.

For example, many participants in the reality TV show “The Biggest Loser” struggled to maintain all the weight they lost during the show. The study was later published obesity In 2016, they found that their metabolism was adjusted to burn fewer calories than before losing weight.

Bariatric surgery works differently because it disrupts the normal signals sent through the gut. When part of the stomach is removed or inaccessible, it alters this communication in a number of ways, including reducing the appetite-stimulating signals associated with the stomach-producing hormone. Decreased ghrelin levels after surgery are thought to be associated with less hunger, which can help people achieve their weight loss goals better.

Different types of bariatric surgery

The American Association of Bariatric Surgery (ASMBS) estimates that 252,000 bariatric surgeries were performed in the United States in 2018. These procedures include:

  1. Ointment gastrectomies, where about 80% of the stomach is removed to leave a banana-like pouch, was the most common, accounting for about 61.4% of bariatric surgeries in 2018.
  2. Roux-en-Y gastric bypass, in which case the food is converted to skip the beginning of the stomach և small intestine, makes up 17% of the procedures. This is the “gold standard” procedure, according to ASMBS.
  3. Reviews:, or further surgeries performed to correct the problems made up 15.4%.
  4. Stomach tapes, which form a small pouch in the upper abdomen using adjustable tape, accounted for 1.1%. The group has lost favor because it requires adjustments և simply not as effective as other procedures, says Stanford.

How much can you lose from bariatric surgery?

A number of studies have shown that bariatric surgery can be effective not only in weight loss but also in improving obesity-related conditions, such as type 2.


diabetes

,


hypertension

, և:


high cholesterol

.

For example, in a 2017 study in the New England Journal of Medicine, researchers followed 1156 people with severe obesity, including 418


bypass surgery

, 12 years. At the end of the study, those who underwent surgery were still an average of 77 pounds less. On the other hand, their colleagues who did not have surgery lost much less weight or did not lose it at all.

The benefits extend to diabetes. From those who had


Type 2 diabetes

About 75% had normal blood sugar levels two years after surgery. Twelve years later, it had halved.

Stanford, however, warns patients to lower their expectations, as many people are still obese after surgery, just to a lesser degree.

“A lot of people come in assuming they’re going to get exactly what they want,” Stanford said. “The body does not work that way, it gets where it gets.”

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