Benefits of Obesity Surgery

While the cosmetic benefits may appear to be the most obvious reason for undergoing bariatric surgery, the health benefits are much more significant. With a host of comorbidities associated with obesity, it is important to understand just how bariatric procedures can help you live a full and healthy life.

Obesity is associated with diseases affecting nearly every organ system. They include the cardiovascular system (hypertension, dyslipidaemia, coronary artery disease, heart failure, stroke), respiratory system (obstructive sleep apnoea, asthma), digestive system (gastroesophageal reflux disease, gallbladder disease, pancreatitis), endocrine system (insulin resistance, type 2 diabetes mellitus), reproductive system (polycystic ovary syndrome, infertility), liver (NAFLD, NASH), kidneys (nephrolithiasis, chronic kidney disease, urinary stress incontinence), musculoskeletal system (osteoarthritis) and mental health. Not to mention obesity can significantly affect your quality of life.

Nearly all of these conditions have demonstrated improvement and, in some cases, remission after weight loss associated with obesity surgery. Substantial evidence demonstrates durable clinical improvement of metabolic syndrome following surgery. There’s also a significant reduction in cancer and cancer mortality after obesity surgery.

Potential benefits include:

• Significant weight loss: Obesity surgery can lead to substantial and sustained weight loss, far greater than can be achieved through diet and exercise alone. 
• Improvement in obesity-related health conditions: Many obesity-related health conditions, such as type 2 diabetes, high blood pressure, sleep apnoea, and joint pain, can improve or even resolve after weight loss surgery. Weight loss can lead to better blood sugar control, reduced blood pressure, improved sleep quality, and decreased joint stress.
• Enhanced quality of life: Losing a significant amount of weight can positively impact an individual's quality of life. It can improve self-esteem, body image, mobility, and overall well-being. It may also increase energy levels and the ability to participate in previously challenging activities.
• Reduced risk of obesity-related complications: Obesity is associated with an increased risk of several serious health conditions, including heart disease, stroke, certain types of cancer, and infertility. Weight loss surgery can help reduce these risks by promoting weight loss and improving overall health.
• Long-term weight management: Obesity surgery helps individuals lose weight and facilitates long-term weight management. Long-term results demonstrate maintenance of significant weight loss at ten or more years after surgery. 
• Psychological benefits: Obesity surgery can have positive psychological effects, such as improved mood and reduced symptoms of depression and anxiety. This may be related to the physical improvements and increased self-confidence often accompanying significant weight loss.
• Increased lifespan: Studies have consistently shown that obesity surgery can increase life expectancy in individuals with obesity compared to obese individuals who do not undergo surgery. Most of this mortality benefit is due to reduced cardiovascular disease, diabetes-related complications and cancer.

How Safe is Weight Loss Surgery?

Over the years, weight loss surgery has become safer due to advancements in surgical techniques, anaesthesia, and post-operative care. However, as with any surgical procedure, potential risks and complications are involved. It's essential to understand both the benefits and the risks before considering weight loss surgery. Here's an overview of the safety aspects:

• Overall safety: Weight loss surgery is generally considered safe when performed by experienced surgeons in appropriately equipped medical facilities. Surgeons specialising in bariatric procedures have extensive training and experience performing these surgeries, contributing to safer outcomes. Large studies have shown a short-term all-cause mortality rate of 0.18% after surgery. The long-term mortality rate is lower in patients who undergo bariatric surgery than obese individuals who do not.
• Surgical risks: Like any surgery, weight loss surgery carries risks such as bleeding, infection, adverse reactions to anaesthesia, blood clots, and complications related to the specific surgical procedure. However, the risk of these complications can be minimised by thorough preoperative evaluations, proper surgical techniques, and post-operative care.
• Short-term complications: Some short-term complications that may occur after weight loss surgery include bleeding, leaks or blockages in the gastrointestinal tract, infections, ulcers, and nutritional deficiencies. These risks can be managed through close monitoring, early detection, and appropriate intervention.
• Long-term complications: Long-term complications of weight loss surgery depend on the procedure. The risk of these complications can be reduced through regular follow-up appointments, adherence to dietary and lifestyle guidelines, and appropriate supplementation if needed.
• Individual factors: The safety of weight loss surgery can vary depending on an individual's overall health, underlying medical conditions, and ability to follow post-operative instructions. It's important to have a thorough evaluation by a healthcare professional to assess whether weight loss surgery is a suitable option and to identify any potential risks or complications specific to an individual's circumstances.
• Patient selection: Appropriate patient selection is crucial for the safety and effectiveness of weight loss surgery. Candidates for surgery undergo a comprehensive evaluation to determine their eligibility, including medical, nutritional and psychological assessments. Identifying and addressing potential risks or contraindications is essential to ensure patient safety.

