Navigating the bariatric surgery journey: A patient's guide

In recent years, bariatric surgery has emerged as a viable option for individuals struggling with severe obesity and its related health complications including diabetes. If you're considering this life-changing procedure, it's crucial to understand the different types of bariatric surgery, when it's recommended, as well as potential risks and side effects. In this guide, renowned upper GI and bariatric surgeon Professor Samer Humadi addresses these key points to help you navigate your bariatric surgery journey.

Understanding the different types of bariatric surgery

Gastric bypass surgery:

• In this procedure, the surgeon creates a small pouch at the top of the stomach and connects it directly to the small intestine, bypassing a portion of the stomach and the first part of the small intestine.
• Gastric bypass surgery restricts food intake and reduces the absorption of nutrients, leading to significant weight loss.

Sleeve gastrectomy:

• During a sleeve gastrectomy, a large portion of the stomach is removed, leaving a sleeve-shaped pouch that limits the amount of food you can eat.
• This procedure also reduces the production of ghrelin, a hormone that stimulates hunger, helping patients feel full more quickly and for a longer duration.

Adjustable gastric banding:

• Also known as lap band surgery, this procedure involves placing an inflatable band around the upper part of the stomach to create a smaller stomach pouch.
• The band can be adjusted to control the amount of food that enters the stomach, promoting weight loss over time.

When is bariatric surgery recommended?

Bariatric surgery is typically recommended for individuals with a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related health issues such as type 2 diabetes, high blood pressure, or sleep apnoeaº. It may also be considered for those who have been unsuccessful in achieving significant weight loss through diet and exercise alone.

Effectiveness in treating diabetes

One of the remarkable benefits of bariatric surgery is its effectiveness in improving or even resolving type 2 diabetes in many patients. Research has shown that gastric bypass surgery and sleeve gastrectomy can lead to rapid improvement in blood sugar levels and a reduced need for diabetes medication. This metabolic effect often occurs even before significant weight loss occurs, highlighting the profound impact of these surgeries on insulin sensitivity and glucose metabolism.

Risks and side effects

While bariatric surgery can offer life-changing benefits, it's essential to be aware of potential risks and side effects, which may include:

• Surgical risks: Like any major surgery, bariatric procedures carry risks such as bleeding, infection, blood clots, and adverse reactions to anaesthesia.
• Nutritional deficiencies: Patients may experience deficiencies in essential vitamins and minerals, such as vitamin B12, iron, calcium, and folate, necessitating lifelong supplementation.
• Dumping syndrome: Rapid emptying of the stomach contents into the small intestine can cause nausea, vomiting, diarrhoea, dizziness, and sweating after eating high-sugar or high-fat foods.
• Gallstones: Rapid weight loss can increase the risk of developing gallstones, which may require further treatment.

Bariatric surgery can be a life-saving intervention for individuals struggling with severe obesity and related health conditions. By understanding the different types of procedures, when it's recommended, its effectiveness in treating diabetes, and potential risks and side effects, you can make an informed decision about whether bariatric surgery is the right path for you. Remember to consult with a qualified healthcare provider to discuss your options and determine the best course of action for your unique situation.

Professor Samer Humadi is an esteemed consultant upper GI and bariatric surgeon based in Berkshire and Chertsey. If you would like to book a consultation with Professor Humadi, you can do so today via his Top Doctors profile.