In addition to weight loss, surgery has been found to have a beneficial effect on many medical problems directly or indirectly related to obesity. Bariatric surgery in India has come of age, since all bariatric operations are available now. Each Bariatric operation whether Laparoscopic Gastric bypass surgery, or Sleeve Gastrectomy have different effects on weight, and the medical conditions; of course they have different side effects too. For example most patients will lose about 55 to 85 percent of their excess body weight depending upon the procedure they receive. Substantial weight loss occurs within the first 18 months of surgery, some weight regain is normal and can be expected at two to five years after surgery. Many medical conditions such as, Diabetes, Hypertension, acid reflux, sleep apnea, polycystic ovary syndrome (PCOS), urinary stress incontinence, low back pain, and many others can either be cured or controlled. Medical research has shown that 80% of diabetic patients had remission from their diabetes (the blood pressure is normal on no medication). Many patients report an improvement in mood and other aspects of psychosocial functioning after surgery.
The overall quality of life is improved. Many patients express elation on being able to do things that may seem trivial to the non-obese person, such as, improvement in personal hygiene, going to the store, playing with their children, getting in and out of a car, riding a roller coaster, shopping for regular sized clothes….the list is endless.
Also, because most surgeries are performed laparoscopically (minimal invasive surgery), patients will typically experience shorter hospital stays, smaller incisions and quicker recovery periods.
Medical conditions that can be improved:
·High blood pressure: At least 70 percent of patients who have high blood pressure, and who are taking medications to control it, are able to stop all medications and have a normal blood pressure, usually within two to three months after surgery. When medications are still required, their dosage can be lowered, with reduction of the annoying side effects.
·High Cholesterol: More than 80 percent of patients will develop normal cholesterol levels within two to three months after the operation.
·Heart disease: Although we can’t say definitively that heart disease is reduced, the improvement in problems such as high blood pressure, high cholesterol and diabetes certainly suggests that improvement in risk is very likely. In one recent study, the risk of death from cardiovascular disease was profoundly reduced in diabetic patients who are particularly susceptible to this problem. It may be many years before further proof exists, since there is no easy and safe test for heart disease.
·Diabetes: More than 90 percent of Type II diabetics obtain excellent results, usually within a few weeks after surgery: normal blood sugar levels, normal Hemoglobin (HbA1C) values, and freedom from all their medications, including insulin injections. Based upon numerous studies of diabetes and the control of its complications, it is likely that the problems associated with diabetes will slow in their progression when blood sugar is maintained at normal values. There is no medical treatment for diabetes that can achieve as complete and profound an effect as surgery – which has led some physicians to suggest that surgery may be the best treatment for diabetes. In the seriously obese patients. Abnormal glucose tolerance, or “borderline diabetes”, is even more reliably reversed by gastric bypass. Since this condition becomes diabetes in many cases, the operation can frequently prevent diabetes as well.
·Asthma: Most asthmatics find that they have fewer and less severe attacks, or sometimes none at all. When asthma is associated with gastro esophageal reflux disease, it is particularly benefited by gastric bypass.
·Respiratory Insufficiency: Improvement of exercise tolerance and breathing ability usually occurs within the first few months after surgery. Often patients who have barely been able to walk find that they are able to participate in family activities, and even sports.
·Sleep Apnea syndrome: Dramatic relief of sleep apnea occurs as our patients lose weight. Many report that within a year of surgery, their symptoms were completely gone, and they had even stopped snoring completely and their spouses agree. Many patients who require an accessory breathing apparatus to treat sleep apnea no longer need it after surgically induced weight loss.
·Gastro esophageal reflux disease: Relief of all symptoms of reflux usually occurs within a few days of surgery for nearly all patients. We are now beginning a study to determine if the changes in the esophageal lining membrane, called Barrett’s esophagus, may be reversed by the surgery as well-thereby reducing the risk of esophageal cancer.
·Stress urinary incontinence: This condition responds dramatically to weight loss and usually becomes completely controlled. A person who is still troubled by incontinence can choose to have specific corrective surgery later, with much greater chance of a successful outcome with a reduced body weight.
·Low back pain, degenerative disk disease, and degenerative joint disease: Patients usually experience considerable relief of pain and disability from degenerative arthritis and disk disease and from pain in the weight –bearing joints. This tends to occur early, with the first 15-25 kg lost, usually within few months after surgery. If there is nerve irritation or structural damage already present, it may not be reversed by weight loss, and some pain may persist.
To sum-up in selected patients bariatric surgery results in a vastly improved health status, according to one research the cost of gastric bypass surgery can be recovered in three years .