What is bariatric surgery?

Bariatric surgery—also known as weight loss surgery—makes surgical changes to your stomach and/or digestive system. These changes limit how much food you can eat and how many nutrients you absorb, leading to weight loss.
By making these changes, bariatric surgery may also reset your body’s “set point,” or weight regulation system, by affecting hormonal signals, resulting in decreased appetite increased feelings of fullness, increased metabolism, and healthier food preferences.

Bariatric surgery

• Limits the amount of food you eat, causing your body to stop storing excess calories and start using its fat supply for energy.
• Causes changes in gut hormones which may impact hunger, satisfaction, and blood sugar control.
• Allows the body to adjust to its new, healthier set point, which enables sustained weight loss, may reduce appetite, and may improve obesity-related conditions.
– Your body’s metabolic set point is the weight range that your body is programmed to function at its best. As your body adapts to a higher-than-normal weight, it establishes and attempts to maintain a higher set point. Bariatric surgery intervenes in this cycle. There are four main types of bariatric surgery:
• Sleeve Gastrectomy.
• Gastric Bypass.
• Biliopancreatic Diversion.
• Gastric Banding.

Most bariatric surgeries today are performed using minimally invasive techniques, called laparoscopic surgery.5 Laparoscopic surgery is done with video cameras and thin instruments inserted through small incisions in the abdomen.

Health benefits of bariatric surgery

Many patients with severe obesity continue to struggle with managing their weight and related health conditions. Bariatric surgery has been shown to be an effective means of achieving lasting weight loss and can improve many obesity-related health conditions.
People who have bariatric surgery also experience improvements in many areas of their life, including physical functioning and appearance and social and economic opportunities.

Potential risks of bariatric surgery

With more bariatric procedures being performed in recent years, safety has improved significantly. The overall death rate is 0.1%—less than gallbladder (0.7%) and hip replacement (0.93%) surgery.
The overall likelihood of major complications is 4%.6. The risk for serious complications depends on the type of surgery, your medical condition, and your age, as well as the surgeon’s and anesthesiologist’s experience.

The long-term commitment to weight loss, and the decision to have bariatric surgery

The decision to have bariatric surgery is an important one. It shouldn’t be made quickly or without weighing the health risks and benefits. It is important to recognize that bariatric surgery is a complement, not an alternative, to lifestyle changes.
The modifications made to your gastrointestinal tract will require permanent changes to your eating habits that must be adhered to for successful weight loss. Having bariatric surgery entails a lifetime commitment to following dietary restrictions, adhering to an exercise program, taking dietary supplements, and complying with follow-up recommendations.
The surgery is one step in a lifelong journey towards better overall health. In order to reach a decision that both you and your doctor feel good about, you should have an open conversation about the surgery you are considering, and make sure your doctor has answered any questions you may have.

Recovery after surgery

After surgery, you will remain in the hospital for a few days, where you will consume a clear liquid diet and be monitored for any immediate complications. Upon discharge, you will be given strict dietary instructions. Depending on the type of surgery you have, about 10 to 14 days after surgery, you will be allowed to add soft or pureed protein sources to your liquid diet and will then gradually build up to a solid food diet at 5 to 6 weeks after your surgery.

In addition to the health benefits of bariatric surgery, keep in mind that you may experience some unwanted changes to your body after surgery, such as scarring or loose skin. Your scars can be various sizes or shapes, depending on the type of surgery you have. Talk to your healthcare team if you are worried about scarring, and they may be able to recommend tips to limit scarring.

Most patients who have bariatric surgery experience loose skin as they lose weight. For some, this may be temporary. The amount of loose skin depends on many factors, including how much weight you lose, your genetics, age, smoking history, and whether you exercise. Clothing or compression garments can often hide loose skin. But, if the extra skin bothers you, discuss options with your healthcare team to see if plastic surgery may be an option for you.

As you begin to lose weight and gain strength, members of your team will help you take the next steps to full health and recovery. They may refer you to support groups or exercise facilities in your community. Studies have shown that patients who have frequent, face-to-face contact with their healthcare team, are most successful in achieving and maintaining their goals.

You will most likely need to see your healthcare team for follow-up appointments every 3 to 6 months, and then every 1 to 2 years after that. It’s important to remember that the decision to have bariatric surgery is the first step in a lifelong commitment to your health, so follow-up
care is recommended for life.