Weight loss surgery in India

Why India is Emerging as a Top Destination for Weight Loss Surgery

Rising Obesity Rates in India

With the persisting need to address the problem of malnutrition, India has developed another nutritional problem, obesity. According to the National Family Health Survey 4, the number of obese people in the country has doubled in the last decade.

Obesity and Type 2 Diabetes

It is a known fact now that obesity is the major reason for developing Type 2 Diabetes. Several studies have revealed that obesity accounts for 80-85% risk of developing type 2 Diabetes. Moreover, most of the world’s population lives in countries where overweight and obesity kill more people than underweight.

Bariatric Surgery as an Effective Solution

Bariatric surgery is now more efficacious than lifestyle changes or medical treatment for sustained weight loss and remission of Type 2 Diabetes.

Cost-Effectiveness of Bariatric Surgery

The cost of weight loss surgery versus the cost of medicines and lifestyle changes has been debated extensively. Similarly, not only savings but also cost-effectiveness of weight loss surgery have also been discussed. Various studies have demonstrated cost-effectiveness and cost savings for bariatric procedures compared with usual medical care or intensive lifestyle interventions. All of these studies have been carried out in setups where weight loss surgery has been expensive as compared to the eastern world.

Delhi: A Hub for Medical Tourism

New Delhi, the capital city of India has now become a popular destination for medical tourism. Millions of foreign tourists visit India annually for their medical needs. There are many world-class and reputed hospitals in Delhi, which provide exemplary services in the field of medical care. The presence of highly qualified and experienced weight loss surgeons along with institutions of international repute have made Delhi a prime city for weight loss surgeries in India.

Reasons to Choose India for Bariatric & Metabolic Surgery

According to Dr. Atul NC Peters, Senior Consultant and Head of Apollo Institute of Bariatric and Metabolic Surgery, Indraprastha Apollo Hospitals, New Delhi, more and more patients are flying from the Western world for bariatric surgery in India. Not only for weight loss surgery, but people have also started travelling for metabolic surgery for Diabetes in India. Reasons for choosing India as a favorite destination for Bariatric & Metabolic Surgery are innumerate, a few of them being:

Bariatric Surgery cost in India is approx. half to one-third of the cost of the Western world.
There are no long waiting lists, as patients seeking weight loss surgery in Delhi are given almost immediate treatment.
International accredited hospitals and surgeons.
Dedicated bariatric surgical program which includes a team of expert surgeons, nurses, dieticians, and bariatric care specialists.
Fully equipped operation theaters with trained anesthetist.
Dedicated intensivist with exposure to more than a thousand operated bariatric surgical patients.
Safe and effective results.
Long-term follow-up schedules.
Options for single incision surgery.
Options of Robotic Surgery.

Hence India is now a preferred destination for weight loss surgery as well as metabolic surgery.

Bariatric and Metabolic Surgery Centre: Essential Components

Key Components of a Leading Bariatric and Metabolic Surgery Centre

Rising Incidence of Morbid Obesity

As the incidence of Morbid Obesity is rising day by day, more and more hospitals have started bariatric surgery programs. However, managing a morbidly obese patient is challenging in the way that obesity brings a lot more other diseases with it. Obstructive sleep apnea, Diabetes Mellitus type 2, Hypertension, and Hypothyroidism are a few of them.

Therefore it’s mandatory to set up a comprehensive management program for treating these patients in the best bariatric and metabolic surgery centre.

The decision to recommend bariatric surgery requires a multidisciplinary approach to evaluate the indications for surgery and to define co-morbidities properly.

Key Components of a Bariatric and Metabolic Surgery Centre

The surgeons at the best bariatric hospital must demonstrate the necessary training skills, experience, and leadership. The essential components of a bariatric surgical center include a Director, critical support, appropriate equipment and instruments, 24-hour qualified call coverage, continuous care, long-term follow-up care, and most importantly regular support groups. There must be facilities for data collection and maintaining a database. By collecting and sorting data, a well-maintained database would demonstrate past performance and help in directing future trends. Periodic evaluation and comparison will allow centers to develop improvement plans.

