Definition
Bariatric surgery is the surgical procedures done on patients with morbidly obesity  to help achive weight reduction.

Morbid Obesity
What is it

Body mass index (BMI) in excess of 40kg/sqm or body weight twice the ideal body weight or body weight 100 pounds above the ideal body weight.

Increased level of the hormone Ghrelin seems to be responsible for increased hunger. The hormone is secreted in the proximal stomach.

Medical Therapy

Diet regimens like atkins and medifast are availabe in the market. They only have a short lasting effect, No long term benefit has been seen with them
Before surgery a medically supervised diet is started with a goal of weight loss of .5lb-2lb/week

Indications of Surgery

Special Tests and workup

        You can read about the types of bariatric surgeries here
     For questions and answers see here


Rectum
Chrnoic Pancreatitis
Cholangiocarcinoma
Laparoscopic Colon Surgery
Operative steps
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Who will benefit from Bariatric (Weight Loss)  Surgery. What are the advantages and potential complcations
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Results

All the bariatric surgery procedures are associated with weight loss and reversal of comorbidities.
There is no consensus on the definition of success for any of these operations in terms of percentage of weight loss or extent of reversal of comorbidities.

Adjustable Gastric Band
Average weight loss is 50-60% of excess body weight in 3 years.
The band is initially placed without adding any saline to distend it. Additions of 1.0 to 1.5 mL of saline are added to produce a desired weight loss of 1 to 2 kg/wk.
The LAP-BAND has been shown to resolve type II diabetes 65-70%. Improved blood glucose control resulted for all patients. Hypertension was resolved in 55%-60% . Patients also experienced a decrease in fasting triglyceride levels and elevation of high-density lipoprotein levels.
Obstructive sleep apnea, asthma and gastro esophageal reflux have all decreased.

Roux-en-Y Gastric Bypass
Excess weight loss from long-term follow-up studies shows that open RYGB provides a weight loss of over 65% at 1 year in many studies. Long-term follow-up studies show that there is a tendency for patients to regain some weight after the first year.
Diabetes improve in 80-85%
Hypertension resolves in 60-65%
Sleep apnea improves in about 65%

Complications

Mortality      Percentage
Banding      .05%
RYGB         .03-1%
Others         Less than 1%

Adjustable Gastric Band
Band slippage, erosions

Roux-en-Y Gastric Bypass
Excess follow-up studies show that there is a tendency for patients to regain some weight after the first year.
Diabetes improve in 80-85%
Hypertension resolves in 60-65%
Sleep apnea improves in about 65%weight loss from long-term follow-up studies shows that open RYGB provides a weight loss of over 65% at 1 year in many studies. Long-term


Problems associated with Morbid Obesity -
Cardiovascular      Metabolic              Pulmonary        Musculoskeletal                 Gastrointestinal              Genitourinary
  Hypertension         Diabetes             Sleep Apnea       Degenerative joint disease          GER                         Incontinence
  Cardiomyopathy    Hyperlipidemia      Ashtma              Osteoarthritis                         Cholelithiasis              Renal diseases