Mini Gastric Bypass vs Roux-en-Y Gastric Bypass

Mini Gastric Bypass vs Roux-en-Y Gastric Bypass: Understanding Your Weight Loss Journey

Embarking on a weight loss journey is a deeply personal experience. As obesity rates continue to rise globally, many people are turning to surgical solutions to help achieve substantial weight loss and improve their overall health.

This blog post addresses this concern and offers a comprehensive overview of Roux-en-Y Gastric Bypass (RYGB) and Mini Gastric Bypass, two popular weight loss surgeries. It discusses the procedures, benefits, and potential risks associated with each option. The article also explores the criteria for eligibility for bariatric surgery in India and offers guidance on choosing a qualified bariatric surgeon in Delhi. Ultimately, the goal is to empower individuals considering weight loss surgery to make informed decisions based on their specific needs and goals.

Introduction

When considering weight loss surgery, understanding the available options is crucial. Two common procedures, Roux-en-Y Gastric Bypass (RYGB) and Mini Gastric Bypass, offer significant weight loss benefits but differ in their techniques and outcomes.

On average, people who undergo gastric bypass surgeries, lose 70 to 80% of excess body weight. However, it’s important to remember that these surgeries require a lifelong commitment.

This blog will delve into the details of 2 such procedures, helping you make an informed decision about which is best suited to your individual needs.

What is Roux-en-Y Gastric Bypass (RYGB) Surgery?

Roux-en-Y Gastric Bypass (RYGB) is a more traditional weight loss surgery that involves creating a small stomach pouch and bypassing a portion of the small intestine. This rerouting of the digestive system leads to reduced food intake and absorption, resulting in significant weight loss.

How RYGB Works:

Stomach pouch creation: The upper portion of the stomach, near the oesophagus, is stapled to create a small pouch that holds less food.
Intestinal rerouting: The lower section is attached directly to the new stomach pouch, creating a pathway called the “roux limb.” The upper section of the small intestine, which carries digestive juices, is then attached further down the digestive tract, to the end of the roux limb. This allows food to bypass the lower stomach, the duodenum (the first part of the small intestine), and a portion of the small intestine itself.
Reduced food intake and absorption: The rerouted digestive system limits the amount of food that can be consumed at once and reduces the absorption of nutrients.

Benefits of RYGB Surgery:

Significant weight loss: Patients often experience substantial weight loss within the first year of surgery.
Improved health outcomes: RYGB can address obesity-related health conditions such as diabetes, high blood pressure, and sleep apnea.
Long-term weight loss maintenance: Many individuals who undergo RYGB surgery are able to maintain their weight loss over the long term.

What is Mini Gastric Bypass Surgery?

Mini Gastric Bypass, also known as one anastomosis gastric bypass, is a less invasive procedure compared to the traditional Roux-en-Y Gastric Bypass. It involves creating a small stomach pouch to limit food intake and rerouting part of the small intestine to reduce nutrient absorption.

How Mini Gastric Bypass Works:

Stomach pouch creation: Similar to RYGB, the surgeon makes your stomach smaller by stapling and reshaping it into a long, slender pouch.
Direct connection: A new path is created for the food to pass through. A section of your small intestine is connected to the new stomach pouch. This bypasses the lower part of your stomach, the duodenum, and some of your small intestine.
Reduced food intake and absorption: The rerouted digestive system limits the amount of food that can be consumed and reduces the absorption of nutrients.

Benefits of Mini Gastric Bypass Surgery:

Potential Reversibility: Unlike some weight loss surgeries, Mini Gastric Bypass is potentially reversible due to its simpler design.
Reduced risk of obesity-related comorbidities: Mini Gastric Bypass can help address other health conditions associated with obesity, such as high blood pressure and sleep apnea like in RYGB.
Less restrictive: Mini Gastric Bypass may allow for a more flexible diet compared to RYGB.

Which Gastric Bypass Surgery is Right for You?

The decision between Roux-en-Y Gastric Bypass and Mini Gastric Bypass depends on various factors, including:

Individual health goals: Consider your desired level of weight loss and any specific health conditions you want to address.
Medical history: Discuss any existing medical conditions or risk factors with your surgeon.
Lifestyle factors: Consider your dietary habits, exercise routine, and overall lifestyle.

There are minor differences in these two procedures. With different advantages and disadvantages, the best outcome will depend by making an informed choice in consultation with your bariatric surgeon.

Who is Bariatric Surgery for?

Bariatric/metabolic surgery should be considered a treatment option for acceptable Indian patients with a BMI ? 35 kg/m², with/without the presence of any obesity-related co-morbidity.

Bariatric/metabolic surgery should be considered a treatment option for acceptable Indian patients with a BMI ? 30 kg/ m², in the presence of two or more obesity-related co-morbidities.

Bariatric/metabolic surgery should be considered as a non-primary treatment option for acceptable Indian patients with a BMI ? 27.5 kg/ m², with uncontrolled type 2 diabetes despite optimum medical management.

Any bariatric/metabolic surgery for an Indian patient with a BMI < 27.5 kg/ m² should be strictly performed under an experimental study protocol with prior ethics committee approval and informed consent from the patient.

Bariatric/metabolic surgery should be considered as a treatment option for acceptable Indian patients with central obesity with a waist circumference ? 80 cm in females and ? 90 cm in males along with type 2 diabetes and other obesity-related co-morbidities.

