Bariatric surgery is the only proven method for sustained weight loss in patients suffering clinically severe obesity. Bariatric surgery also leads to a significant improvement in obesity related co-morbidities. When it is used specifically for the treatment of type 2 diabetes, it is called as “metabolic surgery”.
Bariatric/metabolic surgery has a favourable effect on type 2 diabetes. It leads to better blood glucose control and eventually reduces the need for anti-diabetic medications in more than 80% of patients. At times, the patient may not need to take any medications for diabetes after bariatric/metabolic surgery. Improvement/remission of diabetes after surgery depends on many factors such as duration of type 2 diabetes, age and BMI of the patient, use of insulin and pancreatic reserve as suggested by c-peptide levels.
Studies have shown that bariatric/metabolic surgery leads to improvement in high blood pressure in more than 60 to 70% of patients. The drug requirement goes down significantly after surgery and sometimes patients do not need to take any medications for blood pressure. Regular monitoring of high blood pressure is advisable after surgery as periodic reduction of medications is needed.
There is significant improvement in sleep apnoea after bariatric surgery. 74 to 98% patients experience a marked improvement. Most patients go off C-pap or Bi-pap use within 2 to 3 months after surgery. With weight -loss oxygen levels become better and carbon dioxide levels decrease leading to improved overall health.
Most obese patients suffer from fatty liver and in severe cases- non-alcoholic steato-hepatitis. Both these conditions may reverse after bariatric surgery. Morbid obesity is one of the commonest causes for cirrhosis of liver and all measures must be taken to check this disease when it is in a reversible stage. However, bariatric surgery must be performed with caution in patients with advanced liver disease.
Bariatric surgery leads to improvement of high cholesterol in 60 to 65% of the patients. it reduces the risk of heart disease and decreases obesity related mortality. It also leads to significant improvement in breathlessness, joint pains, mobility and independence, varicose ulcers, risk of blood clotting, PCOD, infertility, gout, arthritis and so on. It leads to overall improvement in the quality of life of more than 95% of severely obese patients.
Bariatric and Laparoscopic Surgeon
Global Hospital, Parel; Apollo group of hospitals; Currae Hospital, Thane; Namaha and Suchak Hospitals, Kandivali