BARIATRIC SURGERY, IS IT FOR ME?

Q: How do I know if I am a candidate? 

A: We all know that the United States and Mexico are leading countries in obesity and that it is very difficult to lose weight. I think we all have gone through wanting to do certain diets and lose weight; But often our lifestyle forces us to eat outside; at late hours, eat junk food, overeating, and so on. It takes a lot of discipline that people generally do not have to achieve weight control.

To find out if you are a candidate you can calculate your body mass index, people above 35 BMI and who have comorbidities (pre-diabetic, hypertension, glucose problems) could be candidates for metabolic or bariatric surgery. Books or standards say patients with a BMI over 40 are already candidates for metabolic surgery. Or if you are a male with over 20% body fat or a woman with more than 30% body fat. Obviously considering that these patients have already tried to lose weight with diet, exercise and have failed, that’s when they are recommended metabolic surgery. It is important to mention that we could operate on a patient with a BMI less than 40, considering the patient’s health state and comorbidities, each patient is different.

         Bariatric Surgeon Specialist

Q: What types of bariatric surgery are there?

A: There are several procedures, broadly divided into two:

Some are the restrictive procedures; That limit the amount of food you can eat; And others are malabsorptive procedures, where what you eat is not completely absorbed.

There are mixed procedures that restrict the amount you eat as well as the absorption; You could say that those are the most complete. At one time Gastric Bypass was considered the gold standard of this type of surgery because it combined both procedures: Restrict what you eat and absorption of calories.

Gastric Bypass consists of cutting the stomach and leaving a small pouch where it fits a small amount of food much smaller than before, and we make a short circuit where the food leaps and unites more distally towards the intestine. Depending on the length we want to give, we can jump up to 3 meters of intestine or more where there will be no absorption. By jumping the pancreas or duodenum we then have a positive metabolic effect on the patient. This surgery helps control comorbidities. Therefore, some patients with diabetes, glucose intolerance, or metabolic syndrome could greatly benefit from the bypass.

Gastric sleeve
It is a restrictive procedure with metabolic changes comparable with bypass. Has become the most popular procedure worldwide. This consists of cutting a part of the stomach, around 70% thereby eliminating its great storage capacity, leaving it in the form of a tube that is calibrated with an oro-gastric boggle and cutting the rest.

With this, we achieve that the patient does not eat as much food and at the same time to eat more times per day. It also gets rid of a hormone that is partly responsible for being hungry. So, if we eliminate a great part of the production of this hormone the patient has no longer the anxiety to eat.

The gastric sleeve is one of the simplest surgeries with the best results.

Duodenal Switch
This is a combined procedure, that has a restrictive and malabsorptive component. where we combine the gastric sleeve and skip a large part of the intestine leaving the absorption of food in about two meters of the intestine before passing to the large intestine for elimination.

The disadvantage of the duodenal switch is that it requires a lot of care with supplements. Because the patient can become malnourished if not fed correctly. Then the patient must visit the nutritionist constantly to take care of all their nutrients and microelements to maintain optimal health.

How much weight will I lose with bariatric surgery?

A: With the gastric sleeve let’s say you can expect a loss of 70% to 80% of the patient’s overweight. Also with weight loss helps the patient to control comorbidities like diabetes, hypertension and dyslipidemias.

The bypass has a greater success rate of weight loss and the duodenal switch even more, up to 90% of the weight loss. That’s why I mentioned that in the duodenal switch, we have to take great care of nutrition because we can go to the other extreme.

Q: What is the impact on a patient’s life?

A: Well, it’s completely radical … In an overweight patient; Their self-esteem, their quality of life are seriously affected. Obviously, if the patient is very young, he may not feel it as much, but as the years’ pass, the overweight begins to affect the knees, the spine and gives some osteoarthritis because of being overweight. Hypertension, diabetes, and other diseases also begin to appear. Then by eliminating all this, it greatly enhances the health of the person.

On the other hand, is the aesthetic aspect. The patient now looks thinner, looks better, becomes motivated, starts to exercise that he has never done or to be more constant. Then he becomes much more motivated and starts to take care of his diet. Something very important is not to see this type of surgery as the definitive way to lose weight and to be well. It is more a tool to learn to eat well, learn new habits that lead to a healthier lifestyle, lose weight and enjoy better health for a longer time.

If you want to know more information about costs or consultations for these and other procedures, please call (664) 608-6460 and (619) 955-6845 from the United States, you can also access a Bariatric Virtual Consultation by going here