Risks and Side Effects of Weight Loss Surgery

As with any surgical procedure, weight loss surgery carries certain risks and side effects. While the overall safety of weight loss surgery has improved over time, it's important to be aware of potential risks. Here are some common risks and side effects associated with weight loss surgery:

• Surgical risks: Weight loss surgery carries risks such as bleeding, infection, adverse reactions to anaesthesia, blood clots, and damage to surrounding organs or structures. These risks are generally low but can occur.
• Leaks and strictures: There is a risk of leaks or strictures (narrowing) at the surgical site after weight loss surgery. Leaks occur when a hole or separation occurs in the stomach or intestines' staple line or sutured area. Strictures can cause a narrowing or blockage in the digestive tract. These complications may require additional procedures or interventions to correct.
• Nutritional deficiencies: Weight loss surgery can impact the absorption of certain nutrients, leading to potential deficiencies. Common deficiencies include vitamin B12, iron, calcium, and vitamin D. Regular monitoring and appropriate supplementation under medical supervision can help prevent and manage these deficiencies.
• Dumping syndrome: Dumping syndrome can occur after certain weight loss surgeries, such as gastric bypass. It happens when food moves too quickly from the stomach into the small intestine, causing symptoms like nausea, vomiting, diarrhoea, dizziness, and sweating. Adhering to dietary guidelines and eating smaller, more frequent meals can help manage dumping syndrome.
• Gallstones: Rapid weight loss after surgery can increase the risk of developing gallstones. Gallstones can cause symptoms such as abdominal pain, nausea, and vomiting. Surgical removal of the gallbladder may be necessary in cases of symptomatic gallstones.
• Excess skin and body contouring: Significant weight loss can lead to excess skin, particularly in the abdomen, thighs, arms, and breasts. Body contouring procedures can be considered once weight loss has been achieved and weight has stabilised.
• Nausea and vomiting: Many individuals experience nausea in the initial days or weeks following weight loss surgery. This can result from the body adjusting to the changes in the digestive system, eating too quickly, or consuming large amounts of food. Adhering to dietary guidelines and eating small meals can help manage these symptoms.
• Changes in bowel habits: Weight loss surgery can cause changes in bowel habits, including diarrhoea or constipation. These changes can be temporary and may resolve as the body adjusts. If needed, adequate hydration, dietary modifications, and fibre supplementation can help manage these side effects.
• Hair loss: Some individuals may experience temporary hair loss, known as telogen effluvium, after weight loss surgery. This usually occurs within the first few months following surgery and results from the body's response to rapid weight loss. Hair growth typically resumes within a few months, and proper nutrition and supplementation can help support healthy hair growth.
• Psychological and emotional effects: Weight loss surgery can have psychological and emotional effects. While many individuals experience improved self-esteem and body image, others may struggle with body image issues, depression, anxiety, or relationship changes. Support from mental health professionals and support groups can be beneficial.

The risks and complications associated with weight loss surgery can vary depending on the specific procedure performed, an individual's medical history, adherence to postoperative guidelines, and other factors. A thorough evaluation and discussion with your bariatric surgeon are essential to understand your situation, potential risks and benefits.

Before you decide about weight loss surgery, your surgeon will discuss all elements and risks of the procedure with you.