Bariatric surgery: A Weight Loss Option for Better Health

 

 

 

     Bariatric surgery is a method used to help those who are overweight or obese, reducing the size of the stomach to treat obesity-related conditions, such as diabetes, hypertension, fatty liver disease, and sleep apnea. 

 

 

 

 

Obesity Classifications

Obesity can be assessed using the following methods:

 

1.  Waist Measurement

     For men, a waist circumference greater than 90 cm (35 inches) is considered high risk. In contrast, for women, a measurement over 80 cm (31.5 inches) indicates risk, especially if accompanied by diabetes, hypertension, or high cholesterol. This condition is referred to as abdominal obesity and is associated with metabolic syndrome, which increases the risk of disability and mortality.

 

2.  Body Mass Index (BMI)

     In medical settings, obesity is typically measured using BMI, calculated by dividing weight (in kilograms) by height (in meters) squared. For example, if someone weighs 90 kg and is 160 cm tall, the BMI would be calculated as (90 / (1.6 x 1.6)), resulting in a BMI of 35.15 kg/m². A BMI over 32.5 kg/m² indicates a high risk and may warrant consideration of weight loss surgery.

 

 

Types of Gastric Surgery

Gastric surgeries are primarily performed laparoscopically and include:

 

1.  Sleeve Gastrectomy

     This popular method involves laparoscopically reducing the size of the stomach to a tubular shape, which decreases hunger hormone levels and leads to quicker satiety and reduced food intake.

 

2.  Roux-en-Y Gastric Bypass (RYGB)

     This procedure combines gastric size reduction with rerouting the digestive tract. The stomach is divided into two parts, with the smaller portion connected to the middle of the small intestine to limit absorption and appetite.

 

 

 

 

 

Pre and Post-Surgery

• Pre-Surgery Diet patients are advised to lose about 5-10% of their body weight in the 1-2 weeks leading up to the surgery to ease the procedure and reduce the risk of complications, such as fatty liver.
• Post-surgery Recovery typically takes about 3-4 days in the hospital. Initially, patients may experience nausea, pain, and fatigue. Doctors may prescribe medications to alleviate these symptoms, and patients should be encouraged to adjust their position in bed to enhance circulation.
• Monitoring Follow-up Appointments are scheduled every 2 weeks for the first month, then every 3 months for 2 years. Patients will have waterproof dressings for their incisions, which do not need to be removed until the follow-up appointment unless there are concerning symptoms such as swelling, redness, pain, or fever.
• Dietary Adjustments After surgery, patients should start with liquid diets of less than 800 calories, aiming for 60-80 grams of protein daily while staying hydrated, as healthcare professionals advise.

 

 

 

 

 

 

Self-Care Stages After Surgery

Patients can begin eating again in four stages:

 

• Stage 1: The patients start with clear liquids like broth, rice water, and sugar-free herbal drinks on the first day after surgery.
• Stage 2: If tolerated well, patients can move to thick liquids like pureed soups or low-carb medical diets on the second day.
• Stage 3: Within 2-4 weeks post-surgery, the patients can progress to soft foods like porridge and tender meats, aiming for about 60 grams of protein daily.
• Stage 4: After one month, patients may return to a regular diet in smaller portions, targeting around 1,000 calories a day while ensuring adequate protein intake.

 

Recommendations

• Start with small portions (2-5 bites per meal) and consider 4-5 meals a day.
• Chew food slowly and stop eating once you feel full.
• Choose quality proteins and low glycemic index carbohydrates and fats, such as fish, chicken breast, eggs, brown rice, and whole-grain bread.

 

 

Q&A Regarding Gastric Surgery

• Is gastric surgery dangerous? While it is becoming more popular, risks depend on individual patient conditions. Advances in laparoscopic techniques have made surgeries less invasive, resulting in quicker recoveries. Risks decrease with care from experienced healthcare professionals.
• What are the benefits of gastric surgery? Surgery not only aids in weight loss but also helps resolve obesity-related disorders such as diabetes, hypertension, liver fat accumulation, heart disease, stroke, sleep apnea, infertility, snoring, and irregular menstruation. It also enhances the ability to engage in daily activities.
• Can recovery happen at home? Patients can return home once deemed ready by their doctors, who will guide diet and self-care.
• What activities should be avoided? Patients should refrain from lifting heavy objects (over 5 kg) and intense physical activities for 6-8 weeks.

 

---

There is a possibility of regaining weight due to various factors such as high sugar or starch intake, snacking, and lack of exercise.

 

 

 

 

Ram Healthy Weight Center

     Ram Healthy Weight Center at Ramkhamhaeng Hospital provides comprehensive weight loss care from specialists and multidisciplinary experts, offering personalized dietary adjustments, exercise regimens, medications, and innovative, effective gastric surgery techniques that minimize post-operative risks, empowering patients to embark on a new life with confidence.