Weight loss surgery: What are the overall health benefits?

Weight loss surgery is for people who are defined as being obese according to their BMI (body mass index). This surgery does not only help patients lose weight but it also prevents or improves health problems associated with excessive weight, such as diabetes, high blood pressure, sleep apnoea, fatty liver disease, atherosclerosis, and joint problems among others.

We asked one of our leading consultant bariatric surgeons, Mr Vittal Rao, just how weight loss surgery can help with co-morbidities related to obesity, what life may be like after surgery, and how easy it might be to gain the weight back.
 

Why do people have weight loss surgery?

Weight loss surgery is also called metabolic surgery as it improves the health profile of patients in the long term. Diabetic patients on medications such as insulin or tablets will either come off from the medications totally or will see a reduction in the dose of these medications. Patient with blood pressure medications will see a reduction in the dose.

Patients with sleep apnoea will come off from the CPAP machines. The levels of cholesterol will come down and there will be a reversal - a rise in levels of good fat (HDL) and a fall in levels of bad fat (LDL and cholesterol).

This will translate into a reduction in the risk of adverse health events such as heart attacks, strokes, kidney disease and other long-term health problems.

Weight loss surgery also has been found to prevent at least 11 different types of cancer including breast cancer, cancer of the womb, pancreatic cancer, liver cancer and bowel cancer. Recently, obesity has overtaken smoking as the leading cause of death due to health problems. Hence weight loss surgery is the only surgery that has shown to reduce death in populations in the long term.
 

Do patients have to lose weight before having weight loss surgery?

It is important that patients demonstrate that they understand the changes which they have to make to their diet and lifestyle which is expected of them after weight loss surgery before they undergo the surgery.

This would mean adopting a healthy diet, eating the right type of food (having healthy portions of proteins, carbohydrates and fats) in the right amounts, and having a healthy lifestyle, including regular exercise.

By doing this, patients naturally lose weight before surgery. In this aspect, it is desirable that patients lose weight before surgery as this will give them confidence that they can stick to a healthy diet and exercise before this life-changing operation. If the patients do not adopt these changes before surgery, they tend to struggle after surgery and would not get the benefits and optimise the outcome.
 

Is weight loss easy after surgery?

There is a common misconception that weight loss surgery is a type of ‘punishing surgery’ whereby the stomach is cut down to size and this will force patients to eat less.

In reality, the surgery is more scientific and involves changes in feedback mechanisms and hormones, which drive the hunger-satiety mechanisms. As a result of this, patients lose weight typically in the first year after surgery and the weight loss gradually plateaus.

But like any other thing, weight loss surgery is nothing but a tool in the hands of the patients who undergo the surgery. If the patients then use the tool of weight loss surgery and optimise the outcome by sticking to a healthy diet and lifestyle, the weight loss is maintained and can improve. If patients fall back into their unhealthy eating habits and do not practice regular exercise, then they can have weight regain as early as two years after surgery.

It is vitally important that after weight loss surgery, patients maximise the benefits by adopting a healthy lifestyle and diet.
 

Is gaining weight impossible after weight loss surgery?

The short answer is no. Patients who do not adopt a healthy diet and lifestyle can easily regain the weight they lose immediately after surgery. They can put all their weight back on and can lose all the benefits of weight loss in a few years. Hence why it is vitally important that patients do not lose sight of the need to adopt a healthy diet.

The difference is that before surgery, patients struggle to maintain weight loss in spite of sticking to a healthy diet and lifestyle. But after surgery, with the tool of weight loss surgery, it would be easier to maintain the weight loss provided the patient adopts a healthy diet and lifestyle.
 

What are the long-term side effects of bariatric surgery?

Bariatric or weight loss surgery has minimal long-term side effects provided the patient commits to the advice and long-term follow up of health professionals. They need to take lifelong multi-vitamin supplements, have annual blood tests to ensure that their vitamin levels are within normal limits and eat healthy to make sure that they take the recommended amounts of protein and not have excessive fat-containing foods.

Due to the guaranteed long-term benefits of the surgery, the patients will be able to lead a healthy life and will see improvement in health conditions associated with being overweight, such as diabetes, high blood pressure, sleep apnoea and fatty liver.
 

Can bariatric surgery be reversed?

Yes, depending on the type of surgery. Gastric bypass can be reversed. The sleeve gastrectomy where a portion of the stomach is removed cannot be reversed. But these surgeries are done not with an intent to reverse it in the long-term.

Reversal is done only when patients are not able to cope with the changes which are required after surgery and develop severe malnutrition as a result. It usually is below five per cent, and it is very rare if patients are assessed properly and guided through the process.

If you are considering weight loss surgery and you would like to discuss your options with an expert, do not hesitate to book an appointment with Mr Vittal Rao via his Top Doctors profile today.