Some cases of obesity are difficult to manage with healthy diets and exercise alone. In such instances, bariatric surgery is a medical intervention that can be considered.

What is Bariatric Surgery?

Bariatric surgery encompasses a series of surgical procedures aimed at helping individuals achieve an ideal weight. 

The primary principle of these procedures is to reduce the size of the stomach, making one feel full after consuming relatively small portions of food. 

This surgical intervention to reduce excess weight is aimed at helping patients avoid life-threatening complications such as stroke, high blood pressure, high cholesterol, type 2 diabetes, heart disease, and sleep apnea.

Who is Eligible for Bariatric Surgery?

Bariatric surgery, also known as metabolic surgery, is typically recommended for individuals with a significantly high Body Mass Index (BMI). 

BMI is an estimate of body fat based on height and weight. There are three categories of overweight individuals often considered for this procedure:

• BMI 30-34 (overweight) with serious weight-related health issues.
• BMI 35-39.9 (obesity) with serious weight-related health issues.
• BMI of 40 or more (extreme obesity).

However, not everyone in these categories qualifies for bariatric surgery. 

A series of medical evaluations is necessary to determine suitability, and one must meet specific medical standards first. 

Additionally, candidates must commit to making permanent lifestyle changes for a healthier future after surgery.

Types of Bariatric Surgery

There are three common types of bariatric surgery performed on overweight patients:

1. Gastric Bypass

Gastric bypass involves stapling the stomach to create a small upper pouch. The main aim is to reduce the stomach's size and the amount of food one can eat before feeling full. 

Then, the small intestine is divided, and the lower part is connected directly to the stomach pouch, bypassing a portion of the digestive system so that your body absorbs fewer calories. 

The upper small intestine is then reconnected to the lower intestine to ensure complete digestion. 

Therefore, this surgery can alter hormone production, bacterial composition, and other factors in the digestive system, affecting appetite and hormone levels. 

Gastric bypass is typically performed on patients with a BMI over 40 or a BMI over 35 with serious health complications.

2. Gastric Sleeve

In this procedure, the surgeon removes a significant portion of the stomach, leaving it shaped like a banana. 

This not only makes one feel full more quickly but also affects hormone production and the bacterial environment in the digestive system, impacting appetite and metabolism. 

Gastric sleeve surgery is permanent, meaning the stomach cannot revert to its original size.

3. Adjustable Gastric Band

The adjustable gastric band procedure involves placing a band with an inner inflatable ring around the upper part of the stomach to create a small pouch. 

The size of the ring can be adjusted by injecting or removing saline through a port implanted under the skin. This surgery aims to create a sense of fullness with smaller food portions. 

After the surgery, patients need regular check-ups. If the band causes health issues or fails to be effective, it may be removed. 

This method is less commonly used today due to its higher risk of complications compared to other stomach reduction methods.

Preparing for Bariatric Surgery

Before undergoing bariatric surgery, you will need to complete several preparatory steps. Your doctor will ask for your medical history, conduct a comprehensive physical examination, and perform blood tests. 

You may also need to meet with a psychiatrist or psychologist to assess your mental readiness for the lifestyle changes required post-surgery. Additionally, you may be required to:

• Have a consultation session with a nutritionist about post-surgery dietary guidelines.
• Follow a special diet as advised by the nutritionist before the surgery.
• Adjust any current medications as directed by your doctor.
• Quit smoking at least six weeks before the surgery to reduce the risk of complications and support healing.
• Increase physical activity to help normalize blood sugar levels.

The Bariatric Surgery Procedure

Bariatric surgery generally takes several hours and involves general anesthesia, meaning you will be completely unconscious during the procedure. 

The specifics of the surgery vary depending on the patient's health condition, the type of surgery, and the surgeon's approach.

However, most bariatric surgeries today are performed laparoscopically, a minimally invasive technique involving small incisions and a small tube-shaped instrument equipped with a camera.

This method promotes quicker healing compared to traditional open surgery, which requires larger incisions. However, some cases still necessitate open surgery.

Post-Bariatric Surgery Care

After the surgery, you will be monitored in a recovery room for any signs of complications. You may need to stay in the hospital for a few days, depending on the type of surgery performed. 

To speed up recovery, your doctor may recommend light physical activities, such as walking. Follow your doctor's instructions carefully.

Initially, you will not be allowed to eat anything for 1-2 days. Once your stomach and digestive system begin to heal, you will be allowed to consume only liquids. 

Gradually, you will transition to soft foods such as cottage cheese, soup, or yogurt), and eventually, to regular foods as advised by your doctor. 

Furthermore, you may need to avoid certain foods and drinks permanently. Portion sizes will be smaller, and you will likely need daily supplements as prescribed. 

Chewing food thoroughly is also essential to avoid digestive problems.

Expected Weight Loss After Bariatric Surgery

Weight loss outcomes vary depending on the individual and the type of surgery performed. 

Research from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) indicates that one year post-surgery, patients typically lose between 17 to 39 kilograms (38-87 pounds.)

Risks and Complications

As with any surgical procedure, there are potential risks and complications associated with bariatric surgery, including:

• Bleeding or leakage from staple lines or intestinal connections.
• Nutrient and vitamin deficiencies.
• Dumping syndrome (occurs after consuming high-carbohydrate foods).
• Low blood sugar.
• Infections.
• Surgical failure.

Your doctor will discuss the risks and potential complications with you in detail before the surgery. If they haven't, don't hesitate to ask for this information to make an informed decision.

For comprehensive consultation about bariatric surgery, you can contact The Sanur, Indonesia’s first Special Economic Zone (SEZ) for Health, which is located in Bali. . 

The Sanur features the Bali International Hospital and Bluecross Medika, international standard health and medical aesthetic centers, offering top-notch services from initial consultation to post-surgery recovery.

Understanding the need for complete and detailed information, our hospital provides a Telehealth Service package, allowing for intensive remote health consultations before visiting The Sanur. 

This package helps you understand:

• Your overall health condition.
• Possible medical procedures.
• Specific risks associated with the surgery.
• Estimated treatment and recovery times.
• Expected costs.

The Sanur also offers Pre-Travel Services to assist with travel itinerary planning, free airport transfers, hotel bookings, and visa assistance for international patients.

To schedule your consultation, contact The Sanur today!