Role of the Bariatric and Metabolic Committee

There must be a bariatric and metabolic committee which is headed by the program director and includes the coordinator, clinical reviewer, and hospital administration staff. All the surgeons included in the committee must focus on quality improvement which includes a reduction in variation, standardization of practice, establishing selection guidelines, and quality improvements. This can result in decreasing rates of complications, re-admissions, length of stays, surgical site infections, etc. The committee also establishes pathways of care for pre-operative and post-operative management. All relevant staff must be educated in patient safety and complication recognition. The goal of the pathways is to prevent failure to rescue situations which means early recognition and treatment of the post-surgical complications.

Responsibilities of the Bariatric Surgical Care Coordinator

The Bariatric Surgical Care coordinator assists and reports to the director of the committee. The coordinator assists in center development, managing the accreditation process, maintaining relevant policies and procedures, patient education, outcomes and data collection, quality improvement efforts, and education of relevant institution staff. The coordinator supports the development of written protocols and education of nurses to recognize the critical vital signs required to minimize delays in the diagnosis of serious adverse events.

Data Management and Accreditation

The clinical reviewer enters data into relevant platforms. The reviewer should not be contributing to patient care to avoid bias.

The hospital must be accredited by relevant authorities to ensure that the care for metabolic and bariatric surgery patients is provided in a safe environment. In this respect, Apollo Hospitals New Delhi has been accredited by the JCI.

Certifications and Training

The director or the chief surgeon must have obtained a verification certificate to operate on morbidly obese patients by relevant governing bodies. These certificates are purely based on the volume of surgeries and quality of care and dedication to the practice. Similarly, there must be 24-hour call coverage for the patients attended by qualified persons.

The bariatric surgical nurse must obtain specialized training such as the Certified Bariatric Nurse certification.

Essential Support Services

There must be dedicated physicians, dieticians, psychologists and psychiatrists, social workers, and physical therapists.

Registered dieticians are absolutely essential for the success of any bariatric surgical center.

They do all the nutritional counseling and follow-up.

Psychologist and psychological evaluation is a must before any bariatric and metabolic procedure. These patients are often suffering from depression, anxiety, and other stress-related disorders. Psychological education, evaluation, and preparation are useful in achieving overall patient stability and emotional well-being.

Facilities and Equipment

Morbidly obese patients must feel welcome upon entering an institution. There must be appropriate furniture to accommodate them in the waiting room as well as the examination room. The plus size hospital clothes, beds wheelchairs, and floor-mounted toilets are a must. There must be dedicated beds or floors for bariatric surgical patients. Similarly, operating room tables and equipment are accordingly sized to the needs of such patients.

Critical Care and Anesthesia

The critical care support providers must be trained in identifying early signs of potential complications. The anesthesia team must be trained to give anesthesia to such patients taking care of DVT prevention and obstructive sleep apnea to name a few.

Various specialty consultants are also asked to give preoperative clearances to the patient in view of the existing co-morbid conditions.

Support Groups and Electronic Media

A pediatric and adolescent medical advisor is also a part of the team at the center. He/she operates on adolescent patients.

Support groups are designed for the patients who are in the recovery phase. These are primarily organized to take care of the medical, nutritional, psychological, and social issues experienced by the patients.

The development of electronic information media such as dedicated websites is an essential part of addressing various issues and reaching people in remote places.

Future Trends and Institutional Commitment

As more and more people are undergoing bariatric surgical procedures these days, the demand for safe treatment facilities will grow. According to Dr. Atul NC Peters, Senior Consultant and Head of Apollo Institute of Metabolic and Bariatric Surgery, Indraprastha Apollo Hospitals, New Delhi, India, the most important element in the best bariatric surgery center is leadership from the surgeon and integrated medical staff. They require dedication, strong fundamental infrastructure, and total institutional commitment.

