Treatment for obesity, or obesity surgery, refers to procedures that help patients lose weight by limiting their food intake and/or reducing their body’s ability to absorb nutrients.
Surgical procedures can restrict the stomach, making it smaller so that less food can be consumed at once, or they can bypass part of the small intestine to reduce calorie absorption.
These procedures are most commonly performed on patients with morbid obesity who have been unable to lose weight on their own through diet and exercise.
In general, there are two main types of obesity surgery: restrictive and malabsorptive. Restrictive surgeries include the placement of a gastric band, vertical sleeve gastrectomy, and gastric bypass. Malabsorptive procedures include biliopancreatic diversion and duodenal switch. Some procedures can be combined, such as gastrectomy with duodenal switch or Roux-en-Y gastric bypass with biliopancreatic diversion.
There are also different ways to perform each type of surgery, which can affect the treatment’s effectiveness for obesity and its long-term results.
Stomach stapling (sleeve gastrectomy) is one method of performing a restrictive procedure. It is one of the techniques used by a plastic or aesthetic surgeon for the treatment of obesity with high effectiveness.
Before undergoing bariatric surgery, your doctor will carry out a series of tests to determine if you are a suitable candidate for the procedure.
Bariatric Surgery Tests
The following tests are required before undergoing bariatric surgery:
Physical Examination: Your doctor will examine you to check for signs of obesity-related conditions, such as high blood pressure, diabetes, or heart disease. Additionally, your doctor may perform a glucose test called an oral glucose tolerance test (OGTT). This involves drinking a sugary beverage and having your blood sugar levels checked at regular intervals over two hours. If your blood sugar rises too high during this test, it may indicate that your body isn’t producing enough insulin to regulate your blood sugar properly.
ECG: An electrocardiogram (ECG) records the electrical activity of the heart. During an ECG, electrodes are placed on the chest using adhesive pads and connected to a machine that records the electrical impulses in the heart muscle. The ECG can detect irregular heart rhythms or electrical conduction issues, as well as abnormalities linked to coronary artery disease (atherosclerosis). It can also identify certain types of irregular heartbeats, known as arrhythmias.
Psychological Assessment: Individuals with a history of eating disorders or current symptoms should be evaluated by a psychologist or psychiatrist before undergoing bariatric surgery. The evaluation may include:
- A psychiatric history, which involves questions about past mental health issues and current symptoms.
- A mental status exam, which assesses your mood, thoughts, and behaviours.
Obesity and Metabolic Risk
Metabolic syndrome is a collection of risk factors that increase the likelihood of developing heart disease or diabetes. These risk factors include:
- High blood pressure
- High blood sugar (glucose) levels
- High triglyceride (fat) levels in the blood
- Low levels of HDL cholesterol (good cholesterol)
Excess body fat around the waist, especially if you have an apple-shaped body rather than a pear shape, or if your waist circumference exceeds 102 cm (40 inches) in men and 88 cm (35 inches) in women.
Metabolic syndrome is more common in individuals who are overweight or obese. However, it can also occur in people who are not overweight and does not always mean you are more likely to develop heart disease or diabetes.
Obesity and Diabetes Risk
Obesity is a major risk factor for diabetes, with the risk of developing diabetes increasing as BMI rises. Additionally, several other factors can influence diabetes risk in people with obesity.
The exact mechanism by which obesity increases the risk of type 2 diabetes is not entirely clear. However, it is thought that fat tissue produces hormones and other substances that raise blood sugar levels and decrease insulin sensitivity. As a result, cells become less responsive to insulin, causing glucose (sugar) to build up in the blood instead of being used as energy by the body’s cells.
There are different types of diabetes:
Type 1 diabetes (also known as juvenile diabetes or insulin-dependent diabetes) usually develops during childhood or adolescence and requires daily insulin injections to control blood sugar levels.
Type 2 diabetes often occurs in adulthood (though it can develop at any age) and is far more common than type 1 diabetes – around 90% of people with diabetes have type 2.
Obesity and Sexual Health
Obesity is a chronic condition that can lead to various health issues. The most common among women is the risk of infertility. A woman’s body mass index (BMI) must typically be below 30 to conceive naturally. When BMI exceeds 30, the risk of infertility increases.
Overweight or obese women may also experience menstrual irregularities and other reproductive health problems, including:
Infertility – Difficulty conceiving or carrying a pregnancy to term.
Menstrual irregularities – Irregular or absent periods (known as amenorrhoea); heavy bleeding during menstruation; heavy bleeding after menopause; spotting between periods; painful cramps during menstruation.
Pelvic inflammatory disease (PID) – Infection of the uterus, fallopian tubes, or ovaries caused by bacteria from a sexually transmitted infection (STI). PID can lead to scarring in the fallopian tubes or other reproductive organs, potentially causing infertility.
