Bariatric Surgery: How It Works and When to Opt for the Procedure

Bariatric Surgery: How It Works and When to Opt for the Procedure. Photo: Pexels
Bariatric Surgery: How It Works and When to Opt for the Procedure. Photo: Pexels

The struggle against the scale is a common factor. In Brazil, according to data from the National Health Survey (PNS, 2020), 60.3% of the adult population is overweight, with a prevalence among women (62.6%).

Cases of obesity affect 25.9% of the population.

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The numbers explain the high demand for bariatric surgery.

According to the Brazilian Society of Bariatric and Metabolic Surgery (SBCBM), 63,969 bariatric surgeries were performed in Brazil in 2018 alone, a number 4.38% higher than the previous year. Despite the estimate, the demand for the procedure still raises questions and deserves attention.

What Bariatric Surgery Is For and When to Have It

Lifestyle changes, such as physical activity and a diet, are always the best option for healthy weight loss and should be undertaken by anyone who wants to achieve this goal — which can bring health improvements, in addition to aesthetic consequences. However, when the desired result is not achieved, in cases of class 3 obesity (BMI > 40kg/m2) and class 2 (BMI > 35 kg/m2) associated or not with other diseases, surgery may be an alternative, explains bariatric surgeon Carlos Saboya. In some cases, it is covered by the Unified Health System (SUS).
“There are different types of surgical procedures, with the two most commonly performed being the Gastric Bypass, which involves a reduction in stomach volume and a bypass of the small intestine, and the Sleeve, which only reduces the size of the stomach. Both procedures result in reduced food intake and decreased nutrient (vitamins and minerals) and calorie absorption,” the doctor details.

Both options can be performed via two methods: the conventional method, where the abdominal cavity is “opened”, or through a minimally invasive surgery, using laparoscopy and robotics.

For a proper indication, it is essential to consult a bariatric surgeon. “If criteria are met for the surgical procedure, the patient will be assessed by a multidisciplinary team, usually composed of a psychiatrist and/or psychologist, nutritionist, endocrinologist, internist/cardiologist, and other specialists, depending on the patient’s health condition,” Saboya explains.

What to Know Before Having Bariatric Surgery

Like any surgical procedure, bariatric surgery requires attention. Therefore, following the guidelines of the multidisciplinary team, from conducting different exams to dieting, is essential for an effective and safe result.
Carlos emphasizes that attention to the period leading up to surgery is crucial. “Especially because patients with obesity often have numerous associated diseases, such as type 2 diabetes mellitus, systemic hypertension, sleep apnea/hypopnea, high cholesterol and triglycerides, as well as fatty liver disease, among others,” he points out.

The doctor stresses that “anyone who chooses to have bariatric surgery must be aware that the procedure does not cure this serious disease”. “There is a long journey that begins when the surgery ends. Lifestyle changes and ongoing follow-up with the multidisciplinary team must be present throughout the entire process,” he informs.

Post-Bariatric Care

The postoperative period also requires care, which includes recovery from anesthesia, physiotherapy for early patient mobilization, and reintroduction of a special diet suitable for the procedure performed.
“Another important point is the supplementation of vitamins, minerals, and proteins, as the anatomical changes caused by the surgeries can lead to deficiencies of macro and micronutrients,” says Carlos.

It is also recommended that the patient maintains psychological and/or psychiatric follow-up, to more easily adapt to the results, which include rapid weight loss, new silhouette, new life situations in the family, professional, and affective scopes.

Finally, the professional emphasizes that maintaining the new lifestyle is also necessary, especially regular physical activity.

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