Surgery helps in severe obesity

Various surgical treatments for obesity help in substantial weight loss and improve weight-related ills in patients.Researchers from the University of Minnesota in Minneapolis found that diet, lifestyle changes and even the help of support organizations often fails to bring lasting benefits to people suffering from severe weight problems. Surgery, therefore, may be the only effective treatment option for morbid obesity. Investigators reviewed 136 studies conducted since 1990 and found that patients who underwent various surgical procedures for obesity lost an average of 61 per cent of their excess weight.

Weight-loss surgery can be performed in several ways. A simpler variation is gastric banding, in which a band is placed around the upper portion of the stomach to form a small pouch that holds only a small amount of food at a time.But the more complicated is the surgery, the more effective it is against obesity. In another form called gastric bypass, staples are used to create a small pouch in the stomach, and a portion of the small intestine is attached to the pouch so that the food bypasses the rest of the stomach and a part of the small intestine. All these procedures carry risks like any other surgery.

Researchers found that around one per cent of patients died after undergoing more complicated procedures known as biliopancreatic diversion (BPD) and duodenal switch, in which portions of the stomach are removed. But mortality rates were lower for gastric bypass and gastric banding. In the long-term, nutritional deficiencies can become a concern with procedures like gastric bypass and BPD, because the digestive tract's absorption of nutrients is diminished. Some patients may suffer from dumping syndrome, where food travels quickly through the small intestine, causing nausea, weakness and diarrhoea. But the risks generally outweigh the gains of reversing the serious conditions that co-exist with morbid obesity.The study review showed that 77 per cent of patients saw their diabetes go away, while 86 per cent showed at least an improvement. High blood pressure resolved in nearly 62 per cent, and fell in more than three-quarters, while about 70 per cent of patients had improvements in their high cholesterol. Sleep apnoea also resolved in nearly 86 per cent of the patients who suffered from it. Patients lost 70 per cent of their extra weight through BPD and duodenal switch, but only 47 per cent of the extra weight was lost with gastric banding.
What is important is that patients need to be ready to change their outlook on lifestyle after the surgery, including turning their attention to eating healthy foods and getting the nutrients they need to avoid deficiencies.

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