Surgical treatments (weight loss surgery / bariatric surgery)
Surgical treatment for obesity (bariatric surgery) may be offered to people who are morbidly obese (BMI> 40) or severely obese (BMI> 35), with medical complications. These patients will already have tried one or more forms of treatment, which will have been correctly carried out but not produced results. Before bariatric surgery is discussed, patients must meet a certain number of medical criteria and be free of any contraindications. They must be motivated and aware of the benefits and, more importantly, they must understand the disadvantages and constraints of any surgical procedure. They must also be ready to change their eating habits after the operation if the procedure is to be successful in the long-term.
The success of bariatric surgery depends on:
- very good pre-operative preparation
- good patient selection (surgery is not suitable for everybody)
- surgery perfectly carried out by a specialist surgeon
- correct follow-up after the surgery
The gastric bypass technique has been in use for more than forty years. It consists of reducing the size of the stomach to decrease food intake and by-passing part of the stomach and intestine so that less of the food is assimilated.
The sleeve is a technique that has been used for the past ten or twelve years. It consists of reducing the size of the stomach by two-thirds. Its effect is to produce a feeling of fullness more quickly during meals and it also has a hormonal effect which decreases feelings of hunger.
The procedure involves placing a rigid ring around the upper part of the stomach, preventing it from stretching when food reaches it. The feeling of fullness occurs more quickly. The ring is connected to a small reservoir under the skin. The band can be tightened or slackened by injecting serum into the reservoir.