Bariatric surgery (also known as weight loss surgery) is the procedure for weight loss in people who are severely obese. Sometimes physical exercise and diet management don't give satisfactory results or in some cases, the individual needs to go through an urgent weight loss due to health or medical reasons. Then bariatric surgery is the best substitute to lose and manage weight.

Bariatric surgical procedures cause weight loss by restricting the amount of food the stomach can hold or the combination of both malabsorption (lesser absorption of nutrients) and gastric restriction (smaller stomach). Bariatric often results in hormonal changes.

The most common bariatric surgeries are Sleeve Gastrectomy, Gastric Plication, Biliopancreatic Diversion with duodenal switch and bypass, Laparoscopic Adjustable Gastric Band (LAGB) and Gastric Bypass. Every surgery has its advantages and disadvantages.

Today most weight loss surgeries are performed using minimally invasive techniques (like laparoscopic surgery).

Who should consider Bariatric Surgery?

A person who wants to go for bariatric surgery should qualify one of the following conditions:

• BMI is 40 or higher (extreme obesity).
• BMI is 35 to 39.9 (obesity), and you have a serious weight-related health problem: type 2 diabetes, high blood pressure or severe sleep apnea.
• In some cases, if BMI is 30 to 34 and you have serious weight-related health problems, you may qualify for some of them.

(BMI calculation is done by dividing the weight in kilograms by height in meters squared)

Apart from the above points, the candidate should take a note for below things;

Before surgery

• Overweight for more than 5 years.
• Failure in the attempts for weight loss.
• Free from an auto-immune disease.

After surgery

1. Willing to exercise for at least 90 minutes each week. 
2. Willing to make lifestyle and change in eating habits.

Metabolic surgery in India has advanced and is growing at a positive rate. Obesity treatment in India is also very effective and popular. Below are the types of such surgeries and treatment:

Gastric Sleeve (Sleeve Gastrectomy)

Gastric Sleeve surgery, is mainly conducted to remove about 85% of the stomach. This results in leaving behind only 15% of the original capacity of the stomach. So the patient will feel full early than before, automatically reducing the food intake than before. As no foreign objects are used or inserted in the patient, he/she recovers in a short stay.

Gastric Bypass Surgery (Roux-en-Y)

The purpose of this surgery is to separate the stomach into 2 unequal sections. Only 5% of the stomach area is left for food consumption. The food gets evacuated from the small stomach pouch into the small intestine. From the original ending of the stomach, bile juice and other important enzymes that are required for the absorption of nutrients flow through. With this procedure, one can lose weight up to 60 to 80 percent.

Medical conditions like high cholesterol, high blood pressure, sleep apnea and acid reflux are improved after this surgery. The surgery also increases insulin sensitivity and alters the metabolism of carbohydrates, in some cases, it also eliminates the necessity for diabetes medications.

Biliopancreatic Diversion

This one's a bit complex, as it's a multipart procedure. Eighty percent of the stomach is removed at first. Then the point (duodenum) where contents exit the stomach and enter the small intestine is cut. Another cut is made in the small intestine like the one in the gastric sleeve.

Duodenum is sealed and attached back at the stomach, the second head of this part of the intestine is attached to the rest of the small intestine, 75-100 cm before the colon. The stomach is smaller so the patient will feel full sooner and as the certain part of the small intestine is shortened, the nutrients will be absorbed less.

LAP-BAND Surgery

This surgery is an easily recoverable short procedure. Around the upper part of the stomach, an inflatable band is used that divides the stomach into 2 unequal parts.

The upper part of the stomach is treated as a new stomach and the food intake is restricted which supports the weight loss. Commonly it is known as lap-band, a laparoscopic adjustable gastric band, an inflatable silicone device.

When the band is removed, the stomach returns to its original form. The recovery period is also slightly shorter, as in this type of treatment no stapling, cutting or removal of the stomach tissue is done. As the band is adjustable, the surgeon can easily control the size of the pouch outlet.

Minimal Access Techniques

• (Single Incision Laparoscopic Surgery) - SILS
  In this surgery the access is only through a single port instead of multiple ports, SILS is the next generation of laparoscopy. This utilizes new articulator instruments and specialized port thus making the procedure scar less as it will be buried inside the belly button. It gives early post-operative recovery with less pain than conventional laparoscopy, though this procedure consumes more time.
• Endoscopic Bariatric Surgery
  Gastric Sleeve a newer minimally invasive weight-loss surgery technique that reduces the size of the stomach capacity to approximately 3 ounces. It is a sophisticated version of sleeve gastrectomy. The sleeve is created by folding the liver rather than removing the stomach a part of it, so you will feel full sooner. It also a reversible process. There is numerous such endoscopic treatment for obese patients. Endoluminal bariatric surgery gives 40% reduction in excess weight loss and around 60 % resolution of comorbidities. This weight loss surgery is gaining popularity as well. Few of the available procedures include primary gastroplasty, intragastric balloon, and outlet reduction for failed pouch creation, gastric bypass and endo-barrier bypass sleeve.

Aftercare for Bariatric Surgery

To maintain weight loss after bariatric surgery, one has to continue to eat less, change dietary habits and increase physical activity. Weight reduction surgery helps you in changing your food behaviour by giving a small meal, early satiety and providing a prolonged feeling of fullness so that one can adhere to the dietary control.

Bariatric Surgery Cost in India

Worldwide, India is well known for cost-effective Bariatric surgery, foreign patients find even the best bariatric surgeons in India affordable. Bariatric surgery in India offers the best and advanced treatments for weight loss. The cost of the surgery also depends upon the type of surgery one chooses. Personalized medical and diet plans are prescribed for long term effectiveness with results.

Top hospitals, comfortable hospitality and the latest technology are some of the finest points of Bariatric surgery in India.