Bariatric/metabolic surgery may be advised as a treatment option for acceptable Indian patients who qualify for the above BMI criteria if they are ? 18 years of age. It may be advised as a treatment option to patients younger than 18 years of age under special circumstances with the approval of a multi-disciplinary team constituting a pediatrician, endocrinologist, dietician, psychologist, and a bariatric team including a bariatric surgeon. Attainment of puberty and completion of skeletal maturity must be taken into account for this patient population when considering the option of surgery.

Bariatric/metabolic surgery should be advised as a treatment option for acceptable Indian patients who qualify for the above BMI criteria for patients up to 65 years of age. Bariatric/metabolic surgery may also be recommended for patients ? 65 years of age if they are medically fit, and the benefits of surgery outweigh the risks.
All patients who are advised of bariatric/metabolic surgery as a treatment option should be motivated to enter a long-term weight management program and should be committed to life-long follow-up.

Long-term weight management programs and follow-ups must be provided by all bariatric teams.

Choosing a Bariatric Surgeon in Delhi

It’s essential to consult with a qualified bariatric surgeon who can assess your individual needs and recommend the most appropriate procedure. A bariatric surgeon can provide personalized guidance, address your questions and concerns, and help you make an informed decision.

Ready to take the next step towards a healthier you?
Here’s a quick checklist to help you find the perfect fit:

Experience and qualifications: Look for a surgeon with extensive experience in performing weight loss surgeries.
Board certification: Ensure the surgeon is board-certified in bariatric surgery.
Hospital affiliation: Consider the surgeon’s affiliation with reputable hospitals in Delhi.
Patient reviews and testimonials: Read reviews and testimonials from previous patients to get a sense of the surgeon’s expertise and patient satisfaction.

Preparing for Weight Loss Surgery

If you decide to undergo weight loss surgery, it’s important to prepare for the procedure and the recovery process. This may involve:

Making lifestyle changes: Adopting healthier eating habits and increasing physical activity can help you prepare for surgery and improve your overall health.
Undergoing pre-operative evaluations: You may need to undergo various medical tests and evaluations to assess your suitability for surgery.
Following pre-operative instructions: Your surgeon will provide specific instructions to follow before the procedure.

Recovery and Post-Operative Care

Recovery from weight loss surgery typically involves a hospital stay of several days, followed by a period of at-home recovery. During this time, you will need to follow your surgeon’s instructions for wound care, medication, and dietary restrictions.

Long-Term Follow-Up

After surgery, it’s important to attend regular follow-up appointments with your bariatric surgeon. These appointments will help monitor your progress, address any concerns, and ensure that you are receiving the necessary support for long-term weight loss maintenance.

Conclusion: Mini Gastric Bypass vs Roux-en-Y Gastric Bypass

Both, Roux-en-Y Gastric Bypass and Mini Gastric Bypass, surgeries offer significant potential for weight loss and improved health outcomes. By understanding the differences between these procedures and consulting with a qualified bariatric surgeon, you can make an informed decision that aligns with your unique needs and goals. Remember, the journey to a healthier you, begins with taking the first step and seeking the right guidance.

Life After Intragastric Balloon Procedure

Life After Intragastric Balloon Procedure: Maintaining Your Weight Loss Success

Intragastric balloon therapy is a non-surgical weight management option that involves placing a temporary, saline-filled device in your stomach through an endoscope. By occupying space, the balloon helps you feel fuller sooner, reducing your overall food intake.

This procedure can be a viable choice if you’ve struggled to achieve your weight goals through diet and exercise alone.

Intragastric balloon procedures typically result in weight loss of 5-15 kilograms, but individual outcomes can vary based on factors such as initial weight, commitment to a healthy lifestyle, balloon type, and metabolic rate. These procedures are generally intended for individuals without any underlying health conditions.

However, it’s important to remember that sustained weight loss requires a holistic approach. Adopting lasting healthy habits, such as nourishing your body with balanced meals and engaging in regular physical activity, is crucial for long-term success.

Understanding the Intragastric Balloon Procedure

Since the beginning of the 1980s, the global prevalence of obesity has substantially increased. An approximate one in three adults is categorized as overweight or obese, equating to greater than 1.4 billion adults. The soaring rates of obesity have triggered a parallel epidemic of associated health problems. These include hypertension, hyperlipidemia, cardiovascular disease, diabetes mellitus, orthopedic conditions, gastroesophageal reflux disease, metabolic dysfunction, psychiatric disorders, obstructive sleep apnea, non-alcoholic fatty liver disease, and cancers.

While bariatric surgery is considered the most effective treatment modality for morbid obesity, the eligibility criteria for these surgical interventions, such as Roux-en-Y gastric bypass, duodenal switch, and laparoscopic sleeve gastrectomy, are clearly defined. Patients must typically exhibit a body mass index (BMI) surpassing 25 kg/m² to qualify as candidates for surgery.

Intragastric balloon therapy is a less invasive but temporary weight management solution compared to the more comprehensive and lasting effects of bariatric surgery. However, it’s essential to emphasize that, like any weight management intervention, long-term success hinges on consistent lifestyle modifications.

Intra-gastric balloon treatment offers flexible options for weight management

Standard duration: The balloon typically remains in place for around 6 months.
Refill: Some types of balloons can be refilled to extend their duration, often up to a year.
Customization: Treatment plans and the size of the balloon can be tailored to individual needs.
Reversible: It refers to the ability to remove the device once its intended purpose has been achieved. The primary method for removing an IGB is through endoscopy.

