TYPES OF SURGERY
There are two types of weight-loss procedures, restrictive procedures and malabsorptive procedures. Restrictive procedures such as gastric band surgery reduce the size of the stomach to that of a walnut. This limits the amount of food a person can eat. Malabsorptive procedures like Roux-en-Y gastric bypass reduce the size of the stomach and create a bypass around part of the small intestine.
The bypass prevents the digestive system from absorbing the nutrients from the food that is eaten. This regulates appetite and makes the person feel full quickly. For continued weight loss patients have to get accustomed to a whole new lifestyle and diet.
Most patients who undergo Bariatric surgery on an average lose 44 to 66 pounds within two years of surgery. It has been noticed that even a reasonable 5% to 10% weight loss through diet and lifestyle changes decreased the risk for conversion from reduced glucose tolerance to evident diabetes and can maintain reduction in blood pressure over prolonged periods. Bariatric surgery leads to higher weight loss when compared to traditional methods of weight loss hence the benefits are greater. Some of the benefits include reduced cardiovascular mortality, reduction in diabetes, hypertension and hyperlipidemia. Functional and electrical cardiac examinations also show progressive changes in cardiac parameters (structural and electromechanical) after weight reduction.
Obesity is related with higher risk for cardiovascular disease (CVD) and mortality. Studies show that weight loss surgery cures or improves CVD risk factors, to a large extent. Most studies showed significant decrease in the postoperative occurrence of CV risk factors, including hypertension, diabetes, and dyslipidemia. Studies reported that the mean systolic blood pressure reduced from to 139 to 124 mm Hg and diastolic pressure from 87 to 77 mm Hg. C-reactive protein (a protein found in the blood & increases with the presence of an inflammatory disease) decreased, endothelial function (Impaired endothelial function, is the cause for hypertension and thrombosis, is often observed in patients with coronary artery disease, diabetes mellitus, high blood pressure and high cholesterol) improved, and a 40% relative risk reduction for 10-year coronary heart disease risk was observed.
RISKS AND COMPLICATIONS
Like any other surgery, weight-loss surgery has its own risks. Death being one of them; about 1 in 100 who undergoes weight-loss surgery dies within a month or so of the operation. Old age and other severe medical conditions increase the risk of post-operative death.
While weight-loss surgery tends to reduce the risk of CVD in the long run, in the short term the surgery places a lot of strain on the heart. Strokes and other cardiac problems account for as many as one in five post-surgery deaths. This is most likely because of obesity related damage to the heart and blood vessels.
Long-term problems of bariatric surgery include nutritional deficiencies, an obstruction in the stomach or intestines, leakages or contraction around the area of the surgery, hernia, and depression. Because of these complications, lifelong medical follow up and care is important.