Management of Diabetes After Bariatric Surgery

Effective Management of Diabetes Through Bariatric Surgery

Obesity has become the principal cause of Type 2 Diabetes Mellitus these days. Excessive fat deposition leads to insulin resistance, which results in metabolic syndrome. There are various ways to treat type 2 diabetes including lifestyle modification, weight reduction, and drugs including insulin. All these conventional methods have proved to be inefficient in achieving long-term results, highlighting the need for effective management of diabetes.

Surgery has evolved as the most efficient alternative to conventional treatment and results in sustained weight loss and remission or resolution of type 2 Diabetes.

Bariatric and metabolic surgery changes the anatomy of the gastrointestinal tract in a beneficial way, this alteration increases good hormones. After bariatric surgery, there is an augmented release of hormones like GLP-1 and PYY from the small intestine that leads to improvement in high blood sugar levels.

Since bariatric surgery is a highly efficient tool to reduce the blood sugar levels in an obese diabetic patient, there is a need for adjustment of anti-diabetes medicines in these patients post-surgery.

Moreover, there is decreased calorie intake after bariatric surgery for which dose adjustments of the anti-diabetes medicines are needed.

The post-operative diet schedule includes:

Phases 1 and 2 are of clear liquids to a full liquid diet for 2 weeks. At this stage, the calorie intake is about 600 to 800 kcal/day.
Phase 3 is of pureed diet.
Phase 4 consists of a soft to normal diet and the calorie intake is about 1200 to 1500 kcal/day.

Before surgery, patients are usually switched over to intravenous insulin, and blood glucose is monitored at regular intervals.

Similarly in the postoperative period, blood sugar is again maintained on intravenous insulin. On discharge, the patient is shifted to tablets along with long-acting insulin in most of cases for an initial few days.

The patient is taught to measure and chart blood sugar twice daily or in a few cases thrice daily and the doses are adjusted accordingly. Subsequently, as patients lose weight, there is a further decrease in the requirement for drugs. Most of the time, almost all of the drugs are withdrawn to avoid any hypoglycemic episode. It is advised to maintain a blood sugar level between 120 to 150 mg %. Remission of diabetes is seen in close to 80% of patients who do not need any treatment. There is a continuous need for follow-up with at least 3 monthly HbA1c levels.

In patients with poorly controlled diabetes mellitus, withdrawal of drugs may precipitate ketoacidosis in the early postoperative period. These patients are monitored carefully for symptoms and signs of diabetic ketoacidosis.

General guidelines:

To Monitor blood glucose at least twice a day with the aim of maintaining it between 110-180mg/dl.

Tab Metformin is started on day 1 of surgery. The long-acting insulin doses are reduced by 50%.

Signs and symptoms of stress hyperglycemia include frequent urination, increased thirst, blurred vision, fatigue, headache or ketoacidosis which includes fruity-smelling breath, nausea and vomiting, shortness of breath, dry mouth, weakness, confusion, coma, abdominal pain, etc. They must be addressed carefully and must be monitored by watching blood gases as well as urinary ketones.
Patients must be educated about signs and symptoms arising from hypoglycemic episodes (Blood sugar less than 70 mg%) like shakiness, dizziness, sweating, hunger, irritability or moodiness, anxiety or nervousness, and headache.
During such episodes, the patient must take 15-200 ml of fruit juice or milk if on a liquid diet. And if on solids, any sweet candy. Similarly patient can take curd or yoghurt if on a pureed diet.
Such people must take adequate protein to avoid episodes of hyper or hypoglycemia.

Looking for diabetes surgery in Delhi? Schedule an appointment with us at Smart Cliniqs.

How Does Bariatric Surgery Reverse Diabetes?

How Bariatric Surgery Can Reverse Diabetes and Improve Overall Health

Obesity is the root cause of diverse diseases such as Asthma, sleep apnea, cardiovascular problems, Type 2 Diabetes Mellitus, joint pains and most important some forms of cancers.

Obesity increases insulin resistance in the body leading to Type 2 Diabetes Mellitus, and also results in Metabolic Syndrome.

There are various ways to deal with these problems which include changes in lifestyle and modification in the eating habits and use of certain drugs. But almost all of the studies conducted have come to the conclusion that these therapies are not effective in providing sustained weight loss. Bariatric surgery has been the most effective treatment option till date which results in effective and sustained weight loss along with resolution of the other problems associated with obesity.

