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Metabolic and Bariatric Surgery

What is Metabolic and bariatric surgery

Bariatric Surgery: This type of surgery is primarily aimed at weight loss. It includes procedures that alter the digestive system to help a person lose weight. Common methods include reducing the size of the stomach (e.g., gastric sleeve, gastric band). Bariatric surgery is typically recommended for individuals who have not achieved significant weight loss through diet and exercise and have a BMI (Body Mass Index) above a certain limit

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Metabolic Surgery: While metabolic surgery also leads to weight loss, its primary aim is to alter the underlying metabolic and hormonal imbalances that contribute to conditions like type 2 diabetes, hypertension, and dyslipidemia. Although these procedures can be similar to those used in bariatric surgery (like gastric bypass), the focus is more on the metabolic effects rather than just weight loss.

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Expected Weight Loss After Bariatric Surgery

After bariatric surgery, the amount of weight loss can vary depending on the type of surgery, the individual's starting weight, and their adherence to lifestyle changes. On average:

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  1. Gastric Bypass: Patients might lose 60-80% of their excess body weight within two years

  2. Sleeve Gastrectomy: Typically results in a loss of about 50-70% of excess body weight in the same timeframe.

  3. Mini Gastric Bypass: Patients might lose 60-80% of their excess body weight within two years.

Reversal of Comorbidities After Metabolic Surgery

Metabolic surgery can lead to the improvement or resolution of several obesity-related comorbidities:

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  1. Type 2 Diabetes: Many patients experience significant improvement or remission.

  2. Hypertension: Blood pressure often decreases, reducing or eliminating the need for medication.

  3. Dyslipidemia: Improvements in cholesterol and lipid profiles are common.

  4. Obstructive Sleep Apnea: Weight loss can improve or resolve sleep apnea symptoms.

  5. Gastroesophageal Reflux Disease (GERD): Symptoms may improve, especially after gastric bypass.

  6. Joint Pain: Reduction in weight can alleviate stress on joints, improving mobility and pain.

  7. Fertility: In women, fertility can improve, and menstrual irregularities often resolve.

  8. Psychological Well-being: Improvements in conditions like depression and anxiety

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Life After Bariatric Surgery

Life after bariatric surgery involves significant lifestyle adjustments and follow-up care:​

  1. Dietary Changes: Patients must adhere to the given diet focusing on protein intake and avoiding high-calorie foods.

  2. Vitamin and Mineral Supplements: Due to reduced nutrient absorption, supplementation of vitamins and minerals is often necessary.

  3. Regular Exercise: Incorporating physical activity is crucial for maintaining weight loss.

  4. Medical Follow-up: Regular check-ups are important to monitor health and nutritional status.

  5. Long-term Commitment: Successful weight management requires a lifelong commitment to healthy eating and exercise habits.​

When to think about Bariatric surgery

1. BMI of 27.5 with diabetes, Hypertension, Obstructive sleep apnea and other complications

2. BMI of 32.5 and above

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