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Obesity surgery also known as bariatric surgery is a surgical intervention designed to help individuals struggling with severe obesity achieve significant and sustained weight loss. It encompasses various procedures that alter the digestive system to restrict food intake, modify nutrient absorption, or combine both approaches. The benefits of obesity surgery extend beyond weight loss, as it has been shown to improve or resolve obesity-related health conditions and enhance psychological well-being. However, careful evaluation by a multidisciplinary healthcare team, commitment to lifelong lifestyle changes, and awareness of potential risks and complications are essential considerations for individuals contemplating obesity surgery [1]. Regular follow-up care and adherence to nutritional guidelines are crucial for long-term success. Obesity surgery should be approached as a last resort after other weight loss methods have been attempted without success. Consulting with a qualified healthcare professional specializing in bariatric surgery is vital to determine the most suitable approach and ensure optimal outcomes for patients.

Obesity surgery encompasses a range of procedures that aim to help individuals achieve significant weight loss by altering their digestive system [2]. These procedures can be broadly classified into three main types: restrictive, malabsorptive and a combination of both. Restrictive surgeries reduce the stomach's size, limiting the amount of food one can consume, while malabsorptive surgeries alter the digestion and absorption of nutrients. Combination surgeries employ elements of both restrictive and malabsorptive techniques.

Benefits of obesity surgery

Significant and sustained weight loss: Obesity surgery has been proven effective in helping individuals lose substantial weight and maintain the loss over the long term. This weight reduction can lead to improvements in overall health, including a decreased risk of obesityrelated diseases such as type 2 diabetes, cardiovascular disease, and certain cancers [3].

Resolution of obesity-related health conditions: Bariatric surgery has demonstrated remarkable success in resolving or significantly improving obesity-related conditions, such as high blood pressure, sleep apnea, joint pain, and metabolic disorders. Many patients experience a reduction or complete remission of these health issues, enhancing their quality of life.

Enhanced psychological well-being: Obesity surgery not only affects the physical aspects of a person's health but also contributes to their psychological well-being. Many patients report improved selfesteem, body image, and mental health following successful weight loss. This positive impact on mental and emotional health can extend to relationships, social interactions, and overall happiness.

Considerations and precautions

Comprehensive evaluation: Before considering obesity surgery, individuals must undergo a thorough evaluation by a multidisciplinary healthcare team. This evaluation typically includes assessments of physical health, psychological well-being, dietary habits, and understanding of the surgical procedure. This evaluation ensures that the patient is well-informed and a suitable candidate for the surgery [4,5].

Lifestyle changes: Obesity surgery is not a magic solution but a tool to aid weight loss. Patients must commit to lifelong lifestyle changes, including dietary modifications, regular exercise, and ongoing medical follow-ups. Adhering to these changes is crucial to achieving successful and sustained weight loss outcomes.

Potential risks and complications: As with any surgical procedure, obesity surgery carries risks and potential complications. Patients should thoroughly discuss these risks with their healthcare team and weigh them against the potential benefits.

Nutritional considerations: Certain types of obesity surgery may impact nutrient absorption and require lifelong vitamin and mineral supplementation. Patients must adhere to the recommended nutritional guidelines to prevent deficiencies and maintain optimal health [6].

Obesity surgery offers a viable option for individuals struggling with severe obesity and experiencing related health issues. With its potential for significant and sustained weight loss, resolution of comorbidities, and positive impact on psychological well-being, it can be life-changing for many. However, careful evaluation, commitment to lifestyle changes, and awareness of potential risks are essential aspects of the decisionmaking process. If you or a loved one are considering obesity surgery, consult with a qualified healthcare professional to determine the most suitable course of action and achieve long-term success in your weight loss journey [7,8].

Description

Types of obesity surgery

Gastric Bypass: This is one of the most common and effective types of obesity surgery. It involves creating a small pouch at the top of the stomach, which is then connected directly to the small intestine, bypassing a large portion of the stomach and the first part of the small intestine. Gastric bypass restricts the amount of food you can eat and reduces the absorption of calories and nutrients [9].

Sleeve gastrectomy: This procedure involves removing a large portion of the stomach, leaving behind a smaller sleeve-shaped pouch. The reduced stomach size restricts the amount of food that can be consumed and also affects the production of certain hunger-regulating hormones, leading to decreased appetite.

The band can be adjusted by inflating or deflating it with saline solution, allowing for flexibility in restricting food intake. This surgery works primarily through restriction rather than malabsorption.

Biliopancreatic diversion with duodenal switch: This is a more complex procedure that combines both restrictive and malabsorptive components. It involves the removal of a large portion of the stomach, similar to sleeve gastrectomy. Additionally, it reroutes the small intestine to limit the absorption of calories and nutrients.

Considerations for obesity surgery

Eligibility criteria: Obesity surgery is typically recommended for individuals with a body mass index (BMI) of 40 or higher (or a BMI of 35-39.9 with significant obesity-related health conditions). It is important to consult with a healthcare professional who specializes in bariatric surgery to determine eligibility based on individual factors and medical history.

Pre-operative preparation: Prior to surgery, patients may be required to undergo a series of pre-operative evaluations, including medical tests, consultations with a nutritionist and a psychologist, and discussions about lifestyle changes and post-operative care.

Post-operative care and lifestyle changes: Following obesity surgery, patients need to make significant changes to their diet and lifestyle to ensure successful outcomes. This includes adopting a nutrient-rich, portion-controlled diet, incorporating regular physical activity, attending follow-up appointments, and adhering to any prescribed medication or supplements.

Potential complications: Although obesity surgery is generally safe, there are potential risks and complications associated with any surgical procedure. These can include infection, bleeding, blood clots, leakage at the surgical site, gastrointestinal issues, and reactions to anesthesia. Close monitoring by medical professionals during the postoperative period can help minimize these risks [10].

Long-term follow-up: Long-term follow-up care is crucial for monitoring weight loss progress, addressing any complications or side effects, and providing ongoing support to patients. Regular check-ups, blood tests, and nutritional assessments are typically part of the followup care.

Conclusion

It's important to note that obesity surgery should be considered as a last resort after other weight loss methods have been tried and proven unsuccessful. The decision to undergo obesity surgery should be made in consultation with a healthcare professional that specializes in bariatric surgery, ensuring an individualized approach to meet each patient's specific needs and goals.

Acknowledgement

None

Conflict of Interest

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