Book an Appointment
April 20, 2022 In Bariatric surgery By Dr. Vikas Singhal

Indications of Bariatric Surgery | Dr Vikas Singhal

Are you unable to lose weight despite prolonged exercising, dieting, or other weight reduction tactics? Bariatric surgery is considered when exercise or diet has not helped reduce weight or being overweight is causing other chronic health conditions.  

Bariatric surgery involves changes in the stomach, and digestive tract, limiting the food intake and reducing the ability to absorb nutrients. Thus, helping one lose weight provided post-surgical precautions are followed aptly and precisely. 

A. Indications for Bariatric Surgery

Bariatric surgeries are performed based on specifications, including body mass index, eating habits, health issues, previous surgeries, and risks involved with each procedure. The following factors are some of the indications for bariatric surgery.

1. Weight-associated issues

Bariatric surgery helps lose excess weight and reduce the risk of weight-related health problems, such as:

  • High blood pressure,
  • Type 2 diabetes,
  • Heart disorders and stroke,
  • Nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH), and 
  • Severe sleep apnea.

2. Weight parameters

Generally, your doctor will consider a bariatric surgery when weight loss through dietary changes and exercises could not work even after six months of supervised weight-loss attempts. 

Bariatric surgery helps lose extra kilos for people having the following body conditions.

  • Extreme overweight conditions- When body mass index (BMI) is 40 with or without weight-related medical conditions,  
  • Moderately obese- When BMI is 35 to 39.9 and has associated weight-related health problems like type 2 diabetes, high blood pressure, or severe sleep apnea, 
  • Sometimes, people with a BMI of 30 to 34 and severe weight-related health problems are also considered. 

It is also important to note that bariatric surgery is not for everyone who is overweight or has a high BMI. Bariatric surgery is recommended only when one qualifies certain guidelines for weight-loss surgery. Your doctors will take you through an extensive screening process to check if you require weight-reduction surgery or not. 

While opting for bariatric surgery, you will need to make permanent changes in eating habits, exercise, and maintain a healthy weight. You will need to follow a long-term follow-up plan to monitor your nutrition, lifestyle, and other health conditions. 

3. Lifestyle and psychological risks factors

Bariatric surgery depends on your lifestyle and behaviours in eating and exercising. Your psychological and mental health condition also decides whether or not you can move ahead with the surgery or not. 

  • Smoking and alcohol: Alcohol and smoking often interfere with weight loss goals. These conditions can cause difficulties when it comes to managing weight after surgery. You will need to make changes before moving ahead with the surgery.
  • Eating habits: Eating disorders and irregular eating habits mainly contribute to overweight problems. The mindset to make changes in diet and eating is essential before you go ahead with bariatric surgery.    
  • Mood disorders: Depression, anxiety, bipolar disorder, or other mood disorders are associated with obesity. Untreated mood disorders can be difficult managing weight, following the new diet restrictions, and exercise habits after surgery. Treatment of such conditions is considered before bariatric surgery.  
  • Poor exercise routine: Fatigue, lethargy, lack of exercise is the real cause of overweight issues and associated metabolic disorders. You will need to follow an exercise routine before undergoing bariatric surgery. 

B. Pre bariatric surgery requirements

As mentioned earlier, bariatric surgery involves a lot of psychological, lifestyle, and nutritional prerequisites. Before bariatric surgery, your doctor will work on the following aspects to make you physically and mentally ready for the surgery. 

  • Nutrition: The dietitian will guide you with nutritional requirements, essential vitamin supplements, and diet planning. The guidelines include both before and after surgery. 
  • Exercise routine: Physical trainer or occupational therapist will help you with exercise plans and achieve weight loss goals through physical activities. 
  • Psychotherapy: For eating disorders and other mental health conditions, a therapist can help you improve your psychological health. These include sessions to cope with a condition, self-esteem, confidence building, and more.
  • Lifestyle modifications: You will need to quit smoking and alcohol before the surgery or participate in the rehab program, which would help you quit. 

These prerequisites or requirements are essential to help you achieve your desired weight loss outcomes after surgery.  

C. Types of bariatric surgeries performed

Though most types of bariatric surgery are performed laparoscopically, they may not be suitable for everyone. Some may require traditional open surgery. The three types of bariatric surgery are: 

  • Gastric bypass: One of the most common bariatric surgeries is gastric bypass. Typically, the stomach can hold more than 1.5 kgs of food. This surgery cuts the stomach’s holding capacity to less than 250 gms. 

Here, the upper portion of the stomach and small intestine is shortened. The food bypasses the stomach and first part of the small intestine, entering directly into the middle small intestine section. 

This procedure works by decreasing the amount of food you eat and consequently reducing the absorption of nutrients.

  • Sleeve gastrectomy: With almost 80% of the stomach removed in the sleeve gastrectomy procedure, the small tube-like stomach is left that cannot hold much food. This lowers the appetite-regulating hormone ghrelin and the amount of food intake. 

The advantage of this procedure is that it reduces your desire to eat without rerouting intestines, but with a shorter hospital stay compared to other weight-loss surgical procedures. 

  • Biliopancreatic diversion with duodenal switch: This surgery is done in two steps. The first step involves a sleeve gastrectomy procedure followed by the second part of connecting the duodenum to the end of the intestine. This procedure allows bypass of the stomach and major intestine portions.  

This surgery is highly effective as it limits food intake and reduces nutrient absorption. However, it can pose a higher risk of nutritional and vitamin deficiencies. 

D. Conclusion

A BMI of 35 or more and associated health risks are vital indications of bariatric surgery. 

However, your doctor decides whether or not you can undergo surgery, as the different types of weight-reduction surgery require a strict diet, exercise routine with adaptability to lifestyle changes. 

The type of bariatric surgery depends on various factors, including your medical condition, psychological aspects, and risks involved in each type of bariatric surgery.  
In Delhi, Vikas Singhal and his team will help you with your weight-related issues with proper guidance, treatment, and the best bariatric surgery in Delhi.

Make an Appointment

Send your request and let one of our experts care about it.


    No Comments

    Your email address will not be published.