There are various bariatric and metabolic surgical procedures available which can be done by Laparoscopic Techniques as well as with Robotic assistance. They include Sleeve gastrectomy, Roux-en-Y gastric bypass, Mini Gastric Bypass, Ileal Interposition, Duodeno-Jejunal Bypass, and so on.

Mechanism of resolution of Diabetes Mellitus:

The intestine is now considered as a metabolic organ and this new insight can be utilized for the treatment of Diabetes. Bariatric and metabolic surgery leads to changes in the anatomy of the gastrointestinal tract resulting in the treatment of obesity and diabetes mellitus.

Reason Behind How Bariatric Surgery Reverse Diabetes?

The quick lowering of blood sugar after bariatric surgery is due to hormonal changes after re-routing of the small intestine and not purely do the restriction of the calorie intake. It has been proposed and proved that after bariatric surgery there is an augmented release of certain hormones like GLP-1 and PYY from the small intestine that leads to improvement in the high blood sugar levels. These hormones not only decrease the cellular resistance to insulin, they also increase the efficiency of insulin. There is also decreased production of glucose from the liver due to their effects.

After surgery, long-term follow-up for the best results is a must. It’s a complete lifestyle change. One must follow instructions carefully for optimum results.There are absolute guidelines decided by the international diabetes federation for the selection of patients who can be benefitted from surgery.

These surgeries must be done at the best bariatric and metabolic surgical centers doing these surgeries routinely and under expert care and experienced hands. Although hospital stay remains from 2 to 3 days, a strict and regular follow-up is a must.

Diabetes Mellitus Type 2 – The Permanent solution

Addressing the Growing Emergency of Diabetes Mellitus Type 2: The Role of Metabolic Surgery

With the increase in obesity during the last few years all over the world, type 2 diabetes mellitus has emerged as one of the largest emergencies related to obesity.

There are various treatment options for type 2 diabetes starting from lifestyle and dietary modifications to various drug schedules including insulin therapy.

The Rise of Metabolic Surgery

These days, metabolic surgery has emerged and is accepted as a new step in the therapeutic regimen for T2DM when lifestyle modifications and drugs don’t give the required sugar control.

Metabolic surgery involves food re-routing through modifications of the gastrointestinal tract by laparoscopic or Robotic approach, it is safe and effective for the treatment of diabetes mellitus type 2. Metabolic surgery is being considered as the only permanent solution for diabetes these days.

Not only Diabetes, this surgery has also been seen to reduce other cardiovascular risk factors (cholesterol and blood pressure) when compared with medical treatment.

The Importance of Cardiovascular Health

According to WHO high blood pressure and tobacco use are the greatest cause of premature deaths; therefore, it becomes more important to focus on preventing cardiovascular complications related to high blood glucose and cholesterol.

Evidence from Global Studies

Several studies done all over the world have demonstrated that metabolic surgical procedures improve blood glucose levels independently of weight loss and also have a positive impact on blood cholesterol and blood pressure, with a very good long-term effect on cardiovascular morbidity and mortality.

Gastrointestinal surgery for the specific intention to treat T2DM was first recommended at the 2007 Diabetes Surgery Summit.

Guidelines for Metabolic Surgery and Their Implications

After going through various studies, the American Diabetes Association has recommended and formed certain guidelines on metabolic surgery for adult patients with type 2 diabetes.

They have expanded the indications for metabolic surgery to include patients with inadequately controlled type 2 diabetes who have a BMI as low as 30 kg/m2 (27.5 kg/m2 in Asians).

With the present guidelines, metabolic surgery is considered a permanent solution for type 2 diabetes and metabolic disease.

Surgery Options for Non-Obese Patients

Not only in the obese, the need for control of diabetes in non-obese patients led to the development of Ileal Interposition surgery or Duodenojejunal bypass surgery. These can be performed in thin type 2 diabetics with BMI as low as 27.5 kg/m2 as well as those who had undergone supervised treatment schedules but still have poorly controlled disease.