Immediate Post-Procedure Care

Effective intragastric balloon procedure requires a programmatic approach. Before the procedure, patients should collaborate with a nutritionist to develop a tailored meal plan. A multidisciplinary team, including your surgeon, will provide ongoing care for up to a year, encompassing the balloon placement and post-removal periods.

Failing to remove an intragastric balloon after its prescribed duration can have serious health consequences.

Potential complications include:

Balloon migration: The balloon may shift from the stomach into the intestines, causing a blockage that can lead to severe abdominal pain, vomiting, and the need for urgent surgery.
Infection: Prolonged balloon placement can increase the risk of infection.
Gastric ulcers: The balloon may irritate the stomach lining, raising the risk of developing ulcers.
Weight regain: The benefits of the balloon may decrease over time, and individuals may regain weight if it’s not removed as scheduled.

It’s essential to adhere to your healthcare provider’s instructions regarding balloon removal to avoid these complications.

Consistent exercise and dietary adherence are crucial throughout the process.

To minimize discomfort, patients typically follow a liquid diet for the first week, transitioning to soft foods in the second week, and gradually reintroducing solid foods, thereafter.

Dietary Adjustments and Nutrition

Intragastric ballooning is known to help one lose between 5 and 15 kilograms over six months to a year. By occupying space in your stomach, the balloon helps you feel fuller sooner, reducing cravings and portion sizes.

The process involves several stages:

Initial weeks: After the procedure, you’ll transition from clear fluids to pureed foods, then soft foods, before gradually returning to a normal diet. This takes about four weeks, but recovery times vary.
Diet: During the first week, stick to clear fluids, avoiding straws and carbonated drinks. Gradually increase fluid intake to ten cups daily, including dairy for essential nutrients.
Progression: As you recover, incorporate pureed foods like khichdi and porridge into your diet. Chew slowly and stop eating when full. In the third week, you can start soft foods. After four weeks, you can gradually return to normal eating but remember to eat slowly, in small portions, and increase physical activity like walking. This procedure requires patience and discipline. By combining the balloon with a healthy diet and regular exercise, you can achieve significant weight loss and improve overall health.

Incorporating Physical Activity

You might be eager to get back to your regular workout routine after receiving a gastric balloon. While it’s possible to resume exercise sooner than you might expect, it’s important to listen to your body and progress gradually.

To allow your body to adjust to the changes in food and fluid intake, it’s recommended to avoid strenuous physical activities such as sports for approximately one to two weeks post-procedure.

During this initial period, gentle activities like leisure walking while staying well-hydrated are encouraged.

Once you’ve acclimated to the balloon and the first week has passed, you can gradually increase the intensity and duration of your physical activities. Choosing enjoyable exercises can help you stay motivated. Remember to start slowly and listen to your body’s signals.

Your healthcare team can provide personalized guidance based on your specific circumstance and recovery. By working together, you can develop an exercise plan that supports your weight loss goals and overall well-being.

Psychological and Emotional Support

The psychological dimensions of weight loss are often overlooked. For individuals undergoing intragastric balloon therapy, emotional well-being significantly impacts weight loss maintenance.

Initially, intragastric balloon therapy can boost self-confidence dramatically as patients experience physical transformations. This newfound positivity often fuels motivation for sustained lifestyle changes. However, the weight loss journey remains challenging, requiring emotional resilience to overcome obstacles.

The journey post-procedure requires both, physical as well as, emotional fortitude. A supportive environment, fostered by positive feedback and encouragement, can further enhance the emotional benefits of intragastric balloon therapy. The interplay between physical and psychological factors underscores the importance of a holistic approach to weight management.

Ultimately, intragastric balloon therapy can be a catalyst for broader personal growth and improved quality of life.

Regular Monitoring and Follow-Up

Regular check-ups are essential after Intragastric Balloon (IGB) placement. These visits allow your healthcare team to monitor your progress, address any concerns, and ensure your overall well-being.

During these appointments, you will undergo assessments to evaluate:

Physical health, including weight loss, any side effects experienced, and overall physical condition.
Nutritional status, to ensure you are getting the necessary nutrients.
Psychological well-being, as emotional factors play a significant role in weight management.

It’s important to be open and honest with your healthcare provider about any symptoms or challenges you may be facing. This information helps them provide the best possible care and support.

Conclusion: Your Journey to Lasting Success

Obesity is a complex metabolic disorder with numerous associated health problems. Effective and safe weight management options have been in high demand. The intragastric balloon offers a promising intermediate treatment between medical therapy and surgical intervention for obesity. Compared to medical treatments, it may provide superior outcomes while carrying a lower risk profile.

Additionally, the intragastric balloon can serve as a valuable initial treatment for high-risk obese individuals who will eventually require surgery. By improving weight loss and overall health, it can help reduce the risks associated with surgical procedures.

References:

Finding the Best Weight Loss Surgeon in Delhi

Finding the Best Weight Loss Surgeon in Delhi: Key Factors to Consider

Choosing the right surgeon for one’s weight loss surgery is a crucial decision that can significantly impact your health and well-being. With numerous options available in Delhi, it’s essential to consider several key factors to find the best surgeon for your surgery.

Delhi, a bustling metropolis, offers an extensive choice of surgeons, each with their own expertise and experience. From traditional bariatric surgeries to innovative new age robotics, the city caters to diverse patient needs. and navigating this landscape so as to make an informed choice requires careful research and consideration.

