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Now weight loss is possible by a surgery !!

Weight loss surgery refers to various surgical procedures, which are performed tocontrol obesity by modifying the gastrointestinal tract and reducing its absorptionof nutrients. This surgery is often termed as bariatric surgery. Prevalence of overweightand obesity has reached pandemic proportions and is contributing to premature morbidityand mortality because of increasing nourishment and a decrease in physical exercise.Surgery for weight loss has shown to be very effective for morbidly obese patients.
Weight loss surgery is generally advised only to thosewho are unable to loose excess weight either through diet and exerciseprograms and are obese with related conditions such as hypertension,Diabetes mellitus and obstructive sleep apnea. It is possible that anindividual can maintain a healthy body weight through this surgery.These procedures maybe carried out medically and safely but yet it isessential to understand the operative risks, mortality, side effects andafter care before making such a decision.
Different surgical procedures Surgical procedures for weight loss can be malabsorptive, restrictive or a combinationof both these procedures. Malabsorptive procedure: The procedure induces decreased absorptionof nutrients by shortening the functional length of the small intestine, so thatthe body absorbs fewer calories. This procedure creates an abnormal situation fordigestion and absorption of nutrients from food. Biliopancreatic diversion, duodenalswitch, etc. are some procedures adopted for malabsorption.
Restrictive procedure: The procedure aims at reducing the size of the stomach by surgery and limits the food intake with reduced feeling of hunger.Vertical banded gastroplasty is done in which the stomach is stapled to forcibly create a smaller pouch and hence also known as stomach stapling. A silicone bandcalled a lap band also creates the same effect.This method does not interfere with the normal digestion of food.
The reduced stomach capacity, along with behavioral changes, can resultin consistently lower caloricin take and consistent weight loss.Restrictive procedures are simpler to performand are accompanied byless procedural complications than malabsorptive procedures.
Combination operation: The procedure takes advantage of both restrictionand malabsorption. In the gastric bypass surgery, a stapled stomach is created andconnected to the small intestine. The upper part of the small intestine is reattachedin a Y-shaped configuration. Hence the stomach volume is reduced and restrictingfood intake. In this case the stomach is disconnected from the duodenum and insteadconnected to the small intestine. Most of these procedures can now be performed through laproscopy  rather than aninvasive surgery. Here less post-operative pain, reduced risk of wound infection,a shorter hospital stay, faster recovery and a more rapid improvement in qualityof life maybe experienced.
Success of surgery The success of bariatric surgery is dependent upon long-term lifestyle changes indiet and exercise. The adaptation a patient makes to the new way of eating becomesvery important. Clinical studies show that, following weight loss surgery, mostpatients lose weight rapidly and continue to do so until 18–24 months after theprocedure. This largely depends on several factors such as patient’s age, weightbefore surgery, overall condition of patient's health, surgical procedure, abilityto exercise, commitment to maintaining dietary guidelines, other follow-up care,motivation of patient and cooperation of their family, friends and associates.
Adverse effects As with any surgery, there are operative and long-term complications andrisks associated with weight loss surgical procedures. Possible risks are bleeding,dehiscence, leaks from staple line breakdown, infections, complications due to anesthesiaand medications to name a few. Complications after surgery are frequently noticedin people over 40 years. A few of the difficulties faced while making adjustmentsafter surgery are bloatedness, diarrhea after eating and  Incisional hernia. Important considerations These weight loss procedures are not cosmetic surgerieshence an assessment of the risk and benefit to the patient and the meticulous performanceof the appropriate surgical procedure should be understood. Bariatric surgery should not be considered until allother options have been evaluated with the long-term side effects, such as possibleneed for re-operation, gall bllader disease and malabsorption. Malabsorption leads to impairment of single or multiplenutrients thus leading to malnutrition and anemia. So, vitamin and mineral supplementsabove and beyond that of the normal person will be required. Several physical and social adjustments have to be madeafter surgery. The stomach pouch is reduced to about the size of a small egg andhence eating too much or too fast may cause either vomiting or an intense pain underthe breastbone. These procedures also demand routine follow up of thepatients particularly on their nutritional status. Associated complications likegallstones might occur and to prevent this, gall bllader maybe removed.
Health benefits of surgery Surgery not only decreases body weight but also improvesmorbid conditions like high blood pressure, high cholesterol, diabetes, asthma,respiratory insufficiency, gastro-esophageal reflux disease, degenerative disk and joint disease to name a few. These patients on an average lose 61% of excess body weight depending on the procedure performed.
However, patients need to be selectedcarefully for surgical treatment of obesity and have to be monitored closely overthe long-term for nutritional deficiencies and other complications.