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Obesity Surgery – Pros and cons

When diet and exercise have failed, some people have nowhere to go. Savvy fatties turn to their surgeons and ask for a gastric bypass, gastric band, gastrectomy or duodenal بهترین جراح چاقی switch operation, types of obesity surgery for those who have tried every other method conceivable to lose weight with little or no result.

While a nip there and a tuck and a gouge there may sound great, obesity surgery is not for everyone. It is almost always only for those who are facing imminent health problems due to their enormous bulk – including those who could die if they do not cut their weight down significantly.

A good doctor will only perform these types of operations on those with a body mass index, or BMI, of at least 35 accompanied with an obesity-related disease such as high cholesterol, high blood pressure and sleep apnoea. If your BMI is 40 and you don’t have such health problems, you could also be a candidate for surgery.

Types of Obesity Surgery

Different types of surgery suit different people. Discuss the options with your doctor first. Surgeries include:

Gastric Bypass Surgery: Originally performed in 1967, this type of surgery has evolved greatly since its introduction. The name comes from the fact that surgeons reconfigure parts of the stomach so that food bypasses the top bit of the gut, or the small intestine, to prevent it from being absorbed by the body, thus less weight being gained.

In most cases, a tiny part of the stomach is sectioned off to create a small pouch which will only accommodate small portions of food. If you eat more you feel sick, and may even throw up. So eventually you will be trained to want – and eat – a lot less. Several types of gastric bypass surgeries are on offer: the Roux-en-Y (distal), and the Roux-en-Y (proximal), the most common, the Mini Gastric Bypass.

Advantages: Gastric bypass surgery is a radical step when all else has failed. It can help people reach a reasonable weight which would then allow them to exercise normally and keep the weight off. For people with severe health problems caused by being obese, it often is the only answer. Often people take this step after being warned they face death unless they achieve significant weight loss.

Disadvantages: Fourteen percent of patients who had this procedure where deep incisions were made suffered complications. General risks overall are respiratory complications, infection, blood clots, bowel obstructions and leakage of the intestine or stomach contents into other parts of the body. It might also exacerbate other health problems common among the morbidly obese.

Gastric Band: This one is performed using keyhole surgery, or a laparoscopic technique, which is why it’s sometimes called “lap band” surgery (not to be confused with lap dances! ). In this case, a pouch is made in the stomach thanks to a small band, kind of like a rubber band, which dictates how much a person can eat at once.

The beauty part is surgeons can make the band either tighter or looser by deflating or inflating a balloon filled with silicone, which lies inside the band itself. This is done by using a sterile needle, and can be carried out every six to eight weeks.

Advantages: Safer as no part of the stomach is actually removed. This type of keyhole surgery is considered less invasive, and most patients absorb nutrients well both during and after the the time when the band is inside them.

Disadvantages: Some people suffer sometimes fatal complications as a result of general anesthesia, and this procedure also carries risks of blood clots, organ damage, and infection. In rare cases the band slips or even erodes through the stomach wall. If you lose weight very quickly you might develop gallstones.

Sleeve Gastrectomy: The stomach is divided length-wise and about 80 percent of it is removed completely to create a banana-shaped tube, or sleeve. As it is much smaller than a regular stomach, the amount of food a patient can comfortably eat is severely restricted. Often this is performed on patients who are so big they cannot safely undergo a bypass operation; at a later date they sometimes have this carried out.

Advantages: Nutrient absorption remains good as no actual bypass has been created. And the amount of weight lost is statistically higher (no surprise there – hard to eat with virtually no stomach! ).

Disadvantages: Believe it or not, the sleeve can expand if the patient continues to eat a lot, and they can regain weight lost – or not lose weight at all. Also, the procedure is a done deal as it’s not reversible, and there is a risk that leakage of the gut may occur.

Duodenal Switch: The stomach is reduced in size and reshaped to form a sleeve or banana shape, like a gastrectomy, but then it bypasses about half of the small intestine and is reconnected to its shortened shape. This forms a conduit in which both gastric juices and food are mixed together. Yum!

Advantages: Patients on the whole lose more weight with this operation.

Disadvantages: You will absorb less food including vital nutrients, and the operation is technically difficult and performed less often, so some surgeons have less experience with it.

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