I’m interested in weight loss surgery. How do I choose the best surgeon for my needs?

When selecting a weight loss surgeon, prioritize the following qualities:

Experience: A surgeon with a proven track record of successful weight loss surgeries is more likely to deliver positive outcomes. Look for individuals who have performed a significant number of procedures and have a reputation for excellence.

Certifications: Ensure the surgeon is certified by recognized professional bodies, such as the American Board of Obesity Medicine or the American College of Surgeons, American Society for Metabolic & Bariatric Surgery (ASMBS), and the Obesity & Metabolic Surgery Society of India (OSSI). These certifications validate their expertise and adherence to industry standards.

Specialization: Consider surgeons who are trained and specialize in weight loss surgery. This focus indicates a deep understanding of the field and a commitment to providing the best possible care.

Patient Reviews and Success Stories: Read patient reviews and testimonials to gauge the surgeon’s reputation and patient satisfaction. Look for feedback on their bedside manner, communication skills, and overall outcomes.

Beyond the Basics

Surgical Approaches: Discuss the different surgical approaches offered by the surgeon, such as gastric sleeve or gastric bypass. Your surgeon can help you determine the best option based on your individual needs and goals.

Minimally Invasive Surgery: Inquire about the surgeon’s experience with minimally invasive techniques, which can often lead to less pain and a faster recovery.

Bariatric Center of Excellence: Choose a surgeon under whose mentorship the department is being awarded as the Bariatric Center of Excellence, accredited by the Surgical Review Corporation (SRC). These centers provide the highest standards of care and support.

Team Qualifications: Assess the qualifications and experience of the surgeon’s team, including any Bariatric Care Specialists certified by the SRC.

Pre- and Post-Surgery Support: Inquire about the pre-and post-surgery education and support programs offered by the surgeon and their team such as long-term follow-up, patient support group meetings, connecting with other operated patients, etc.

Communication and Comfort: Ensure you feel comfortable and confident in your interactions with the surgeon. Ask questions and express your concerns to gauge their responsiveness and understanding.

Consultation Process: What to Expect

The process of consulting with a weight loss surgeon typically begins with a comprehensive evaluation. During this initial appointment, the surgeon will carefully assess your medical history, current health status, and weight loss goals. They will also discuss the various weight loss surgery options available, their potential benefits, and associated risks.

To ensure your suitability for surgery and identify any underlying health conditions, the surgeon may recommend a series of assessments, including blood tests, physical examinations, and psychological evaluations.

Your surgeon will provide guidance on pre-surgery preparations. This may involve dietary changes, medication adjustments, and lifestyle modifications to optimize your health and prepare for the surgical procedure.

Why Choose Dr. Atul Peters for Metabolic or Bariatric Surgery?

Dr. Atul N. C. Peters is a renowned surgeon and the Senior Director and Head of the Department of Bariatric, Minimal Access, and Robotic Surgery at Max Smart Super Speciality Hospital, Saket, Delhi, India. With over two decades of experience, he has established the department as a leading center of excellence. Dr. Peters’ expertise and dedication to patient care have earned him international recognition, including the prestigious Surgeon of Excellence accreditation from the Surgical Review Corporation.

His contributions extend beyond clinical practice. Dr. Peters is a mentor to aspiring surgeons and has played a pivotal role in advancing the field through research and innovation. His commitment to providing the highest quality care has earned him respect in the medical community.

Conclusion

Choosing the best weight loss surgeon is a crucial step towards achieving your weight loss goals. By carefully considering factors such as experience, certifications, specialization, and patient reviews, you can make an informed decision and find a surgeon who is committed to providing exceptional care.

Ready to take the next step towards a healthier you? Consult with the best weight loss surgeon in Delhi today. Schedule a consultation and explore the life-changing benefits of weight loss surgery.

How Weight Loss Surgery Can Improve Your Health & Wellbeing

Imagine a Life Free from the Struggles of Obesity: Your Guide to Weight Loss Surgery

Imagine a life where every step feels like a struggle, and your breath hitches with every simple task. That’s the harsh reality for many living with severe obesity.

Struggling with obesity can be overwhelming, impacting daily life and long-term health. obesity-related comorbidities like heart disease, diabetes, and high blood pressure can significantly affect one’s quality of life. Weight loss surgery offers a lifeline to those battling not just the bulge, but a cascade of health problems that come with it.

It not only improves mobility by taking pressure off joints but also reduces the risk of associated health complications. For some, the most life-changing benefit is the effective management & control of type 2 diabetes, often happening soon after surgery.

Understanding Weight Loss Surgery

Weight loss surgery, also known as bariatric surgery, includes interventions such as gastric bypass and sleeve gastrectomy and offers a transformative approach to obesity management by modifying the anatomy of the stomach and small intestine. These interventions act on the body’s hormonal signaling system, influencing satiety (feeling of fullness) and hunger cues, while also impacting metabolic processes that regulate calorie intake. As a result, individuals experience a shift in their physiological makeup, facilitating significant and fast weight loss.

If you qualify for bariatric surgery, your weight loss surgeon and the healthcare team will determine the best surgical intervention for you and tailor a pre-surgery plan specific to your needs accordingly. Your pre-surgery preparation may involve:

Medical Checkups: Expect pre-operative lab tests and physical exams to establish your fitness levels for surgery.

