When diet and exercise are not enough to lose weight, it may be time to consider other options. Among the methods to lose pounds when you have obesity is the so-called bariatric surgery, an operation to reduce the stomach and, with it, the amount of food that fits in it. But who can undergo this surgery?
What is and who can get a stomach reduction
Generally, it is an intervention indicated for people between 18 and 60 years morbidly obese, meaning that the risk of surgery to remove excess kilos is greater than the intervention itself. Initially, the doctor assesses the factors that have triggered the excess weight, study why the patient does not lose weight with diet and exercise and analyzes the body mass index (BMI).
A person is considered as a candidate for this operation when his BMI is 40 or higher, that is, he is at least 45 kilograms more than the recommended weight, or when the BMI is 35 or more and he suffers a serious pathology, such as Type 2 diabetes, heart disease or obstructive sleep apnea, joint damage, liver disease, gallbladder problems or hyperlipidemias – elevated levels of blood lipids – among others.
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It is an operation in which the surgeon stapled the stomach in two parts, leaving the upper part – called a bag – to store food, with an initial capacity of about 28 grams, but then increase slightly. That part of the stomach connects with the small intestine, a process called a shunt. All this leads to feeling full very soon and, therefore, to eat less, and that the absorption of calories is less.
Types of Bariatric Surgery
It can be done as open surgery or through laparoscopy – with the introduction of a device (laparoscope) that guides the doctor. The latter requires less hospitalization time, pain, scarring and risk of infection, and recovery is faster. There are different techniques and as medicine advances, new methods emerge. Among the most practiced, it is worth mentioning:
- Adjustable gastric band: with the band on the top of the stomach, a bag is created that fits a small amount of food.
- Roux-en-Y gastric bypass: A small stomach sac forms in one part of the stomach and the food is derived so that it does not pass through the larger part or the duodenum and goes directly into the small intestine.
- Vertical sleeve gastrectomy: most of the stomach is removed and what is left is a small tube-shaped stomach.
Some 6,000 people a year undergo this type of intervention in Spain. It is estimated that the operation helps to lose between 4 and 9 kilograms a month during the first year and that in the first two years can lose up to half the extra weight. After that time, the reduction of kilos will be slower.
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That weight loss is beneficial for high blood pressure, cholesterol levels, gastroesophageal reflux, sleep apnea, diabetes, and asthma; In addition to allowing greater mobility, raise testosterone levels in men and increase fertility in women, especially in those with polycystic ovarian syndrome.
Possible risks of stomach reduction
Like any operation, stomach reduction carries risks. They are the ones of all general surgery and anesthesia – an allergic reaction to medications, bleeding, blood clots, infection or respiratory problems. And others specific to this type of intervention:
- Filtration in the division of the stomach.
- Injuries to the stomach, intestines or other organs.
- Gastritis, acidity or ulcer in the stomach.
- Scarring in the abdomen by blocking the intestines.
- Hemorrhage, infection, thrombosis or embolism.
- Loss of bone mass by lower absorption of nutrients.
- Vomiting from eating amounts that does not tolerate the new size of the stomach.
- Low levels of glucose in the blood.
Day after surgery
The lifestyle to take after a stomach reduction surgery is completely different from what you had, mainly due to changes in the body’s way of processing food: reduced capacity in the stomach and poor absorption of the nutrients.
Although after the operation the stomach is the size of a walnut, as time passes it will widen, so the specialists recommend not ingesting food in excess so that its size does not exceed 250 ml capacity (a normal stomach can Store up to 1 liter of food).
In addition to exercising, patients undergoing an operation of this type should take into account the following recommendations:
- Swallow liquids and purees during the first two to three weeks.
- Eat slowly, using at least 20 to 30 minutes at meals, and chew the food a lot to avoid blocking the connection between the stomach and the intestine.
- Stop eating as soon as there is a feeling of satiety.
- Make six meals, without snacking between hours.
- Drink 2 liters of water a day to small sips. Drink liquids at meals after half an hour.
- Do not eat caloric foods.
- Bet on foods rich in nutrients such as vegetables, fruits, whole grains, and proteins.
- Take vitamin supplements with iron, vitamin B12, calcium and vitamin D.
- Some foods can be annoying, such as pasta, rice, bread, meats and raw vegetables.