Surgery or diet?

Many of us, when we gain weight, the first thing that comes to our mind is undergoing bariatric surgery; because we think it is the quickest solution to losing this extra burden.
But that kind of surgery is not always the first choice to solve this weight problem.

In order to be a candidate to undergo this surgery, some conditions and procedures must be there to ensure your safety and ensure the best results.
Each type of surgery has its conditions and procedures. We will talk about them in this article, and you will know whether you should take this decision or just adhere to a diet and exercise regime?

What is the difference between normal weight gain and morbid obesity?

Weight gain:

The fat that increases and accumulates over the whole body, and is due to eating a large amount of food irregularly and so, the body intakes a large number of calories.
This weight gain can be noticed when we stand on the scale, or when the size of the clothes begins to change to a larger one.

As for morbid obesity:

As we neglect this increased weight, the percentage of fat increases more and the body mass increases more than the normal rate, causing chronic and dangerous diseases and complications. This morbid Obesity has become one of the most dangerous diseases of the era and its symptoms are:

• A body mass index (BMI) of 35 or more
• Severe shortness of breath, especially when doing physical exertion.
• Increased heart rate and lung problems.
• Excessive sweating.
• Severe pain in the joints, knees, and foot joint
• Frequent skin infections.
• Disturbances in the digestive system such as indigestion, bloating, constipation,…etc

The most common diseases associated with obesity:

• Diabetes
• Heart disease
• High cholesterol
• Reproductive health disorder in women
• Sleep Apnea
• Osteoarthritis and joint pain
• Depression

What are the conditions to undergo bariatric surgery?

Surgical intervention is not always the first solution to losing weight, we must first try to lose this extra weight using the effective means such as:

• Diet
• Sports

Suppose we fail in the first two solutions or have concomitant diseases like diabetes of the second type, or reflux esophagus or pressure. In that case, we can head to bariatric surgeries after consulting the bariatric surgeon.

What are the types of bariatric surgeries? What are the conditions for conducting each type?

There are two main types of bariatric surgeries, namely Sleeve Gastrectomy and Gastric Bypass, these two are the most famous and internationally approved bariatric surgeries

Sleeve gastrectomy has the following techniques, including:

• Laparoscopic Sleeve Gastrectomy
• Bikini Sleeve
• Modified Sleeve Gastrectomy

As for the Gastric Bypass, there are two types:

• Classic Gastric Bypass
• Mini-Gastric Bypass

LAPAROSCOPIC SLEEVE GASTRECTOMY

• Approximately 75% – 80% of the original stomach size is removed along its greater curvature
• In this process, ghrelin (the hormone responsible for hunger) is removed.
• Also, all excess is removed from the stomach through the measuring tube
• After sleeve gastrectomy, you will lose at least 70% of your excess body weight within 12 months

MODIFIED SLEEVE GASTRECTOMY 

These are the same steps that are used in the traditional Sleeve Gastrectomy Surgery, and then a silicone ring (Minimizer Ring) is placed around the stomach.
This surgery is suitable for large weights that are more than 170 kg.

BIKINI SLEEVE

It is a sleeve Gastrectomy Surgery done at the bikini line, and it is characterized by the fact that the scars of the surgery are not visible to the eye.

Candidates for all sleeve gastrectomy types:

• That morbidly obese needing to lose almost half their weight.
• For those whose morbid obesity causes a danger to their lives and surgery is the main step to treating those with a mass who will also need to follow a nutritional diet after the surgery to attain satisfactory results.

MINI-GASTRIC BYPASS

The smaller part of the stomach is connected with the small intestine, so that the size of the stomach that can receive food is less, and bypassing a part of the small intestine aims to reduce the rate of food absorption.

Candidates:

• BMI is greater than 35
• For an obese patient suffering from type 2 diabetes (stubborn), which means that the cumulative test will have a high rate even after adherence to treatment, or people with chronic reflux disease.

GASTRIC BYPASS

• First, we do a small pocket of the stomach is made, which is separated from the rest of the stomach and duodenum
• Then, we bypass part of the intestine and connect it to the new pouch
• And finally, we connect the intestines to each other to reduce bile reflux

Candidates:

• BMI is greater than 35
• If the obese patient suffers from type 2 diabetes and chronic gastroesophageal reflux disease (the highest degrees)

On what basis is the type of operation chosen for the patient?

We must make sure that the doctor is the one who determines the type of surgery that is appropriate for the case, and this will be through:

• Knowing the medical history of the case
• What are the diseases associated with obesity and the type of treatment that they’re taking?
• Knowing the patient’s behavior

Are there medical tests conducted before and after determining the type of surgery?
Naturally, the doctor asks the patient to do some tests to make sure that he is ready and qualified for the surgery, such as:

• heart drawing
• Some lab tests are:
  • Complete Blood Count.
  • Analysis of bleeding rate, coagulation rate, and prothrombin time
  • Urea and liver function tests
  • Fasting and cumulative glucose test
  • Cholesterol and triglycerides test
  • Thyroid hormone test
  • Hepatitis C Viral Load Test
• Some of the rays are:
  • Abdominal and pelvic ultrasound
  • Cardiac ultrasound (Echo)

Regardless of the right surgery that should be applicable for your body, the role of the right system is the one that leads you to your safety. 

Such as the follow-up before and after surgery, the experience of the surgeon and his medical team, as well as the tools used; that should be in good quality and only one-time use.

Here at Dr. Mohamed Hany Ashour Bariatric center, We always provide you with the newest techniques for your comfort and safety, And a medical team at the highest level of professionalism that consists of a surgeon (Dr. Mohamed Hany Ashour), assistant surgeon, Nutritionists, psychiatrists, endocrinologist, internist, and dermatologists, they are with you from the beginning of the examination, and after the surgery, they will follow up with you until you reach your goal

Our center is one of the few centers in Egypt that are accredited by the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) 

We are always keen to provide you with the best services, including our presence in more than one hospital in more than a Governorate,  a free vitamins course after surgery, as well as online and clinic follow-ups,  in many medical departments to ensure a safe and successful weight loss journey.