Dietary and Medication Adjustments: You may receive instructions on what to eat and drink, and which medications (if any) need to be stopped or taken before surgery.

Exercise and Lifestyle Changes: Starting a physical activity program and quitting tobacco and alcohol might be crucial for a successful surgery and recovery.

Health Benefits of Weight Loss Surgery

Imagine shedding 70 to 80% of your excess weight and keeping it off for good!
Bariatric surgery offers impressive long-term success rates. Patients achieve substantial weight loss, shedding around 70 to 80% of their excess weight and keeping it off in the long term. Beyond the numbers, the impact is life-changing. Many report increased energy, reduced pain, and the ability to engage in activities they once struggled with. The rapid weight loss even triggers hormonal changes that further support weight management. Remember, consistency is key! Regular exercise and a healthy diet regimen after surgery play a crucial role in maintaining weight loss and newfound vitality.

Moreover, studies show a significant reduction in the risk of death from various conditions:

Heart Disease: Patients see a remarkable 40% decrease in their risk of dying from heart-related issues.
Diabetes: The risk of death from diabetes plummets by an impressive 92% after surgery.
Cancer: The chances of succumbing to cancer also see a significant 60% drop.

Well-being and Quality of Life Improvements

Diet-induced weight loss often isn’t sufficient nor sustainable, so health complications associated with obesity tend to persist.

Bariatric surgery offers a significant transformation that extends far beyond just weight loss. While significant weight loss is a key benefit, the true magic lies in the overall health improvements it unlocks. Patients report a surge in energy, a brighter outlook, and a newfound confidence that empowers them to fully embrace life. Activities that may have once been difficult or avoided become accessible, leading to a more fulfilling lifestyle.

The positive impact doesn’t stop there. Bariatric surgery becomes a catalyst for adopting healthier habits, including better food choices and regular exercise. This ripple effect often extends to loved ones, creating a supportive and healthy environment within families. Ultimately, weight loss surgery empowers patients to take control of their health, not just for the present, but for the long term. It’s a testament to the power of modern medicine in promoting a healthier, longer, and more fulfilling life.

Who Should Consider Weight Loss Surgery?

If you are trying hard to lose weight and/or have been battling weight-related complications, you might be wondering if weight loss surgery is a viable option for you. It is important to understand that Weight Loss Surgery is not a one-size-fits-all solution. Here’s a breakdown of who might be a good candidate for bariatric or weight loss surgery:

BMI above 32.5 kg/m2 with obesity-related co-morbidities
BMI above 37.5 kg/m2 without co-morbidities.
BMI > 30 kg/m2 with life-threatening obesity-related disorders like uncontrolled diabetes, cardiovascular disease/cardiomyopathy, and severe obstructive sleep apnoea.
Patients motivated to lose weight and are committed to long-term follow-up.
Patients who have unsuccessfully attempted conservative methods of weight loss in the past.
Weight Loss Surgery is to be considered only between the ages of 18 – 65 years.
Weight Loss surgery may be considered in patients more than 65 years old in case of severe obesity-related co-morbidities/disability.
Weight Loss Surgery may be considered in patients < 18 years in special situations as recommended by a trained pediatrician/endocrinologist, or after attainment of puberty/completion of skeletal maturity.

Weight Loss surgery is a life-changing procedure, and the surgeon you choose plays a critical role in your safety, success, and overall experience. Here’s why selecting a right bariatric surgeon is crucial:

Long-Term Support: A good bariatric surgeon offers comprehensive care beyond surgery. They will guide you through pre-operative education, support you during recovery, and provide long-term follow-up care. This includes nutritional counseling, managing potential side effects, and monitoring your overall health.
Understanding Your Needs: Not all bariatric surgeries are the same. A skilled surgeon will take the time to understand your individual needs, medical history, and weight loss goals. They should discuss the various bariatric surgery options available (gastric bypass, sleeve gastrectomy, etc.) and explain the advantages and disadvantages of each concerning your specific situation.
Experience Matters: Look for a surgeon who specializes in bariatric surgery and has a high volume of successful weight loss procedures under their belt. Experience translates to better surgical technique, improved efficiency, and a deeper understanding of potential complications and how to manage them.

Why Choose Dr. Atul Peters for Metabolic or Bariatric Surgery?

At Smart Cliniqs, we’re dedicated to your overall well-being, from the surgery itself to your post-operative recovery. Dr. Atul Peters, a renowned bariatric surgeon with over two decades of experience, has successfully performed numerous surgeries and is passionate about helping patients achieve their health goals. He leads comprehensive bariatric programs both locally and nationally, supported by a highly skilled team. Our global certification and active involvement in various National & International Surgical Societies underscores to our commitment to providing you with the best possible care.

Conclusion

While undergoing a weight loss surgery, you need to understand that results can vary, and long-term success requires a commitment from your side as well. Remember, obesity is a chronic condition, and additional treatments might be needed down the road. There are different surgical options with varying risks and benefits. Discuss these with your surgeon to see which weight loss surgery works for you.

References:

Understanding the Causes of Obesity in Children and Adolescents

Causes of Obesity in Children & Adolescents: Unraveling the Complex Factors

Recognizing the Growing Epidemic

According to the World Health Organization (WHO), children and adolescents from all walks of life, are increasingly facing the health threat of excess body fat, leading to overweight and obesity.

However, managing weight isn’t a quick fix; it’s a journey that requires lifelong support. The WHO emphasizes the importance of sustainable lifestyle changes that promote long-term well-being, not crash diets or rapid weight loss.

