Is Bariatric Surgery Safe Long Term?
Bariatric surgery is a general term used to refer to various kinds of weight-loss surgeries that facilitate weight-loss through food restriction, malabsorption of calories or both in morbidly obese individuals.
Weight loss begins with the surgery. The changes that the surgery brings about and the adherence to the strict diet, activity and medication plans designed for each patient is what determines the range of weight loss.
Before we have a look at the long-term risks it is important to understand the long-term benefits
Long term benefits include more than just the weight loss involved. Bariatric surgery reduces mortality from cancer (by 60%), coronary heart disease (56%), and Type 2 Diabetes (92%) according to the American Society for Metabolic and Bariatric Surgery (ASMBS). It improves or treats more than 40 obesity related health issues. Health care costs are reduced over the years after surgery, which is also due to the reduction or resolution of obesity related health conditions. Added to this are improved quality of life, improved mobility and self-image of the patient.
Laparoscopic surgery now offers less invasive surgical procedures with smaller, faster healing wounds, lesser post-operative pain and better post-operative pulmonary function. However, there are risks involved as with any major surgery. Anastomotic stricture, gastrointestinal bleeding or late postoperative bowel obstruction may be seen.
Development of gallstones, hernias, bowel obstruction, dumping syndrome (nausea, vomiting, diarrhoea), hypoglycemia (low blood sugar), malnutrition (if supplements have not been taken regularly), ulcers, stomach perforation, leakage along surgical wounds are various risks associated with different bariatric surgeries.
In the case of the lap band technique, the risks are of a unique type not seen in other methods due to the involvement of the band. Tube or port malfunction requiring reoperation, erosion of the band, pouch dilation or band slippage are the risks involved in gastric band method.
Dumping syndrome is seen in some persons after gastric bypass surgery, when food with excess sugar or excess amount of food is passed directly into the intestine, patients might feel nausea, dizziness or cramps.
In some cases, hypoglycemia might develop when the body produces insulin, but not enough blood glucose. Slow-release carbohydrates and proteins can help combat this. Since the usable stomach is small, the amount of food the patient can contain is restricted. Hence, getting the balance right will be a challenge.
Fecal incontinence is a factor that is not commonly discussed. This can be emotionally disturbing for some. This probably develops as a part of dumping or because the patient might have had an underlying incontinence issue prior to surgery.
Gallstones might develop in some due to fast or significant weightloss. Obese persons produce more cholesterol than normal, and sometime the gall bladder does not function the way it should.
In restrictive and malabsorptive procedures, the patient can contain only small amounts of food to begin with. Added to this, the caloric and nutrient absorption is limited. They must take nutrient rich and protein packed food in order to avoid malnutrition and osteoporosis.