Bariatric Surgery Process

Bariatric Surgery

Obesity is a great problem in the world today. But what exactly defines obesity? Is it simply someone who is overweight? It is in fact someone who is overweight but is usually applied to those that are excessively so. Obesity has many possible causes. One can become obese as a result of the following:


  • Genetics
  • Physiological influences
  • Food intake and eating disorders
  • Weight history
  • The risk factors include:
  • Hereditary
  • Unhealthy diet
  • Sedentary lifestyle
  • Drugs like steroid hormones and Drugs used to treat psychiatric conditions
  • Pregnancy
  • Lack of sleep
  • Quitting smoking


As you can see that list is a mixture of clinical and lifestyle issues. Being obese puts added strain on the heart and other organs and can be dangerous. Fortunately, there are surgical treatments available, and these go by the name of Bariatric Surgery. That term is an umbrella for a group of surgical procedures aimed at tackling obesity. In the article that follows we will look at those different types, at who is an ideal candidate for bariatric surgery, and at what the patient should expect following surgery.


What is Bariatric Surgery?


Bariatric surgery is another name for weight loss surgery. There are several types of surgical procedure that can be carried out. In each one, the main aim is to reduce the size and capacity of the stomach so that the patient cannot eat large amounts. This is done by various means. The most common types of bariatric surgery are as follows:


  • Intragastric Balloon, is a device placed non-operatively, using a scope and camera system, whereby a balloon is placed inside the stomach for a period of 6-12 months, limiting food intake and promoting weight loss. It is reversible and some balloons are adjustable.
  • Laparoscopic adjustable gastric banding, shortened to lap band, is a procedure carried out using a laparoscope. This is a small surgical instrument which is inserted into a minimal incision in the abdomen. The instrument is then used to wrap a band – somewhat like a belt – around the stomach creating two parts. The result is that food has to pass slowly through the passage in between the two parts. Therefore, the upper part will fill faster, giving the illusion you are full.
  • Gastric bypass surgery involves the creation of a pouch in the upper stomach. This immediately reduces the amount of food the patient can eat. The small intestine is moved from the bottom of the stomach and connected to the new pouch. The result is that food effectively misses out the stomach completely going straight to the intestine.
  • Sleeve gastrectomy is the fitting of a sleeve around the stomach which permanently reduces the size of the stomach to around 15% of the original, this limiting the amount the patient can east.


Each of the above procedures is minimally invasive and these are all commonly performed. Let’s move on and look at who is the ideal candidate for bariatric surgery.


Indications/Candidates for Bariatric Surgery


Bariatric surgery is not recommended for every patient. If an individual visits a doctor about their weight the first step will be to devise a diet and exercise plan. If the person is obese and has a BMI of more than 40 the chances are surgery will be suggested. The type of surgery proposed will depend upon the patient’s health otherwise and personal circumstances. We need to cover the subject of Malabsorptive vs Restrictive Procedures at this point as the difference is important in determining the correct treatment for each individual.


Malabsorptive vs Restrictive Procedures


We have in fact already talked about malabsorptive and restrictive procedures above, so let’s separate one from the other. Both the lap band and sleeve gastrectomy are restrictive weight loss procedures. Each aims to physically restrict the amount of food the patient eats by reducing the size of the stomach using the means described earlier. These procedures enable the patient to feel ‘full’ faster, hence reducing the hunger feeling.


The gastric bypass surgery procedure is a malabsorptive procedure. The effect here is achieved by bypassing the small intestine where nutrients are usually absorbed. The result of this is additional weight loss. This method requires the patient to take supplements to replace these nutrients.


The procedure that is prescribed will depend upon the personal circumstances and reasons for the obesity and will be discussed at length with the patient.


Weight Loss After Bariatric Surgery


It is important to be aware that after undergoing one if the bariatric surgery procedures the patient does not automatically lose weight. There need to be lifestyle and dietary changes that will be laid down in a routine by the consultant. The patient will be on a liquid diet for a couple of weeks after surgery and will be given an exercise routine to follow for the immediate aftermath of the surgery.


Ongoing, the patient will be expected to commit to diet and exercise routines such as the following:


  • Increased exercise on a regular basis.
  • Healthy eating and cutting down on fatty foods.
  • Pay attention to weight and health.
  • Stop smoking and moderate alcohol.
  • Take vacations that involve activity.
  • Live a generally healthy life.


The above are just a few of the requirements a bariatric surgery patient will need to meet in order to be granted the procedure.


Life After Surgery


If the patient follows the instructions from the multidisciplinary bariatric team regarding how to live a healthy lifestyle after bariatric surgery, they will lead a life much more enjoyable and productive than that when they were obese. It is essential that the dietary and lifestyle requirements are continued if the surgery is to be worthwhile.

Surgery will be considered after the patient has unsuccessfully undergone medical diets; has been under the care of a dietician and a psychologist and feels that further attempts at diets will be unsuccessful i.e. a candidate for surgery must have first tried and failed less invasive treatment options.

Obesity Unit South Africa