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Weight loss surgery

What is weight loss surgery?

Weight loss or bariatric surgery is done to help reduce obesity and help those who are obese lose weight. This surgery is done to the intestines and stomach, depending on which type of bariatric surgery is done. Weight loss surgery is used as a last resort for those who have tried exercising and following a strict diet but failed to lose adequate weight and remain overweight. Gastric surgery is known to help reduce up to 50% of the weight when comprehensive lifestyle changes are made.

Who qualifies for weight loss surgery?

Dr. Noorbhai will be able to assess whether or not you are a candidate for weight loss surgery. Men and women who between the ages of 17 and 64 and have a body mass index (BMI) between 30 and 40 are candidates for weight loss surgery. Because weight loss surgery is relatively invasive surgery, it should only be done if all other options have failed. It is essential to understand that weight loss surgery doesn’t comprise of only surgery and requires discipline, behavioural therapy, lifestyle changes and continuous effort to maintain weight loss and keep the weight off.

How is weight loss surgery done?

Before weight loss surgery is done, Dr. Noorbhai requires his patients to prepare for surgery in the following ways:

  • A psychological evaluation of both the patient and family of the patient is done before surgery.
  • A dietician then evaluates the dieting history and eating habits in order to address lifestyle changes. Nutritional education is taught, and an eating plan is given to the patient to begin before surgery.
  • Treatment is then initiated by an endocrinologist after assessing the candidate.
  • Once it is decided that the person is indeed medically fit to have this surgery done, tests are done, and medical history is investigated to understand the medical health of the patient.

How surgery is done will depend on the type of weight loss surgery. The four most popular methods include:

Gastric Bypass: this surgery is done by removing part of the stomach leaving only a small part of the stomach meaning food you consume is bypassed straight to the intestine. This surgery can be done through open surgery or laparoscopically.

Adjustable Gastric Band: this is done by placing a band around the top of the stomach which is controlled by a balloon. The balloon then controls how tight or lose the band is and thus how much food can go into the stomach. This surgery is done laparoscopically.

Gastric sleeve: by removing most of the stomach and leaving only a narrow section of the upper stomach, this surgery is able to prevent the hunger hormone, Ghrelin, allowing you to eat less.

Duodenal switch: by using a gastric sleeve and bypassing to the intestine, this surgery limits the amount of food you can eat. This surgery may not be preferred as mineral and vitamin absorption is restricted.

Electrical implant: like a pacemaker, this implant works by delivering electrical impulses to the nerve between the stomach and brain which tells you when you are full.

Additionally, an endoscopic gastric balloon placement [insert hyperlink to page] may also be considered to lose weight.

No matter what type of weight loss surgery is performed, discipline and healthy lifestyle choices are required.

Why would weight loss surgery be done?

A weight loss surgery is done for those who are having trouble losing weight and have tried dieting and exercising. One of these surgeries may be an option if you are willing to commit to a healthy lifestyle and do the hard work. Most surgical interventions are able to help patients lose from 40-70% of their excess weight within a year and a half. Whether or not you are a candidate for weight-loss surgery, Dr Noorbhai will advise in your consultation. 

Aside from losing weight, weight loss surgery can help treat glucose intolerance, diabetes, sleep apnea, hypertension and ventricular wall thickness. Those who have had weight loss surgery also report increased stamina, mobility as well as enhanced mood and self-esteem. Overall weight loss surgery is able to better quality of life.

How long will I be in hospital?

The duration of this procedure will depend on the type of surgery Dr Noorbhai deems best. All these surgeries are done under anaesthesia and require a few days of observation in hospital. How soon you will be able to go home depends on the surgery done as well as how well you are healing and responding to surgery. Whether you are able to drink liquids when waking up, how much pain you have and whether you have someone to look after you at home will be the factors to consider for discharge.

What will happen after the weight loss surgery?

After surgery, you will not be able to eat for one or two days. You will then begin with a liquid diet and slowly move to solid foods in the next 12 weeks. You may be restricted on how much you can eat and drink at a time. It is normal to experience the following symptoms after any of the above surgeries:

  • Nausea
  • Vomiting
  • Bloating and gas
  • Diarrhea
  • Dizziness
  • Abnormal sweating

In the following weeks, you can expect constipation, dumping syndrome after sugary meals which may cause vomiting, nausea and weakness and gallstones once you begin to lose weight. You will have regular checkups with Dr Noorbhai in the next few months to ensure you are healing correctly and the surgery is successful. In the next 3 - 6 months you can expect body aches, fatigue, feeling cold, hair thinning, changes in mood and dry skin as these are typical responses to the surgery and changes in weight.

You will need to monitor your nutrition after weight loss surgery as your body changes. Absorbing iron, vitamin B12, folate, calcium and vitamin D may be problematic and may require you to take supplements. You will need to make changes and uphold a healthy lifestyle to keep the weight off once you begin to lose it. These changes may include eating small frequent meals, commit to good nutritional meals, exercising to tone up and maintain the weight loss.

What are the potential risks and complications of weight loss surgery?

Weight loss after surgery is usually dramatic. The risk of complications are rare; however, these surgeries are invasive, and the following complications can occur:

  • Bleeding.
  • Infection.
  • Internal leaking.
  • Perforation of the gastrointestinal tract or digestive organs.
  • Deep vein thrombosis (DVT) or blood clots.
  • Risks from general anaesthetic.
  • Dumping syndrome.
  • Nausea, weakness, diarrhoea, fatigue and sweating after eating.
  • Gallstones.
  • Hernias.
  • Ulcers.
  • Low blood sugar problems.
  • Rapid weight loss can be problematic if pregnant.
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