Obesity is a major health problem for many people and can contribute to the development of arthritis, diabetes and heart disease. Some people are unable to lose weight through diet and exercise alone. Bariatric surgery provides a way to help these people lose excess weight and improve their overall health in the process.
Principles
There are two main ways in which bariatric surgery can work: restriction and diversion. The concept of restriction, KidsHealth explains, focuses on reducing the functional space within the stomach, which means that a patient can only consume a limited amount of food. Diversion, on the other hand, focuses on redirecting food around part of the small intestine. This causes less of the food to be absorbed. It also causes more of certain hormones that signal satiety to be released, causing patients to feel full after eating smaller amounts of food.
Indications
Patients may consider receiving bariatric surgery if they are obese. Obesity is often defined in terms of a patient's BMI, or body mass index. A person's BMI, the "Journal of the American Medical Society" explains, can be calculated by dividing his weight in kilograms by the square of his height in meters. A BMI of over 25 means that the patient is overweight, whereas a BMI over 30 is indicative of obesity. Patients with a BMI over 40 are morbidly obese and are especially likely to benefit from bariatric surgery.
Types
There are a number of different bariatric surgery procedures. Roux-en-Y surgery, also known as a gastric bypass, involves the stapling of the stomach, creating a small pouch where food can accumulate. The rest of the stomach and part of the small intestine is then bypassed by rerouting food around them. Laparoscopic banding, on the other hand, involves wrapping an inflatable band around the upper portion of the stomach, restricting the stomach's usable area. Other options include a biliopancreatic diversion with duodenal switch, vertical-banded gastroplasty and a sleeve gastrectomy. All of the procedures work by restricting the volume of the stomach and/or bypassing some of the digestive tract.
Effectiveness
Bariatric surgery, the "Journal of the American Medical Association" explains, works best when it is combined with a regular exercise routine and lifestyle changes that are designed to improve a patient's health. Bariatric surgery is not recommended for patients with certain health problems, such as liver and cardiovascular disease or a history of kidney stones. A patient's mental health should also be assessed; patients who suffer from substance abuse, depression or binge-eating may have a hard time making the kinds of behavioral changes that are necessary for the effectiveness of bariatric surgery.
Complications
According to the National Institute of Diabetes and Digestive and Kidney Disorders, some early complications of bariatric surgery include infection of the surgical site, leakage of the gastrointestinal system where the intestines have been stapled together, and blood clots which can form in the veins and travel to the heart or brain. Later complications include malnutrition as a result of not taking vitamin supplements and eating a carefully designed diet. Patients are also at a higher risk of developing hernias in their abdomens after bariatric surgery.
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