However, these surgeries must be performed in specialized centers and in expert hands where these procedures are being performed regularly with long follow-up schedules.

Looking for diabetes surgery in India? Consult Prof. (Dr.) Atul N.C Peters at Smart Cliniqs for the metabolic treatment of diabetes in India.

Obesity and Cancer

Understanding the Connection Between Obesity and Cancer

For us the word cancer evokes panic and fear of imminent death, whenever someone close is diagnosed with cancer we are shocked. All cancers though are not the same; a great majority can be cured when caught early. And then there are types associated with predisposing medical conditions. We normally picture cancer patients as thin, worn out, barely able to eat, in pain, and a state of constant dread. This may be true to a large extent. However many recently diagnosed cancer patients are overweight and even obese.

Obesity as a Major Risk Factor

You will be surprised to know that obesity is a major risk factor for many cancers, so much so that it is considered to be second only to smoking, the most common one. Here are a few well-known facts, for example, obesity in women increases the risk of Breast cancer fourfold, uterine and ovarian cancer 5 fold, obese men and women are much more prone to cancers of the esophagus, colon, gall bladder, and thyroid, and many more.

Challenges in Diagnosing Cancer in Obese Patients

Not only does Cancer occur more in obese, but it is also more difficult to diagnose early. A lump may remain hidden in fat for a long time. The imaging and tests are less reliable in bulky and are less sensitive making it difficult to pick even a moderate size tumor. Severely obese even cannot be accommodated in a standard-size CT scanner. Secondly, it is diagnosed at a more advanced stage, so is difficult to treat, and the surgery becomes riskier and limited in scope for serious obesity. Radiation and chemotherapy likewise are needed in larger doses resulting in more side effects and morbidity.

The Importance of Managing Weight

So it is all the more important to keep weight in check and treat serious obesity early. Bariatric surgery with its long long-lasting and superior results is the best way to lose weight in suitably selected patients. Bariatric surgery`s benefits compound with time and are consistent with lifelong health and happiness.

Obesity Discrimination and Gastric Bypass Surgery

Understanding Obesity Discrimination: Types, Impact, and Effective Solutions

Definition: Obesity Discrimination

Obesity discrimination can be defined in either of several ways, including:
1. The unjust treatment of an overweight or obese person based on bias, or misconception.
2. Ill-treatment of obese people purely because of their weight as compared to non-obese people.

There are mostly four types of discrimination prominently described: Employment, Health Care, Education, and Relationships

Employment Discrimination:

Several studies have shown that obese people find more difficulty in finding a job, are paid lower wages, are discriminated against in promotions, and have more likelihood of early termination.

Healthcare Discrimination:

It is unfortunate that even, doctors and healthcare workers are not immune from obesity discrimination. It is a place where caring, trust, and unbiased treatment should be guaranteed. The problem is, that most of the doctors do not have a sound knowledge of obesity or its treatment.

Physicians spend less time discussing health with obese patients. They are more biased towards technical issues rather than discussing nutrition to patient’s obesity.

Discrimination at Schools:

At schools, discrimination is a bigger concern. It causes emotional distress, as children who are obese are less likely to succeed. It appeared in various studies that young men had a much lower chance of attaining higher education than their normal-weight counterparts. Obesity was also associated with lower educational attainments than normal-weight students.

Discrimination in relationships:

When it comes to finding a romantic partner, obesity appears to play a big role, especially for women. When studied among people, it was found that boys were less interested in looking for obese women.

Effectively Addressing Obesity Discrimination: Tips For All 4 Types Of Discrimination

The ideal solution is obvious: weight loss treatment.

Finding the medically supervised weight loss treatment program composed of the right diet and exercise is the most appropriate first step.

Research has shown diet and exercise programs supervised by a medical professional to be much more effective than doing it alone.

If your body mass index is over 35 which means that you are morbidly obese and attempts at sufficient weight loss, even under a medically supervised program, have yielded no results, you may be a candidate for weight loss surgery or laparoscopic gastric bypass surgery.

