There are clear indications and benefits of surgery when correct patient is selected and appropriate procedure is performed. Weight loss surgery helps one to loose weight but one has to be prepared for it and know what to expect and what to do afterwards. It is never that I will have weight loss surgery and we do not have to do anything. One needs to be prepared and highly motivated to have surgery with clear understanding of risks and benefits.

When chosen in a correct manner, the after care becomes invaluable in the quest for weight loss. This also means one is committing for life long for healthy life style to look after their health.

Bariatric (Weight loss) surgery is no longer considered as cosmetic surgery. It is preventive surgery at best or curative surgery at the least.

I eat less but still put on weight. Is it possible?

Probably it is not possible unless you suffer from some medical conditions like hypothyroidism or on medicines like
steroids. The food we eat gives us energy in calories and energy used to do any work is counted in calories. One you understand this basic consider the following is true in almost all conditions

    1.Calories consumed = Calories used = No weight gain

    2.Calories consumed > calories used = weight gain

    3.Calories consumed < calories used = weight loss

You might feel you are eating less but if you consume high calorie food then you are likely gain weight. Most times
snacking in-between food itself gives enough calories for the day.

How does weight loss surgery (Bariatric Surgery) work?

Once you have understood the above weight gain logic its easy to understand how the surgery work.

    1.Reduce/restrict the amount one can eat – significantly reduce the size of the stomach. By doing so, one
    will feel full early and has to recognize and stop eating

    2.Reduce the absorption of food/calories - this can be done by bypassing part of gastro-intestinal track.

    3.Combination of both - this will induce significant weight loss.

How should one look at bariatric (weight loss) surgery?

One should look at weight loss surgery as helping hand in vicious cycle of weight gain or inability to induce
weight loss. Once one is overweight, he has to significantly reduce the amount one is eating which is very difficult as the stomach is expanded to accommodate previous habits and will constantly feel hunger when one does not eat enough. One already has side effects like arthritis which significantly impairs ability to do exercise hence loose weight.

Weight loss surgery will break the vicious cycle and induce the weight loss and one has to be motivated to maintain it through out the life.

What are the indications for weight loss surgery?

BMI >37.5

BMI > 32.5 with co morbidities
(Hypertension, Diabetes, Sleep apnea,Severe arthritis)

If ones BMI is >50 then surgery recommended before trying dieting option.

What are the benefits of weight loss surgery?

1. Cure of type 2 diabetes induced by obesity

2. Cure of hypertension induced by obesity

3. Cure of obstructive sleep apnea (stopping of breathing while sleeping)

4. Cure of arthritis induced by obesity

By this weight loss surgery, not only is the survival rate increased but the quality of life is also improved for obese people. Life expectancy is significantly increased in these people.

What are the different kinds of weight loss surgery?

1. Sleeve Gastrectomy: Most suitable of procedures for India population. Mainly restrictive as>75% of stomach is removed. Very little Mal-absorption hence suited to Indian subcontinent.

2. Gastric By pass ( Roux – En – Y): Both restrictive and Mal-absorption. Might lead to nutritional deficiencies if
supplements are not taken regularly.

Above two are the most common procedures. New evidence suggests Sleeve Gastrectomy is as beneficial as
Gastric By pass in motivated patients with less immediate and long term complications and hence as emerged as first choice in India.

3. Adjustable Gastric banding: Needs repeated adjusting to reach optimum level. Needs higher motivation. Long term
benefits yet to be proven.

4.Gastric balloon: Temporary restrictive for 3/6 months.

5. Others: Duodenal switch, Bilo Pancreatic diversion.