The National Institute for Clinical Excellence does recommend surgery if for appropriate patients at the appropriate time. Their recommendation is that it should be considered for all patients with a body mass index over 40. There are numerous different types of gastric or bariatric surgery. The two most common are the gastric band which is often done laparoscopicaly (keyhole) and also the bypass procedure which again, with a skilful surgeon can be done laparoscopicaly

In patients who eat big volumes and big massive meals may be appropriate for a gastric band. This restricts the size of the stomach and means that their stomach will become much more full much more quickly. However, if a particular patient is a constant snacker, always snacking throughout the day on high calorie and calorie dense foods, like chocolate bars, you can see how, with the band these types of foods just seeps through the band and they’re still getting the same amount of calories in. For these patients, a band won’t be appropriate and they’re the type of patients who would benefit much more from a bypass.

Most bypass procedures have an element of restricting the size of the stomach but also, they bypass part of the intestines that’s involved with absorbing the nutrients from the food so it induces a degree of malabsorbtion and these calories aren’t absorbed into the body and you cannot fail to lose dramatic amounts of weight in a short space of time.

Side effects

If you consistently lose more than seven pounds each month it increases the likelihood of ending up with excess skin even if you’re exercising to try and tone up the skin tone and this can result in an apron of excess skin that subsequently needs cosmetic surgery that isn’t funded by primary care trusts.

Although bariatric surgery is effective, people shouldn’t think of it as the quick and easy fix. It is major invasive surgery and it is not without its complications. There are potential complications from the anesthetic  - and these are patients that are an anesthetic risk because of their size – plus there’s post operative complications such as infection and regrettably like with most surgery, some patients may fail to survive the procedure.

Those that do well from the procedure have to accept the fact that the first few months after surgery, they’re going to have a tough time adapting to the fact that they need to be on a liquid diet and also make other changes in their lifestyle to be able to maintain the weight that they’ll achieve from the surgery.

Liposuction

Lots of patients get confused between bariatric surgery for weight loss and cosmetic procedures such as liposuction. Somebody wanting to look thinner who has the funds to investigate going privately for these type of procedures may be tempted to have liposuction thinking that this will make them look thinner and improve their health.  In fact, liposuction only removes subcutaneous fat, and subcutaneous fat is not linked with their cardio metabolic risk. And so by removing this subcutaneous fat it does not improve their health it’s only the visceral fat that’s removed by true bariatric surgical techniques that actually improves their risks.

Date posted: 27/01/2009