It has been proved time and again that bariatric surgery results in sustained weight loss in morbidly obese people. In other words, Bariatric surgery may improve occupational outcomes in morbidly obese individuals by reducing levels of unemployment and absenteeism. The evidence regarding this is limited and studies are needed before any conclusions could be drawn on this aspect. Similarly, there could also be economic, social, and psychological benefits of bariatric surgery which might help in improving relationships among individuals after weight loss.

It is advisable to visit a well-experienced bariatric surgeon as they usually have more knowledge about caring for obese patients, and they also work with doctors who are empathetic toward the difficulties of being obese.
Similarly, the research suggests that an obese child, especially an obese girl, is more likely to succeed in schools where obesity is more common.
If you find that your weight is getting in the way of your romantic relationships, several options may help:

First and foremost: weight loss treatment
• Consider dating partners who are also overweight or obese
• Choose partners who are willing to get to know you as a person before judging you only by your appearance

Consider Laparoscopic Gastric Bypass Surgery if you are morbidly obese.
There are certain non-surgical options also available like endoscopic intra-gastric balloons which are available these days to lose weight for overweight people.

These methods are temporary but might result in good outcomes for people who are serious and motivated.

Women’s Health and Gastric Bypass Surgery

The Impact of Obesity on Women’s Health and How Gastric Bypass Surgery Can Help

In recent years obesity among Indian women has increased exponentially. According to the National Family Health Survey, obesity rates double every 10 years in India. Over 16% of women in the country and up to 50% of women in Delhi are overweight or obese. With this growing menace more and more women who conceive also happen to be obese.

A multitude of problems is associated with obesity in women particularly those who are in the reproductive age group. Apart from physical problems, others range from difficult intercourse, symptomatic fibroids, dysfunctional uterine bleeding, PCOD, anovulatory cycles, urinary stress incontinence, and infertility. Again birth defects, difficult labor, increased risk of caesarian section delivery, and cancers like ovarian cancer, endometrial cancer, cervical cancer, and breast cancer, are all associated with obesity. There is a very high risk of gestational diabetes mellitus as well as pregnancy-induced hypertension in ladies who are obese.

There are additional risks to babies born to such mothers, such as developmental anomalies, intrauterine deaths, and preterm deliveries. These babies have an increased lifetime risk of developing diabetes and high blood pressure.
Bariatric surgery or Gastric Bypass Surgery has emerged as the most effective treatment option for obesity over the last few decades. Women account for about 83% of bariatric procedures among reproductive age. Laparoscopic sleeve gastrectomy has been the most commonly performed weight loss treatment among women of reproductive age.

In addition to sustained weight loss, there is also resolution or improvement in obesity-related diseases after gastric bypass surgery. Diabetes mellitus, hypertension, OSA, fatty liver disease, and joint pains are just a few among them. There is also improvement in fertility, menstrual cycles, and ovulation so much so that infertile obese ladies have conceived normally after weight loss treatment. They give birth to babies with a lower risk of cardiovascular complications or birth defects.

After gastric bypass surgery, pregnancy is better avoided for a minimum of 12 months. As by that time the mother has resumed her normal diet, and she has been allowed to achieve full weight loss. Most importantly, the baby is not exposed to maternal rapid weight loss environment or maternal malnutrition.

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Home Care After Bariatric Surgery

Essential Care After Bariatric Surgery: Tips for a Smooth Recovery at Home

Now that you have been discharged from the hospital and have reached home, you might feel relieved but also apprehensive about home care after bariatric surgery. You might worry about whether stitches could break, experience pain at home, or have questions about how much to walk and whether or not to take a bath. These are some helpful points for your guidance.

Wound Care

Change the dressings every day, if your doctor tells you to do so. Be sure to change your dressing always whenever it gets dirty or wet.
You may have bruising around your wound or redness around the incisions, do not panic, this is normal.
Avoid wearing tight clothing to prevent rubbing against your incisions.
Stitches or staples are usually removed within 7 to 10 days after surgery. some stitches dissolve on their own. Your doctor will tell you if you have them.
You can have a shower when advised by your doctor, let the water run over your incision, and do not scrub over the incisions.

