Bariatric surgery induces changes in various hormones which helps in increasing BMR causing weight loss, reduces hunger and early satiety, and it is important to know that these changes are opposite to those induced by dietary weight loss.
Most patients lose about 65 to 85% of their excess body weight with the bariatric procedures. Substantial weight loss occurs within the first 18 months of surgery, some weight regain is normal and can be expected at two to five years after surgery.
Bariatric surgery improves overall quality of life by providing:
- Weight loss, and
- Resolution of comorbidities
With ongoing weight loss, people become more active, independent and are more involved in daily routine. All these activities add to the weight loss mechanism.
Rerouting gastro-intestinal tract leads to changes in gut hormone secretion which, in turn, may potentiate the antidiabetic effects of bariatric surgery. However, the resolution rates after metabolic surgery vary with type of procedures, duration of diabetes, the number of anti-diabetic medications, and the use of insulin and presence of end organ involvement.
In general, the short term results of sleeve gastrectomy, gastric bypass are similar though in the long run the bypass may be superior. Morbidly obese patients generally suffer from sleep-related breathing disorders, symptoms would be snoring, and poor sleep quality with early morning headache and reduced performance on the work front. Many studies have concluded that even moderate amount of weight loss can effectively treat symptoms of sleep apnea.
Abdominal obesity is strongly associated with dyslipidemia. Dyslipidemia associated with hypertension, insulin resistance, and abdominal obesity is collectively referred to as metabolic syndrome. The metabolic syndrome is a cluster of risk factors for heart disease and type-2 diabetes that occur together more often than by chance alone.
Several studies have reported significant improvement in lipid profile, reduction in hypertension, decrease in risk of coronary artery disease and mortality after bariatric surgery.
Bariatric surgery also remarkably improves asthma, other breathing disorders, arthritis, GERD (gastro esophageal reflux disease), fatty liver, urinary stress incontinence, etc.
There is an improvement in health and longevity as well as mobility, self-esteem, work, social life, and sexual interactions after bariatric surgery. There are more chances to find a partner and issues like depression and anxiety are significantly reduced.
Various research studies have found that individuals affected by severe obesity who have had bariatric surgery, have a lower risk of death than individuals affected by obesity who do not have surgery.
During the pandemic, people with obesity who lost weight with the help of bariatric surgery and who afterwards contracted COVID-19 were less likely to be admitted to the hospital, and the effect was less severe than among COVID patients with obesity who had not submitted to the surgery.
Also, because most surgeries are performed laparoscopically, patients will typically experience shorter hospital stay, smaller incisions and quicker recovery.
Obesity poses multiple health issues, most of these issues can be greatly improved, or entirely resolved with successful weight loss with the help of bariatric surgery.
The overall quality of life gets improved. Many patients express elation on being able to do things that may seem trivial to the non-obese person, such as improvement in personal hygiene, going to the food store, playing with their children, getting in and out of a car, riding a roller coaster, shopping regular sized clothes…….the list is endless!!!
