Who is the right candidate for bariatric surgery?
When should you consider Bariatric surgery ?
You are extremely obese. Your body mass index (BMI) is 40 or more. Your BMI is above 35. You also suffer from one or more weight-related health issues such as hypertension, type 2 diabetes, osteoarthritis, heart diseases, non-alcoholic fatty liver disease, gastrointestinal disorders, lipid abnormalities, and severe sleep apnea.
Dr. Samrat Jankar, one of the best gastroenterologist in Pune, is the most-sought after surgeon for bariatric surgery as he has years of experience and has handled several complicated cases successfully. Being a laparoscopic surgeon in Pune, he specializes in Laparoscopic Sleeve Gastrectomy, Laparoscopic Roux-en-Y Gastric Bypass, and Laparoscopic Mini Gastric Bypass.
Apart from medical evaluation including your weight and nutrition habits, Dr. Samrat will assess you on the following factors –
- Your Mental Status
If you are normal individual with a positive frame of mind then you are suitable for bariatric surgery. If you are suffering from psychological disorders such as anxiety disorder, childhood sexual abuse, binge eating, bipolar disorder, depression, substance abuse, schizophrenia and so on, then the surgeon will have reservations regarding the outcome of the surgery.
- Your Zeal and Motivation
The surgeon and his team will assess you for your adaptability to adjust to significant changes in eating habits and lifestyle. You will be required to strictly follow the prescribed food and eating guidelines along with an exercise regimen for the best outcome of the bariatric surgery. If you pass this test, then the surgeon will agree to perform the bariatric surgery on you.
- Your Age
Age is yet another vital factor. It is not advisable to perform a bariatric surgery if you are a teenager with a BMI of 35 or more accompanied by obesity-related health conditions. The surgery can be safely performed on adults including those who are above 60 years.
Understanding Bariatric Surgery
Bariatric Surgery is a procedure that helps you to lose weight by making changes to your digestive system. This surgery is recommended when you cannot lose weight by exercising and dieting or when you have serious health issues due to your excess weight. This surgery will help you limit your food intake and the amount of nutrients you can absorb, which lead to weight loss. The surgeon will conduct a thorough physical as well as mental evaluation before recommending a bariatric surgery. It is essential to determine whether you are capable of adapting to a lifelong change in your style of living following a bariatric surgery procedure.
Different types of bariatric surgeries
Laparoscopic Sleeve Gastrectomy
During this procedure, the surgeon will remove around 75% of your stomach, leaving a tube-shaped stomach. This procedure takes about 1 to 2 hours to complete. By limiting the size of your stomach, you are prevented from consuming more food, and also it brings about hormonal changes that help you lose weight. Patients are mostly discharged within 1 to 3 days after Laparoscopic Sleeve Gastrectomy. You can return to your everyday activities within a week, but it will take 2 to 3 weeks for the incision to heal.
Laparoscopic Roux-en-Y Gastric Bypass
In this procedure, the surgeon will divide the stomach into a large and small portion. The smaller section is stapled or sewn to make a small pouch. Then the surgeon will directly connect the pouch to the small intestine. By doing so, the swallowed food goes to the small pouch and then directly into the small intestine. It bypasses the larger portion of the stomach and the first section of your small intestine. After Laparoscopic Roux-en-Y Gastric Bypass surgery, you will be in the hospital for around 2 to 3 days and return to normal activities within 2 to 3 weeks.
Laparoscopic Mini Gastric Bypass
The Mini Gastric Bypass is a short, simple and reversible laparoscopic surgery that combines some properties of both gastric sleeve and gastric bypass surgery. In this procedure, the stomach is divided by the laparoscopic stapler to reduce its size to hold less food. Then the surgeon bypasses around 2 to 7 feet of the intestine and attaches the new stomach to the remaining intestine. This surgery offers shorter operating time and less re-routing of the intestine. Depending on your overall health, you will have to stay around 1 to 2 days in the hospital. The recovery period is mostly similar to gastric bypass surgery.
These guidelines are prescribed months or weeks before the surgery as they depend upon your overall health conditions. You are likely to
Restrict your food and drink intake
Seek lifestyle counseling
Quit tobacco and alcohol
Undertake an exercise program or physical activity under the supervision
Dr. Jankar may even suggest you lose some weight before bariatric surgery.
What to expect after bariatric surgery?
Yes, this is an important topic to which you are required to pay extra attention to.
Post-bariatric surgery guidelines have to be followed dedicatedly, especially for the first couple of months before you can consume normal foods. Remember
- Your stomach requires healing
- Your food intake should match the size of your reduced stomach
- The stomach should be able to digest the food comfortably
- Avoid complications or side effects arising out of surgery
- Concentrate on weight loss and avoid weight gain
Diet suggested for the initial period after the bariatric surgery -
1st – 2nd day – Consumption of clear liquids
3rd day onwards – consumption of broth, juice, decaffeinated tea or coffee, skim milk, etc
From 2nd week after surgery
Consumption of pureed food with absolutely no solids.
The foods should be pureed, mashed, and strained.
Each meal should be approx. 4 – 6 tablespoons
You can have up to 3 – 6 meals per day
It would help if you chew the food very slowly - it is ok to take 30 minutes per meal
After a few weeks, you will be allowed to have –
Soft foods – eggs, cooked cereal, rice, fruit without skin or seeds, vegetables without skin, flaked fish, 3 -5 meals per day,1/3 – ½ cup portion of food per meal
General Diet Instructions to be followed always
- Liquids should be consumed between meals, not with meals
- Keep a gap of 30 minutes before consuming liquids or meals
- Chew well and eat slowly
- Drink slowly as well
- Choose healthy and natural foods that are less sweet and less fattening
- Limit your caffeine intake
- Have supplements regularly