A study by the American Medical Association found that obesity is linked to reduced libido in both men and women. This can lead to erectile dysfunction in men and a lack of desire or difficulty achieving orgasm in women. The study also revealed that obesity can cause poor blood circulation, resulting in painful intercourse for both men and women.
Obesity is also associated with an increased risk of infertility in both sexes. Research presented at the annual meeting of the European Society of Human Reproduction and Embryology in Vienna, Austria, found that obese men have half the sperm count of men with a normal weight. Among obese women, the number of eggs available for fertilisation was lower compared to women of a normal weight.
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F.A.Q
A gastric band (part of an obesity treatment plan) is a surgical procedure that limits the amount of food you can eat. The gastric band is mainly used for people suffering from morbid obesity who want to lose weight.
The procedure involves placing an adjustable band around the upper part of the stomach. This band creates a small pouch at the top of the stomach, which limits the amount of food you can eat and helps you feel full more quickly.
After the operation, the band remains in place, and your doctor adjusts it to ensure it is tight enough to restrict the amount of food you can eat, but not so tight as to cause discomfort or pain. Over time, as you lose weight, your doctor will readjust the band until it fits comfortably around your stomach.
Gastrectomy is the removal of all or part of the stomach. It is performed to treat various stomach conditions, including cancer and other disorders affecting the digestive system.
Gastrectomies are carried out through an open procedure, laparoscopic surgery, or robotic surgery.
A gastrectomy is also performed during bariatric surgery to remove part or all of the stomach so that weight-loss patients can feel full after eating smaller amounts of food.
This reduces their calorie intake and helps them lose weight more quickly than they otherwise would.
Gastrectomy remains one of the options surgeons may consider for the treatment of obesity.
The risks of obesity in children and adolescents are as follows:
Diabetes. An obese child is more likely to develop diabetes than a slimmer child. The risk is even higher if the child has a family history of diabetes or has been overweight from an early age.
Heart disease. Obese children may suffer from high blood pressure, high cholesterol, and other heart-related issues, making them more likely to develop heart disease in adulthood.
Joint problems. Excess weight can put strain on the joints, potentially leading to issues such as early-onset osteoarthritis (a degenerative joint disease).
Respiratory problems. Excess body fat can hinder breathing, affecting both shortness of breath and exercise tolerance.
What is BMI?
BMI stands for Body Mass Index. It is a measure of body fat based on height and weight. The index was created by Belgian mathematician Lambert Adolphe Jacques Quetelet (1796-1874) in the early 1830s. Originally, it was intended to assess obesity and provide data for statistical studies on populations. It was not until 1972 that the National Heart, Lung, and Blood Institute (NHLBI) officially approved the use of BMI as an indicator for evaluating weight issues in America.
What does BMI mean?
BMI is a number calculated from a person’s weight and height. For most people, BMI is a reliable indicator of body fatness. However, since it does not directly measure body fat, individuals with the same BMI can have different body fat levels. Some people with a high percentage of muscle mass may have a high BMI without excess body fat. Conversely, some individuals with excess body fat may have a normal or low BMI because they carry their weight in the lower part of their body rather than around the waist, where it is more easily measured by doctors using standard methods.
Gastric bypass (part of an obesity treatment plan) is a surgical procedure that involves dividing the stomach into two sections and then reconnecting it using staples.
The goal of gastric bypass is to reduce the size of the stomach and slow down food intake, leading to weight loss. The procedure also changes the way the body absorbs nutrients from food.
Gastric bypass is most commonly used to treat severe obesity (body mass index [BMI] of 40 or higher). It may also be used when other methods have not been successful in helping you lose weight or maintain weight loss.
The procedure also involves rearranging the small intestine to lengthen it, reduce nutrient absorption, and increase the speed at which food moves from the stomach to the small intestine. This helps you feel full sooner, even when eating less than before.
The surgery is performed laparoscopically through several small incisions in the abdomen.
The best way to prevent obesity is to adopt a healthy diet and exercise as much as possible. This means eating a variety of foods from all food groups – including fruits, vegetables, bread, cereals, and seeds – at every meal. It also means reducing the amount of fat in your diet.
The best way to prevent obesity is to adopt a healthy diet and exercise as much as possible. This means eating a variety of foods from all food groups – including fruits, vegetables, bread, cereals, and seeds – at every meal. It also means reducing the amount of fat in your diet.
A healthy diet includes:
A variety of fruits and vegetables; whole grains; low-fat dairy products (such as milk and yoghurt); fish (especially oily fish like salmon); lean meat and skinless poultry; legumes such as beans, peas, and lentils; nuts; seeds; olive oil for cooking instead of butter or margarine; and fresh or frozen fruit instead of sugary drinks or sweets.
Reduce your intake of saturated fats (mainly found in animal-based foods like butter or lard) by avoiding them as much as possible – for example, by using vegetable oils instead of butter for cooking.
