Month: April 2019

Side Effects of Bariatric Surgery

Understanding the Side Effects of Bariatric Surgery: What You Need to Know

Overview of Bariatric Surgery

Bariatric surgery is increasingly being accepted as a viable option for treating morbid obesity and its associated diseases such as diabetes mellitus and hypertension. Surgery provides long-term sustained weight loss as well as resolution of co-morbid conditions.

The benefits of bariatric surgery are numerous but there are also a few risks and side effects associated with various bariatric surgical procedures.

Common Bariatric Procedures in India

The most common bariatric surgical procedures performed in India are:

Immediate Side Effects of Bariatric Surgery

There are a few immediate side effects that can happen after bariatric surgery like bleeding, leak, intestinal obstruction, and venous thromboembolism. The side effects due to malnutrition or undernutrition are seen in the long term, particularly after laparoscopic gastric bypass surgery.

The incidence of bleeding is less than 4% in patients undergoing bariatric surgery. Most cases can be managed by blood transfusions alone. Some cases might require laparoscopy to stop the bleeding. A leak from the anastomosis site or sleeve staple line occurs in about 0.7% to 5% of the patients. If the leak is early, re-laparoscopy with identification of the leak and its closure is done with adequate drainage, bowel rest, and antibiotics.

Similarly leaks after a mini gastric bypass can be managed early by drainage and conversion of the procedure to Roux-en-Y gastric bypass along with a feeding tube in the intestines. The other rare immediate problem can be that of wound infection which is managed by dressing and antibiotics. Obesity is an independent risk factor for thromboembolism which is the clotting of blood in the veins of the body particularly the legs. This is best avoided by taking heparin injections for the first few days after the surgery and wearing graded pressure stockings for a few weeks. Early active mobilization is the best precautionary method.

Long-Term Side Effects and Nutritional Deficiencies

Lately, there can be obstruction of the intestines due to various factors which result in pain and distension of the abdomen along with vomiting. The possible causes usually are smoking, and the formation of ulcers. This can be identified by doing an endoscopy or a CT scan. Treatment of the possible causes can be done immediately.

After bariatric surgery, iron, vitamin B12, and other micronutrient deficiencies can occur.  Iron deficiency occurs in patients within 2 to 5 years after surgery. Supplementation with iron can reduce iron deficiency significantly. Calcium and vitamin D absorption are impaired after gastric bypass as well. We obtain a complete blood count and iron, B12, calcium, folic acid, vitamin D, levels before surgery, 6 months and 1 year after surgery, and yearly thereafter. We recommend routine daily supplementation with a multivitamin, iron, vitamin B12, and calcium along with vitamin D supplementation depending on the serum levels.

Dumping Syndrome

Dumping syndrome is a common side effect after Roux-en-Y Gastric Bypass (RNYGB) surgery. This usually occurs due to poor food choices. It is related to the ingestion of refined sugars (including high fructose corn syrup) or high glycemic carbohydrates. It can also occur with dairy products, some fats, and fried foods.

The fact is that these foods will interfere with long-term weight loss and should not be eaten anyway.

Symptoms start typically 20-30 min after the food. It includes sweating, flushing, lightheadedness, tachycardia, palpitations, desire to lie down, upper abdominal fullness, nausea, diarrhea, cramping, and active audible bowel sounds.

Conclusion

In summary, although bothersome and sometimes worrisome, dumping syndrome is not a life-threatening problem. Patients need to learn about and read basic nutrition labels. The benefit is that it teaches patients quickly that certain foods and additives cannot be tolerated. Patient compliance and commitment to long-term follow-up are mandatory.

In short, the side effects of bariatric surgery are rare. Timely
identification and intervention are the keys to preventing serious complications.

Still confused about bariatric surgery? Then schedule your consultation with the top bariatric surgeon in Delhi at Smart Cliniqs.

Obesity in Metros

Addressing the Growing Concern of Obesity in Metros: Causes and Implications

Obesity is a medical condition when a person carries excessive weight. It increases the risk of various non-communicable diseases like type 2 diabetes, hypertension, etc. For weight maintenance, energy intake should be equal to energy expenditure. Imbalance leads to underweight and obesity.

Adults residing in Metropolitan cities are increasingly becoming obese. Even Childhood obesity is also emerging as a major health concern in metros. The reasons being excess consumption of calorie-dense fast food, processed food, ready-to-eat food, etc. Portion sizes that fast food restaurants offer contribute to excessive energy intake. As most of the fast foods are made of refined cereals, fat, and sugar. There is a drastic decrease in energy expenditure owing to reduced physical activity as people use motorized means of transport and spend most of their awake time sitting glued to Television, mobile phones, and Laptops. The present work culture in the corporate and public sectors is also responsible for obesity in adults. Long working hours, late night shifts, sitting jobs, sleep deprivation, excessive tea and coffee consumption, and unhealthy snacking in offices predispose obesity.

Obesity surgery in India is being performed to facilitate weight loss in children and adults when non-surgical treatment strategies fail.  Although GI surgeons and general surgeons in India are performing obesity surgery specially trained bariatric surgeons are now available. Bariatric surgery is growing as a specialty in itself. as surgery constitutes only a small part in overall management. A fully equipped, and well-staffed department is a must for the dedicated follow up which is so essential for good outcomes. A dedicated high-volume Bariatric surgery unit in a tertiary care hospital is your best bet if you are seeking bariatric surgery.

Are you Seeking obesity surgery in Delhi or want to more about obesity in metros? Consult with us today at Smart Cliniqs!

Can Malnutrition cause obesity?

How Malnutrition Can Cause Obesity: Insights from Top Bariatric Surgeons

Obesity is a multi-factorial disease; it simply means that, no single cause which can be solely attributed to it. It is also well known that scientists do not know exactly what exactly causes weight gain.  Often, we all see people who can eat whatever comes their way and they still remain thin. With the exception of these lucky few, we are programmed to gain weight with age.

According to top bariatric surgeons, it is a matter of the balance between what you eat, and how much you spend. If we consume calorie-dense food regularly and don’t burn those extra calories, we are likely to gain weight. But can malnutrition cause obesity?

 Surprisingly yes.

Obesity Surgeons who treat obese teens know that children who were underweight at birth are prone to gain too much weight in their childhood and adolescence. Children who faced food shortages during famines later on developed abdominal obesity, the classic Indian Subcontinent profile of thin people with paunch, the so-called thin- obese in medical jargon. As we know that the tummy fat or abdominal obesity is the medically worst. This fat is the harmfully active type that leads to diabetes, heart disease, and cholesterol disorders, the so-called metabolic syndrome.

Malnutrition means not eating right; right food at the right time. People who starve for too long to lose weight are initially successful in losing some weight, but complex hormonal reactions result in weight regain, overshooting the earlier weight. This is known Yo-Yo dieting. Secondly, prolonged fasting slows down our metabolism and stops losing further weight, and starts regaining on the same diet. We tend to lose more muscle mass than fat during the starvation phase and fail to regain our muscle back. So with each dieting cycle of malnutrition, we lose more and more muscle mass and gain more fat.

Starvation or fasts followed by eating calorie-rich low protein food ultimately results in further weight gain and obesity. The best bariatric surgeons know well from their experience that protein-deficient diets after bariatric surgery are counterproductive in the long run and patients may end up regaining all their weight.

Malnutrition can really make us obese.

Still confused that malnutrition can cause obesity? Visit us at Smart Cliniqs and learn more about obesity.