Personal hygiene

Take a shower daily.do not rub the wounds. let only water run on your incisions
You can oil massage and wash your hair daily to feel fresh and active
Change your clothes daily
Clean your skin folds well with soap and water once a day and keep them dry, especially during the rainy season

Activity

Walk as much as you can, move around, and use stairs at home
Do not lift things heavier than 5 to 7 kgs in the initial months
Increase your exercise slowly
Take short walks
Get up and move around if you have some pain in your belly, it may help
Do not join the gym until recommended by your doctor.

Follow-up

To help recover from surgery and changes in your lifestyle, see your surgeon regularly and other health care providers.
The dietitian will teach you to eat correctly with your small stomach.
The psychologist can help you deal with the feelings or concerns you may have after surgery.
Blood tests are important as recommended by your surgeon, get them done timely to prevent vitamin and mineral deficiencies.

When to Call the Doctor

Temperature is above 100°F.
You have redness, pain, swelling, or bleeding around your incision
You have pain that your pain medicine is not helping
You have breathing difficulty
You cannot eat or drink
You are vomiting after eating

These simple precautions will help you tide over the initial difficult time at home after your bariatric surgery. Bariatric surgery is the best way to lose weight and regain health.

Infertility in Women and Bariatric Surgery

Improving Infertility in Women with PCOS: The Impact of Bariatric Surgery on Reproductive Health

The relationship between PCOS, obesity and infertility has been documented for many years. Anovulation, miscarriage, impairment in follicle formation and altered activity are the known effects of these. These women also face difficulty in managing diabetes, pre-eclampsia, growth disorders, higher rates of caesarean delivery, higher maternal mortality, and increased children’s risk for metabolic disease in the future.

A considerable weight loss can increase the chances of spontaneous ovulation, which is why the solution – bariatric surgery. This surgery is known to improve both fertility and pregnancy in women with reproductive concerns, polycystic ovarian syndrome (PCOS), along with metabolic syndrome (MS).

Bariatric Surgery’s Positive Effect on Women

Bariatric surgery in reproductive-age women has been shown to decrease menstrual irregularities. Women suffering from hormonal imbalance show considerable improvement postoperatively, and chances of conceiving increase after this surgery. Sensitivity to leptin levels increases post-surgery, reflecting improved reproductive metabolic status. Many women (about 10%-25%) with subclinical hypothyroidism, haven also shown a significant improvement following surgical weight loss.

Women already take pregnancy into consideration when electing for bariatric surgery. Nowadays women undergoing surgery are aware of their own reproductive risks and a significant number of these women are thinking ahead.

Studies on Infertility in Women and Bariatric Surgery

Bariatric surgery has attracted the interest of many scholars with more individuals showing improved fertility post-weight loss treatment. An older study implied that a BMI drop greater than 5 kg/m² was a significant predictor of fertility within 2.5 years of follow-up after surgery. There was also a trend of a reduced need for fertility treatment in women conceiving within 3 years of weight loss surgery compared to their need for fertility treatment prior to surgery. Reports also show previously anovulatory women conceiving post-operatively without ovulation induction agents.

Comparing Pregnancy Outcomes in Women Pre and Post-Bariatric Surgery

A study comparing pregnancy outcomes in women before and after weight loss surgery showed improvements in pregnancy-related hypertension and diabetes mellitus, and a significant drop in caesarean delivery rate too. Moreover, bariatric surgery did not result in increased rates of post-partum haemorrhage, infection, shoulder dystocia or foetal demise.

The benefits of bariatric surgery in women suffering from PCOS with metabolic syndrome are discussed extensively on various platforms, leading in favour of surgery in such cases. Nutritional and vitamin deficiencies in these women during that time frame of rapid weight loss can be dealt with supervised supplementation and regular follow-ups with the surgeon and obstetrician. There were no differences in maternal complications, foetal outcomes or delivery complications, making bariatric surgery a highly recommended solution and one of the best ways to lose weight in morbidly obese people.