We used to think weight was simply about ‘calories in’ versus ‘calories out’, but science reveals a more complex picture. Genetics, environment, stress levels, emotional well-being, sleep patterns, underlying medical conditions, and even medications can all influence how our bodies store and manage fat.

Recognizing this complexity is crucial.

By addressing these multifaceted factors – behaviour, environment, and genetics – we can create a more effective and holistic approach to childhood weight management, paving the way for a healthier future for all.

Genetic Factors Contributing to Obesity

While we inherit a blueprint (genes) that influences weight, obesity isn’t just about our DNA. It’s a complex mix of factors. Genes can make some people more likely to gain weight, but hormones, metabolism, and even our culture and habits can all play a role in fat storage.

Even early in life, certain factors can increase a child’s chances of becoming obese. A mother’s weight before pregnancy, how much weight she gains while being pregnant, and even gestational diabetes (pregnancy-related high blood sugar) can all play a role. These factors can sometimes lead to a higher birth weight for the baby, which can independently be a risk factor for obesity, later in life. Additionally, a family history of weight issues, diabetes, high blood pressure, or certain hormonal problems can also increase a child’s risk of being overweight.

The good news? …Even with a genetic nudge, healthy choices like diet and exercise can make a big difference.

Dietary Habits and Nutrition

Childhood obesity may be linked to certain dietary habits. One major contributor is the overconsumption of calorie-dense foods that are low in essential nutrients. This includes things like processed snacks, fast food, and sugary drinks. These types of foods are often heavily marketed to children, making them even more appealing. While the research is ongoing on the exact impact of other dietary factors like snacking frequency, meal skipping, or one’s eating speed, it’s clear that an overall healthy diet plays a crucial role in weight management for young people.

Shedding extra kilos through calorie restriction (dieting) may be an effective strategy in the short term, but it’s important to consider how our bodies respond over time. While dieting offers a jumpstart, our bodies adapt to changes in calorie intake. This adaptation can sometimes involve a slowdown in metabolism, making it trickier to maintain weight loss in the long run.

Physical Activity Vs Sedentary Lifestyle

Children tend to become less active as they grow older, with a dip seen around age 6 and another around 13. This is especially more true for girls than boys. Children who are overweight or obese tend to move less throughout the day compared to their thinner peers. There’s also a general trend of children spending more time sitting as they get older.

Catching those Zzzs is important for more than just feeling well-rested! Studies have established a direct link between sleep habits and weight gain in children. Children or adolescents who don’t get enough quality sleep, whether it’s due to shorter sleep duration, restless sleep, or going to bed too late, seem to be at a higher risk for obesity. This might be because insufficient sleep is associated with being less active, having unhealthy eating habits, and even developing insulin resistance.

Screen time could also play a role. Too much screen time can disrupt sleep patterns and potentially mess with hormones that control hunger and fullness. Think of it as a domino effect: less sleep can lead to cravings for unhealthy foods and less energy for exercise, which can contribute to weight gain.

Psychosocial and Economical Factors

Weight stigma, the societal devaluation of people who are overweight or obese, can be a major psychosocial factor contributing to obesity. Negative stereotypes paint them as lazy and lacking willpower, creating a discouraging environment. This stigma manifests as bullying and social rejection, especially for children, impacting their mental health and self-esteem. The stress and negativity can even lead to disordered eating behaviours, making weight management even harder. Feeling ashamed and less motivated to participate in social activities due to weight stigma can further hinder progress. This cycle of negativity and discouragement creates a significant barrier to healthy lifestyle changes for those struggling with weight.

Building on the complex challenges of weight management, obesity also carries a significant cost burden. Not only does it strain healthcare systems financially, but it also has a profound impact on individual and societal well-being. The long-term nature of obesity means managing weight requires sustained commitment and lifestyle changes. This burden, coupled with psychosocial factors like weight stigma, can create a discouraging cycle that makes weight management even more difficult.

Environmental and Socioeconomic Influences

Our surroundings strongly influence how we live and our health. Modern life has become less active. Cars replaced walking, technology replaced exercise, and quick meals replaced healthy cooking. This makes it easy to fall into unhealthy habits like eating poorly and not getting enough exercise. As a result, we consume more calories than we burn, leading to weight gain.

The obesity spike in recent times is largely due to the surrounding environment that promotes weight gain.
This can happen at the family level (habits modelled by parents), community level (access to parks, healthy food options, and safe walking areas), or even national policies (government food subsidies or marketing practices). These influences can take advantage of our biological, psychological, social, and economic vulnerabilities.

Prevention Strategies and Early Intervention

Helping children and adolescents with obesity requires a multi-faceted approach. The goal is to reduce excess body fat, improve health problems related to weight, and prevent the development of chronic diseases in the future.

Treatment typically integrates a combination of different components. This may include learning healthy eating habits with the help of a nutritionist, incorporating regular physical activity into the child’s routine, and providing psychological support to address any emotional challenges associated with weight. In some cases, medication might be prescribed to assist with weight management.

Metabolic and bariatric surgery offers the best long-term results for weight loss in severely obese adolescents.
Studies show significant weight reduction (25-40%) even years after procedures like Roux-en-Y gastric bypass or sleeve gastrectomy.

The benefits go beyond weight loss!

Individuals often see improvement in health problems linked to obesity, like cardiometabolic risk factors, musculoskeletal pain, and functional mobility.

