Sleeve Gastrectomy Surgery: A Key to Better Health and Improved Quality of Life

Sleeve Gastrectomy Surgery: A Comprehensive Guide to Transformative Weight Loss Surgery

Sleeve gastrectomy is a weight-loss surgery that involves reducing the size of the stomach into a tube-like shape. This is often referred to as vertical sleeve gastrectomy surgery or gastric sleeve.

This procedure helps patients eat less by limiting stomach capacity, without altering the digestive process. It’s primarily used for individuals with a BMI of 30 or higher.

Sleeve gastrectomy is considered a relatively safer surgical intervention. The procedure is typically performed using minimally invasive techniques, such as laparoscopy or robotic surgery.

Understanding Sleeve Gastrectomy Surgery

Sleeve gastrectomy involves the removal of approximately 75% of the stomach, leaving a tubular-shaped remnant. Unlike other weight-loss surgeries, it doesn’t alter the anatomy of the small intestine.

The bariatric procedure is performed under general anaesthesia. Surgeons typically employ a minimally invasive approach using laparoscopic/robotic surgery, which involves several small incisions in the abdomen. The method entails removing approximately 75-80 percent of the stomach, and reshaping the remaining portion into a narrow, banana-shaped sleeve using surgical staples. Once completed, the incisions are closed. The entire procedure usually takes between 30 to 45 minutes.

Sleeve gastrectomy significantly impacts appetite regulation by modifying gut signals associated with taste, hunger, and blood sugar control. The reduced stomach capacity limits food and liquid intake, contributing to weight loss by decreasing calorie consumption.

Moreover, by removing the portion of the stomach responsible for producing a significant amount of the “hunger hormone,” sleeve gastrectomy influences metabolism, reducing hunger, enhancing feelings of fullness, and facilitating weight management and improved blood sugar control.

Health Benefits of Sleeve Gastrectomy

People who undergo sleeve gastrectomy typically lose between 70 to 80 percent of their excess body weight. The bariatric procedure offers a transformative approach to weight management, providing a range of benefits that contribute to improved overall health and quality of life.

  • Technically simple and shorter surgery time
  • Can be performed on certain patients with high-risk medical conditions
  • May be performed as the first step for patients with severe obesity
  • May be used as a bridge to gastric bypass or SADI-S procedures
  • Effective weight loss and improvement of obesity-related medical conditions

Quality of Life Improvements

A remarkable 95% of patients reported a significant enhancement in quality of life following bariatric surgery, while mortality rates decreased by a substantial 89% within five years.

  • Migraines 57% resolved 
  • Depression 55% resolved 
  • Pseudotumor cerebri 96% resolved 
  • Obstructive sleep apnea 74% -98% resolved 
  • Dyslipidemia hypercholesterolemia 63% resolved 
  • Asthma 82% improved or resolved 
  • Cardiovascular disease 82% risk reduction 
  • Hypertension 52% -92% resolved 
  • Non-alcoholic fatty liver disease 90% improved steatosis; 37% resolution of inflammation; 20% resolution of fibrosis 
  • GERD 72% -98% resolved 
  • Metabolic syndrome 80% resolved 
  • Type II diabetes mellitus 83% resolved 
  • Stress urinary incontinence 44% -88% resolved 
  • Polycystic ovarian syndrome 79% resolution of hirsuitism; 100% resolution of menstrual dysfunction 
  • Degenerative joint disease 41% -76% resolved 
  • Venous stasis disease 95% resolved 

Who Should Consider Sleeve Gastrectomy?

Bariatric surgery can be considered an appropriate alternative for:

  • 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 apnea
  • Patients motivated to lose weight and committed to long-term follow-up
  • Patient should have attempted conservative methods of weight loss and failed in the past
  • Bariatric surgery is to be considered only between the ages of 18 – 65 years
  • Bariatric surgery may be considered in patients more than 65 years in the presence of severe obesity-related co-morbidities/disability
  • Bariatric surgery may be considered in patients < 18 years in special situations after paediatrician/endocrinology certification, or after attainment of puberty or completion of skeletal maturity

Bariatric surgery offers potential benefits, but it’s essential to weigh these against individual risks. Your weight, age, and medical history play a crucial role in determining your suitability for surgery. To make an informed decision, careful consideration of specific guidelines and patient factors is necessary.

Choosing the Best Weight Loss Surgeon and Facility

Your choice of clinic and surgical team plays a crucial role in the success of your sleeve gastrectomy. Here’s why top bariatric surgery centres can make all the difference:

  • Expertise at Every Step: A renowned bariatric surgeon runs a comprehensive bariatric program with all the infrastructure required to facilitate bariatric surgery candidates. They’ll guide you through pre-operative evaluation, ensure you have access to state-of-the-art surgical facilities, and provide extensive support post-surgery.?
  • A Team You Can Trust: To run a comprehensive bariatric program, it is essential that the team comprises a Bariatric Surgeon, Bariatric Nurse, Bariatric Dietician, Program Managers and Coordinators to provide the best guidance and facility.

Before deciding, take some time to research renowned bariatric surgeons. Here are some key factors to consider:?

  • Accreditation: Look out for clinics and surgeons accredited by recognized healthcare organizations, ensuring they meet the highest safety standards.?
  • Surgeon’s Qualification: Research the surgeon’s experience and qualifications in performing sleeve gastrectomy. ?
  • Success Rates: Inquire about the surgeon’s success rates for the procedure.?
  • Patient Testimonials: Reading real patient experiences can offer valuable insights into the surgeon’s approach and patient care.?

Real-Life Success Stories

Peter Arthur, a Kenyan businessman, was struggling with severe obesity, diabetes, hypertension, high cholesterol, joint pain, and backache. His weight of 171 kilograms significantly impacted his professional and personal life.

Despite repeated attempts at diet and exercise, he was unable to achieve sustainable weight loss.

Bariatric surgery ultimately proved to be a successful intervention, leading to a weight loss of nearly 45 kilograms within a year. As a result, he has experienced significant improvements in his overall health and quality of life.

Conclusion

Sleeve gastrectomy offers a transformative path to improved health and well-being for individuals struggling with obesity. By reducing stomach capacity and regulating hunger and satiety hormones, this procedure can lead to significant weight loss and the resolution of obesity-related health conditions. However, it’s essential to remember that surgery is just the beginning. Long-term success depends on adopting healthy lifestyle changes, including balanced nutrition and regular exercise.

In cases of extreme obesity (BMI 60 or above), sleeve gastrectomy surgery can be the initial step in a two-part surgical plan. This first surgery helps patients lose significant weight, making them healthier candidates for a second weight-loss procedure, if necessary.

If you’re considering sleeve gastrectomy surgery, it’s crucial to consult with a qualified bariatric surgeon to determine if you’re a suitable candidate. By partnering with experienced professionals and committing to a holistic approach, you can embark on a journey towards a healthier, happier you.

Remember, every individual’s experience is unique. While sleeve gastrectomy has shown remarkable results for many, it’s important to manage expectations and understand the potential risks and benefits involved.

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: 

  1. showPdf (thelancet.com) 
  1. What is obesity? (bomss.org) 
  1. Obesity – American Society for Metabolic and Bariatric Surgery (asmbs.org) 
  1. https://www.atulpeters.com/blog/obesity-children-adolescents/