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Weight loss surgeries and medicines
Why Medicines and surgeries are used for reducing weight in some cases?
Weight loss surgery, also called bariatric surgery, is used to treat people who are dangerously obese.
Clinically severe obesity is a BMI > 40 or a BMI > 35 with a serious health problem linked to obesity.
Recent studies suggest that bariatric surgery may even lower death rates for patients with severe obesity. The best results occur when patients follow surgery with healthy eating patterns and regular exercise.
This type of surgery is only available in authorized medical centers to treat people with potentially life-threatening obesity when other treatments, such as lifestyle changes, haven't worked.
Potentially life-threatening obesity is defined as:
• Having a body mass index (BMI) of 40 or above
• Having a BMI of 35 or above and having another serious health condition that could be improved if you lose weight, such as type 2 diabetes or high blood pressure
• Adults who have recently been diagnosed with type 2 diabetes may also be considered for an assessment for weight loss surgery if they have a BMI of 30-34.9.
For people who meet the above criteria, weight loss surgery has proved to be effective in significantly and quickly reducing excess body fat.
However, it's always recommended that you try to lose weight through a healthy, calorie-controlled diet and increased amounts of exercise before you consider weight loss surgery, as surgery carries a risk of complications and requires a significant change in lifestyle afterwards.
What is weight loss surgery?
Currently, bariatric surgery may be an option for adults with severe obesity. Body mass index (BMI), a measure of height in relation to weight, is used to define levels of obesity. Clinically severe obesity is a BMI > 40 or a BMI > 35 with a serious health problem linked to obesity. Such health problems could be type 2 diabetes, heart disease, or severe sleep apnea (when breathing stops for short periods during sleep).
Severe obesity is a chronic condition that is hard to treat with diet and exercise alone. Bariatric surgery is an operation on the stomach and/or intestines that helps patients with extreme obesity to lose weight. This surgery is an option for people who cannot lose weight by other means or who suffer from serious health problems related to obesity. The surgery restricts food intake, which promotes weight loss and reduces the risk of type 2 diabetes. Some surgeries also interrupt how food is digested, preventing some calories and nutrients, such as vitamins, from being absorbed.
If you’re very obese and you’ve already tried improving your diet and exercise levels without success, then weight loss surgery could be the right option for you. But it’s not a short cut to losing weight easily as it will mean changing the way you eat forever.
But in cases where lifestyle changes, accompanied by weight loss medicines when appropriate, are not enough, then weight loss surgery, also called bariatric surgery, may be an option.
Having surgery to produce weight loss is a serious decision. Anyone thinking about having this surgery should know what it involves
When considering weight loss surgery, it’s important to bear the following in mind:
• Weight loss surgery should be seen as a last resort.
• Not everyone is eligible to have it done as it depends on hospitals terms and condition.
• After surgery, you will never be able to eat the same way again, or you will become very ill if you do.
• After surgery, you will need to follow a carefully controlled diet and take regular exercise.
There is no sure method, including surgery, to produce and maintain weight loss. Some patients who have bariatric surgery may have weight loss that does not meet their goals. Research also suggests that many patients regain some of the lost weight over time. The amount of weight regain may vary by extent of obesity and type of surgery. Habits such as snacking often on foods high in calories or not exercising can affect the amount of weight loss and weight regain.
Problems that may occur with the surgery, like a stretched pouch or separated stitches, may also affect the amount of weight loss.
Success is possible. Patients must commit to changing habits and having medical follow-up for the rest of their lives.
If you’re interested in weight loss surgery, talk to your physician to learn more.
Bariatric Surgery for Youth
Rates of obesity among youth are high. Bariatric surgery is sometimes used to treat youth with extreme obesity. Although it is becoming
clear that teens can lose weight after bariatric surgery, many questions still exist about the long-term effects on teens' developing bodies
Who is a good youth candidate for surgery?
Experts in childhood obesity and bariatric surgery suggest that families consider surgery only after youth have tried for at least 6 months
to lose weight and have not had success.
Candidates should meet the following criteria:
• Have extreme obesity (BMI > 40 )
• Be their adult height (usually at age 13 or older for girls and 15 or older for boys)
• Have serious health problems linked to weight, such as type 2 diabetes or sleep apnea, that may improve with bariatric surgery.
In addition, health care providers should assess potential patients and their parents to see how emotionally prepared they are for the
surgery and the lifestyle changes they will need to make. Health care providers should also refer young patients to special youth bariatric
surgery centers that focus on meeting the unique needs of youth.
Mounting evidence suggests that bariatric surgery can favorably change both the weight and health of youth with extreme obesity. Over
the years' gastric bypass surgery has been the main operation used to treat extreme obesity in youth. An estimated 2,700 youth bariatric
surgeries were performed between 1996 and 2003.2 A review of short-term data from the largest inpatient database in the United States
suggests that these surgeries are at least as safe for youth as adults. As yet, AGB has not been approved for use in the United States for
people younger than age 18. However, favorable weight-loss outcomes after AGB for youth have been reported abroad.
How does surgery promote weight loss?
Bariatric surgery restricts food intake, which leads to weight loss. Patients who have bariatric surgery must commit to a lifetime of healthy eating and regular exercise. These healthy habits may help patients maintain weight loss after surgery.
The Normal Digestive Process
Normally, as food moves along the digestive tract, digestive juices and enzymes digest and absorb calories and nutrients. After we chew and swallow our food, it moves down the esophagus to the stomach, where a strong acid continues the digestive process. The stomach can hold about 3 pints of food at one time. When the stomach contents move to the duodenum (the first part of the small intestine), bile and pancreatic juice speed up digestion. Most of the iron and calcium in the food we eat is absorbed there. The other two parts of the nearly 20 feet of small intestine absorb nearly all of the remaining calories and nutrients. The food particles that cannot be digested in the small intestine reside in the large intestine until eliminated.
What are the side effects of these surgeries?
Some side effects may include bleeding, infection, leaks from the site where the intestines are sewn together, diarrhea, and blood clots in the legs that can move to the lungs and heart.
Examples of side effects that may occur later include nutrients being poorly absorbed, especially in patients who do not take their prescribed vitamins and minerals. In some cases, if patients do not address this problem promptly, diseases may occur along with permanent damage to the nervous system. These diseases include pellagra (caused by lack of vitamin B3-niacin), beri beri (caused by lack of vitamin B1-thiamine) and kwashiorkor (caused by lack of protein).
Other late problems include strictures (narrowing of the sites where the intestine is joined) and hernias (part of an organ bulging through a weak area of muscle).
Two kinds of hernias may occur after a patient has bariatric surgery.
An incisional hernia is a weakness that sticks out from the abdominal wall's connective tissue and may cause a blockage in the bowel. An internal hernia occurs when the small bowel is displaced into pockets in the lining of the abdomen. These pockets occur when the intestines are sewn together. Internal hernias are thought to be more dangerous than incisional ones and need prompt attention to avoid serious problems.
Some patients may also require emotional support to help them through the changes in body image and personal relationships that occur after the surgery.
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Types of weight loss surgeries?
There are two main kinds of weight loss surgery.
• Gastric banding. Here, a band is fitted around the top of the stomach. This causes a feeling of fullness after eating a very small amount of food, and means that food must be eaten very slowly.
• Gastric bypass. Here, a much smaller stomach is made. This causes a feeling of fullness after eating a small amount of food, and means that the body absorbs fewer calories.
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