Alternative to Bariatric Surgery

Bariatric surgery is a compound name for the procedures used for the removal of excess fat from the body of extreme cases of obese individuals. Bariatric surgery is an invasive procedure, and it involves opening the patient up, which bears a lot of health risk. This procedure is an immediate and quick remedy for those who have tried but failed at diet and physical exercise. In bariatric surgery, the excessive weight is lost by decreasing the size of the stomach, with a band. It can also be achieved by splitting the stomach into two and reconnecting the small intestine to the two parts. There is the smaller upper part, and the bigger lower part (gastric bypass surgery). The bariatric surgery is needed by those who are suffering from morbid obesity, obstructive sleep apnea, hypertension, diabetes mellitus and so on. The people who are classified as obese, are those who have excess fat deposit in their body, and can whose joints and bones can barely support their weight. Obesity can be determined based on the body mass index. This body mass index has three classifications, which are underweight, normal weight and overweight.

Underweight- These people have a BMI of less than 18

Normal weight- Have a BMI of between 18 to 25

Overweight- Have a BMI of between 25-30

Obesity- Have a BMI of above 30

People with a body mass index of above 40 are candidates of bariatric surgery, while individuals with a body mass index of between 35 to 40, and with associated conditions such as type 2 diabetes mellitus, obstructive sleep apnea or cardiovascular system related diseases would need this procedure.

Although the surgery helps people lose their excessive weight just after the procedure, however, like all other types of surgery, it has a lot of health risks and complications that might occur after the surgery. This is what necessitated the need for alternatives, so patients can choose the one they would like to go for, after weighing their options carefully. Below are some of the risks associated with bariatric surgery

Risks Associated with Bariatric Surgery

1. Hospital Infection: This cannot be eliminated from surgeries as nurses and doctors do slip up sometimes. This kind of infection is known as nosocomial infection, and they could be from infected hospital equipment or gloves that were not thoroughly sanitized. Hospital infection if not well taken care of can lead to a delay in wound healing. In severe cases, it can lead to sepsis. Antibiotics should be administered after surgical procedures to prevent the development of these conditions.
2. Bleeding: There are many vessels in the abdomen, that might be ruptured accidentally during surgery. It would require a doctor with a good knowledge and skills to manage this kind of situation. Abdominal hemorrhages that are not well managed can lead to hypotension, and in severe cases can lead to shock, and eventually death. This is worse, especially when patients are giving blood thinners to prevent them from having thrombi and emboli. A rupture of the abdominal vessels would be severe if not promptly managed. Blood transfusion should be done to effectively manage the blood loss.
3. Formation of clots in the vessels: Injuries do occur in surgeries, and this leads to the formation of blood clot. This blood clot might combine with other particles in the vessel such as fat particles, a cluster of bacterial remnants and so on, to form a ball. This kind of substance often obstructs the flow of blood, limiting the amount of oxygen and nutrient available for use by the tissues and organs. This kind of substance, that attaches itself to the wall of the vessel is known as a thrombus. These particles sometimes break away from the vessel wall and move to other parts of the body. These traveling thrombi are known as emboli. They can travel to the respiratory system to form pulmonary embolism. Blood-thinning medications are usually given to patients before the procedure to reduce the risks of this kind of conditions.

There are alternatives to bariatric surgery, which patients can choose from. Some of them do not bear the same risk as bariatric surgery

Alternatives to Bariatric Surgery

There are four options for patients to choose from when considering alternatives to bariatric surgery. They include lifestyle modification, diet, weight loss medications, and non-surgical procedures.

1. Diet change: This is usually the first line of action. Even though the patient decides to change to another procedure, later on, diet change is always the first thing to do. Patients should consume less of heavy calorie food. Essentially, patients should eat less starchy and carbohydrate food. In addition, he should totally eliminate junks and other fast food such as McDonald’s, KFC and so on. Rather than consuming all these foods with a large number of calories, patients should drink more fluid before eating, and eat more of vegetables and other low-calorie
2. Physical exercise: Taking part in physical exercises can never be overestimated. However, this should be done in combination with diet change. Patients should register in a gym, and possibly get a trainer, that would monitor the progress of the weight loss, and give out the needed routines to achieve the patient’s goal. It has been observed that people tend to achieve more when they work under the guidance of their doctor in the weight loss journey.
3. Gastric balloons: This procedure is suitable for patients looking for the right alternative to bariatric surgery, with a near success rate. Although gastric balloons are effective, they only achieve half the weight loss associated with bariatric surgery. However, the good sides of this procedure are that it’s not invasive and can also be reversed. The balloons are introduced into the stomach of the patient through the mouth. Once the balloon has been placed in the stomach, they’re filled with saline water, which causes them to inflate. The balloon gives the patient a feeling of satiety after eating a portion that is relatively smaller than what he used to it. This balloon is usually left in the stomach for about 6 months, after which it’s removed.

All these alternatives remove the risks associated with bariatric surgery, but they don’t achieve the same level of results as the surgery.

References

Kayaalp, C. (2017). Laparoscopic Roux-en-Y gastric bypass. Laparoscopic Endoscopic Surgical Science.

Post-Surgical Effects of Roux-En-Y Gastric Bypass on Glucose Homeostasis, Intestinal Morphology and L-Cells in Obese Gottingen Minipigs. (2015). Journal of Obesity and Bariatrics, 1(1).

Schmidt, T., Garren, M., Campos, G. and Gould, J. (2011). Outcomes of Laparoscopic Gastric Bypass Vs. Laparoscopic Adjustable Gastric Band Up To 5 Years Post-op. Journal of Surgical Research, 165(2), p.175.

Stubbs, R. (2014). What makes a gastric bypass a good gastric bypass? Opinion and hypothesis. World Journal of Surgical Procedures, 4(2), p.48.