References:

showPdf (thelancet.com)

What is obesity? (bomss.org)

Obesity – American Society for Metabolic and Bariatric Surgery (asmbs.org)

https://www.atulpeters.com/blog/obesity-children-adolescents/

Nutritional Problems after Bariatric surgery

Essential Follow-Up Care: Addressing Nutritional Problems After Bariatric Surgery

Maintaining weight loss after Bariatric surgery requires lifelong commitment and care. Bariatric surgery is the most effective tool to lose weight substantially and for the long term. But there is no guarantee that you will stay fit all your life unless you eat healthy and exercise regularly, and stay off alcohol or drink in moderation. You must follow your Bariatric team every 3 months in the first year and then annually at least to manage any nutritional problems after bariatric surgery.

Why regular follow-up is necessary after Bariatric surgery?

Regular follow-up is necessary after Bariatric surgery. The most important reason is to prevent nutritional deficiencies which are bound to creep up unless monitored. As many of the obese already have low vitamin D and iron levels, the situation gets worse after the surgery due to inadequate diet.

Vitamin B1 or thiamine is a special case in point. This vitamin is essential to keep your nerves and haemoglobin healthy. Thiamine is found in abundance in fresh vegetables and fruits. As it is, Its stores are small and can be depleted quickly in just a few days if there is persistent vomiting. This problem is more common in people who have been drinking heavily. An acute deficiency can damage nerves and the brain and impair vision permanently. The more acute form is known as Wernick’s encephalopathy which requires prolonged hospitalization and its symptoms may not reverse completely.

The blood tests to check its levels are not commonly available; therefore the treatment is started immediately without waiting for the results. In its mild form, thiamine deficiency is difficult to detect, so one should take it routinely.

We will discuss other nutritional deficiencies in our next blog.

Have more questions related to nutritional problems after bariatric surgery? Consult today with the top bariatric surgeon in Delhi at Smart Cliniqs.

Can Lack of Sleep Cause Obesity?

How Lack of Sleep Contributes to Obesity and Weight Gain

There are many possible ways that lack of sleep could increase the chances of becoming obese. Obesity develops when energy intake is more than depletion. Diet and physical activity play an important role in this, but in addition, inadequate sleep may also be an equally important factor. Unfortunately, many people are not getting enough sleep.

Sleep-deprived people may be too tired to exercise or may take in more calories than those who do, clearly because they are awake longer and have more chance to eat. It’s not that if you sleep, you will lose weight, but if you are not getting enough or good quality sleep, your metabolism will not function properly.

Not getting enough sleep is common, even talked about with pride by some people, but we do pay a price for staying up late and getting up early.

Less sleep makes you more likely to eat more calories at night, your appetite increases and you are less likely to resist eatables and control portions which may lead to weight gain.

Poor food choices combined with lack of physical activity set the stage for obesity and further sleep loss.

Poor sleep completely alters the way the body responds to food.

On the other hand, starting healthy sleep habits can help your body maintain a healthy weight.

Tips for Better Sleep

Here are a few tips to keep in mind to get a good night sleep:

1. Avoid any caffeine late in the evening

2. Exercise also helps improve sleep quality.

3. Turn off all electronics – no screen time before bed

4. Make sure your bedroom is dim and quite

5. Have a bedtime routine – try to go to bed the same time daily, your body gets used to a schedule

6. Avoid big meals before bedtime – can increase the risk of heartburn, which will certainly keep you up all night.

Suffering from obesity? Looking for obesity surgery in Delhi? Schedule your appointment with us at Smart Cliniqs.

Also Read: Understanding the Causes of Obesity in Children and Adolescents

Benefits of Losing Weight

The Comprehensive Benefits of Weight Loss: Health, Lifestyle, and Social Gains

If you are overweight or obese and planning to lose weight, it’s important to understand the benefits of losing weight. Actually, weight loss has to be pleasing or it isn’t sustainable. You are either stressed or relaxed. Anything stressful will give you a stress response. Find things that are enjoyable and use it to construct a healthier lifestyle.

Every weight loss plan falls apart at the seams at some point. Therefore, to set yourself up for favorable outcome, understanding the extended weight loss benefits that help to keep you motivated after Bariatric Surgery (Weight loss surgery) include Health benefits, lifestyle benefits, and social benefits. There are different approaches to losing weight depending on your BMI and health issues. A BMI greater than 32.5 with one or more significant obesity-related medical conditions or a BMI 35 and above can be taken up for Bariatric Surgery (Weight loss surgery).

Diet and exercise would work for people with a BMI less than 32.5 but beyond this Bariatric Surgery (Weight loss surgery) is recommended for realistic, sustainable, and long-term results. This also means that surgery is more likely to improve the health conditions connected to obesity.

Health Benefits of Losing Weight

Lowers the risk of some types of cancers
Lowers the risk of / resolves Diabetes
Decreases the risk / resolves Hypertension
Improves / resolves Lipid profile
Reduces / resolves backache
Improves Fertility
Reduces the symptoms of Arthritis (Osteoarthritis)
Lowers the risk of Cardiovascular disease
Improves breathing
Reducing the risk of Kidney disease
Decreases risk of / resolves Sleep Apnea
Reduces risk of a weak bladder (in women)
Decreases/resolves Joint pains Reduces symptoms of Gastric Reflux
Reduces the risk of Stroke
Reduces the risk of varicose vein or DVT
Improves mobility

Your doctor will inform you more information about the health benefits you can expect when you lose weight. He may also recommend a dietician and physical activity post Bariatric Surgery.

