Our Summary

This research paper discusses the risks and necessary medical care for obese patients who require surgery, specifically bariatric (weight loss) surgery, under general anesthesia. Obesity often comes with a group of conditions – high blood pressure, abnormal cholesterol levels, and type 2 diabetes, collectively known as the ‘metabolic syndrome’. The metabolic syndrome not only increases the risk of heart disease and heart-related problems, but also makes surgery and the recovery period more risky and complicated. The paper emphasizes the need for advanced care and planning for obese patients undergoing surgery, to minimize complications and improve recovery.

FAQs

  1. What is the “metabolic syndrome” and how does it relate to obesity?
  2. What are the perioperative risk factors for obese patients needing bariatric surgery?
  3. Why is there a need for advanced care for obese patients undergoing bariatric surgical procedures?

Doctor’s Tip

A helpful tip a doctor might tell a patient about obesity surgery is to make sure to follow the recommended diet and exercise plan provided by the healthcare team post-surgery. This is crucial for successful weight loss and overall health improvement. It is also important to attend regular follow-up appointments to monitor progress and address any concerns. Additionally, staying committed to a healthy lifestyle, including proper nutrition and physical activity, can help maintain the weight loss long-term and reduce the risk of complications.

Suitable For

Patients who are typically recommended for obesity surgery are those who have a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related health conditions such as hypertension, dyslipidemia, type 2 diabetes mellitus, or obstructive sleep apnea. These patients may have tried other weight loss methods without success and are at high risk for complications related to their obesity. Additionally, patients who have a BMI of 30 or higher may be considered for surgery if they have obesity-related health conditions that are not well controlled with other treatments.

Timeline

Before obesity surgery:

  1. Patient undergoes extensive evaluation by a multidisciplinary team including a surgeon, endocrinologist, dietitian, and psychologist to determine eligibility for surgery.
  2. Patient undergoes preoperative testing such as blood work, imaging studies, and nutritional assessments.
  3. Patient may be required to follow a preoperative diet and exercise program to optimize their health before surgery.
  4. Patient may attend counseling sessions to address any underlying psychological issues related to their obesity.
  5. Patient may be prescribed medications to help manage comorbid conditions such as hypertension, dyslipidemia, and T2DM.

After obesity surgery:

  1. Patient undergoes the surgical procedure, which may include gastric bypass, sleeve gastrectomy, or gastric banding.
  2. Patient is closely monitored in the immediate postoperative period for any complications such as bleeding, infection, or pulmonary issues.
  3. Patient is started on a strict postoperative diet and exercise program to help facilitate weight loss and prevent complications.
  4. Patient attends regular follow-up appointments with their healthcare team to monitor their progress and address any concerns.
  5. Patient may experience rapid weight loss in the months following surgery, leading to improvements in comorbid conditions and overall quality of life.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with obesity surgery?

  2. How will my current medical conditions (hypertension, dyslipidemia, T2DM) be managed before and after the surgery?

  3. What is the expected weight loss and improvement in my overall health after the surgery?

  4. How will my diet and exercise regimen need to change after the surgery?

  5. What is the long-term follow-up plan after the surgery?

  6. How will the surgery impact my medication regimen?

  7. What are the different types of obesity surgery available and which one is best suited for my individual needs?

  8. What is the experience and success rate of the surgical team performing the procedure?

  9. How long is the recovery period and when can I expect to return to normal activities?

  10. Are there any support groups or resources available for post-surgery care and maintenance?

Reference

Authors: Pouwels S, Buise MP, Twardowski P, Stepaniak PS, Proczko M. Journal: Obes Surg. 2019 Aug;29(8):2670-2677. doi: 10.1007/s11695-019-03952-y. PMID: 31127496