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bariatric surgery in jaipur

  • Writer: Dr Kapileshwer Vijay
    Dr Kapileshwer Vijay
  • May 30, 2022
  • 2 min read

Bariatric surgery (or weight loss surgery) includes a variety of procedures performed on people who are obese. Long term weight loss through the standard of care procedures (Roux en-Y bypass, sleeve gastrectomy, and biliopancreatic diversion with duodenal switch) is largely achieved by altering gut hormone levels responsible for hunger and satiety, leading to a new hormonal weight set point.

Bariatric surgery is a hormonal surgery in these procedures, for which the alteration in gut hormones develops as a result of the procedure's restriction and malabsorption.

[1] Long-term studies from 2009 show the procedures result in significant long-term loss of weight, recovery from diabetes, improvement in cardiovascular risk factors, and a mortality reduction from 40% to 23%.

[2] As of 2009, the U.S. National Institutes of Health has recommended bariatric surgery for obese adults with a body mass index (BMI) of at least 40 and for people with a BMI of at least 35 and serious coexisting medical conditions, such as diabetes.

[3] However, research is emerging that suggests bariatric surgery could be appropriate for those with a BMI of 35 to 40 with no comorbidities or a BMI of 30 to 35 with significant comorbidities. The most recent American Society for Metabolic & Bariatric Surgery guidelines from 2008 suggest the position statement on consensus for BMI as an indication for bariatric surgery. The recent guidelines suggest that any person with a BMI of more than 30 with comorbidities is a candidate for bariatric surgery.

[4] The risk of death in the period following surgery is less than 1 in 1,000.

[5] A meta-analysis in 2021 found that bariatric surgery was associated with 59% and 30% reduction in all-cause mortality among obese adults with or without type 2 diabetes, respectively.

[6] This meta-analysis also found that median life-expectancy was 9.3 years longer for obese adults with diabetes who received bariatric surgery as compared to routine (non-surgical) care, whereas the life expectancy gain was 5.1 years longer for obese adults without diabetes.

[7] A National Institute of Health symposium held in 2013 that summarized available evidence found a 29% mortality reduction, a 10-year remission rate of type 2 diabetes of 36%, fewer cardiovascular events, and a lower rate of diabetes-related complications in a long-term, non-randomized, matched intervention 15–20 year follow-up study, the Swedish Obese Subjects Study.

[8] The symposium also found similar results from a Utah study using more modern gastric bypass techniques, though the follow-up periods of the Utah studies are only up to seven years. While randomized controlled trials of bariatric surgery exist, they are limited by short follow-up periods.

 
 
 

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