Lifestyle Benefits of Losing Weight

Better Hormonal Imbalance
Better Sleep
Clearer and brighter skin
Increased sexual performance
Improved memory
Active social life
Stress relief
More confident
Improves vitality
Better wardrobe
Less medications
Better mood
Improves energy level

For many people, their weight defines how they feel about themselves. Our body image states how we connect with others, and our confidence, and it affects how healthy we feel going about our daily lives. Apart from the medical benefits of weight loss, you will also experience an improved lifestyle.

Social Benefits of Weight Loss

More comfortable in your body
Moving around is easier
Satisfaction of knowing you look your best
You can focus on improving yourself in other ways
Decreases the perspiration levels
Being confident in a group

The social benefits of weight loss are mostly very substantial short-term motivators. However, these incline to be less potent at sustaining long-term lifestyle change because they often are geared towards short-lived events, such as some social function. Positive changes in lifestyle that are not externally imposed may more likely be able to sustain themselves over time.

Enjoying the Benefits of Weight Loss

If you decide that there are significant reasons for you to lose weight, then there’s no time like the present to start your weight loss journey. Our physique dictates how we feel about ourselves and that lightens up our confidence. Your first step should be to set a reasonable goal. Then make small changes to your daily routine and eating habits.

Suffering from being overweight and wanna lose weight through bariatric surgery? consult us at Smart Cliniqs as we have the team of the best bariatric surgeons in Delhi.

Do I qualify for bariatric surgery?

Growing Importance of Bariatric Surgery: How to Qualify for Bariatric Surgery

Growing Importance of Bariatric Surgery

Since, progressive generations are growing heavier with increased association with other metabolic disorders – diabetes, hypertension, and dyslipidemia. There has been an increasing role of bariatric surgery in the management of obesity and its associated co-morbidities. Technological leaps in the field of Laparoscopic Bariatric Surgery as well as Robotic Bariatric Surgery have led to the evolution of bariatric surgery from a major, uncommon, and often dangerous surgery with doubtful outcomes to a much safer, routine procedure with assured results.

Evolution of Bariatric Surgery Criteria

Initially, it was a difficult task to elect candidates who could undergo bariatric surgery. In 1991 the National Institutes of Health (NIH) consensus statement for the first time defined clear universally acceptable criteria for patient selection. This statement was revised and re-defined as more and more data began to be analysed subsequently. The cut-off BMI to undergo surgery was lowered over a period of time.

Types of Bariatric Surgery

Starting with Gastric Bypass surgery, in which Roux-en-Y gastric Bypass being the gold standard, nowadays Gastric Sleeve Surgery is becoming more and more popular among surgeons since it is relatively simple to perform with similar post-operative outcomes.

Shift from Weight Loss to Metabolic Surgery

With the understanding of the metabolic syndrome, of which obesity was just one part, there was increasing interest in the role of surgery in the resolution of co-morbidities, particularly diabetes and dyslipidemia.

The increasing incidence of diabetes and cardiovascular disease even at lower BMIs, particularly in specific populations such as Asians led to a demand to consider these surgeries for selected candidates with low BMIs also. The emphasis shifted from ‘weight loss’ surgery to ‘metabolic’ surgery. It was suggested that perhaps action points for Asians should be 2.5 BMI points lower i.e. at 32.5 and 37.5.

New Eligibility Criteria and Recommendations

With this background, the International Diabetes Federation (IDF) released a position statement on 28^th March 2011 supporting surgery to treat Type II diabetes in obese patients. It defined new lower BMI criteria for patient selection as explained in the table below.

Eligibility and prioritization for bariatric surgery based on failed non-surgical weight loss therapy ⁺, BMI, ethnicity ⁺⁺, and disease control.

BMI range	Eligible for surgery	Prioritised for surgery
< 30	No	No
30 – 35	YES – Conditional ⁺⁺⁺	No
35 – 40	YES	YES – Conditional ⁺⁺⁺
> 40	YES	YES

+ In all cases, patients should have failed to lose weight and sustain significant weight loss through non-surgical means, and have type II diabetes that has not responded adequately to lifestyle measures (+/- metformin) with HbA1c < 7%.

++ Action points should be lowered by 2.5 BMI points for Asians.

+++ HbA1c > 7.5 despite fully optimized conventional therapy, especially if weight is increasing, or other weight-responsive co-morbidities not achieving targets on conventional therapies.

Impact and Endorsements

The new recommendations significantly lowered cut-off BMIs making many more patients eligible for surgery. Theoretically, an Asian patient with a BMI as low as 27.5 could be a candidate for metabolic surgery, provided other conditions are met. This is a significant shift from the previously recommended cut-offs.

These have received widespread attention in the medical community and have been endorsed by several medical bodies – The American Heart Foundation (AHA), the American Medical Association (AMA), The American Society of Metabolic and Bariatric Surgeons (ASMBS), and The American Association of Clinical Endocrinology (AACE).

Confused if you qualify for bariatric surgery or not? Consult us at Smart Cliniqs and we will schedule your appointment with the best bariatric surgeon in Delhi.

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:

laparoscopic sleeve gastrectomy,

laparoscopic roux-en-y gastric bypass, and

laparoscopic mini gastric bypass.

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.