With metabolic disorders are on the rise in recent decades, it is becoming increasingly difficult to manage them with just lifestyle and food habit changes. The new mantra is surgery where the results are immediate, but of course at a cost.
Metabolic surgery refers to a variety of surgical procedures that are performed to control metabolic disorders like diabetes and obesity. Bariatric surgery is specifically aimed at people with a body mass index of more than 40 (morbidly obese patients). Metabolic surgery, on the other hand, can be done on obese and/or diabetic people who have a BMI of about 28 to 30. They are not able to bring their disease under control with lifestyle changes, and so surgery is recommended. It is essential that they have tried medications and lifestyle changes to control their diabetes and failed before going in for surgery as a last resort.
Important facts about metabolic surgery are:
- As mentioned, this is done as a last resort to treat type 2 diabetes which has failed to improve with medications and lifestyle. Type 1 diabetes, being hereditary, is not often associated with obesity, though there are obese type 1 diabetics.
- Obesity with high body mass indices and poor glycemic control will be the determining factors for a person to sign up for metabolic surgery.
- A few years ago, about 40% of the US population had diabetes and obesity, giving rise to a new term diabesity. They also have higher cholesterol and blood pressure levels, and surgery helps them have immediate control over these conditions.
- Of course, follow-up lifestyle changes are essential, which happen in a satisfying manner in most of these people. Women who are in their 40s are the major candidates for metabolic surgery. The advantage is also that it improves their esthetics which further increases the follow-up and thereby success rate.
This is a well-established surgery to treat cases of morbid obesity. People with a BMI of equal to or greater than 40 have a 50% greater chance of premature death, and bariatric surgery can help control that. The benefit of bariatric surgery is not just limited to correcting obesity but also correcting all the other associated conditions like risk of heart disease, cancers, sleep apnea, and joint problems.
Some common metabolic and bariatric procedures are listed below, with all of them aimed at reducing stomach size.
- Gastric bypass: The size of the stomach is reduced and attached to the middle of the small intestine, bypassing the first and last sections of the small intestine. This reduces the overall ability for food intake.
- Laparoscopic adjustable gastric band: An adjustable silicone band is filled with saline and wrapped around the upper portion of the stomach. This restricts food intake and helps further weight gain.
- Sleeve gastrectomy: The stomach is vertically stapled, thereby reducing the amount of space for food.
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So, while the approach and benefits for metabolic and bariatric surgery are the same, candidate selection differs, which depends on various factors.