How effective is obesity surgery

Obesity surgery helps if obesity makes you sick


Obesity surgery

Obesity (obesity) often leads to serious illnesses. In many cases, only surgery will help in the end.

Susanne Amrhein, PRIMO MEDICO

 

The delicate limit is a body mass index (BMI) of 35: From this guideline value, people who are overweight are considered morbidly obese, morbidly obese. In the past 25 years, the proportion of severely overweight people has increased significantly. In Europe, almost every sixth adult is now considered obese, reports Eurostat, the statistical office of the European Union. Many of those affected not only suffer from being overweight and the associated restrictions on movement and social exclusion, but also from the resulting health problems.

Serious secondary diseases such as high blood pressure, diabetes 2 or Arthritis in the joints. Advice like “You should lose weight urgently” usually doesn't work, knows Prof. Dr. med. Rolf B. Schlumpf, Specialist in visceral surgery, at the Hirslanden Clinic in Zurich. “In weight classes with a BMI of 35 or more, sustainable weight loss is usually hardly possible. Many of my patients have had countless unsuccessful diet attempts when they come to me. Your only chance is to make your stomach smaller or to shorten the digestion time. "

Which surgical procedures help with obesity?

The one often used in the past Gastric band to reduce the stomach diameter in the entrance area, is rarely used today. The golden standard is that Gastric bypass, says Prof. Schlumpf: “We reduce the stomach to the size of an espresso cup and connect it directly to a loop of the small intestine. The other part of the small intestine with the digestive juices from the pancreas and bile is only connected further down with the rest of the small intestine, which significantly shortens the 'digestive tract'. In this way, on the one hand, the amount of food is massively reduced (restriction) and, on the other hand, the full utilization of food is made impossible (malabsorption). "

Less often, e.g. with a BMI just over 35 or at the express request of the patient, Prof. Schlumpf carries out a so-called "Sleeve stomach surgery" out. This involves removing part of the stomach so that only a tube is left. Similar to the gastric band, the more rapid saturation effect leads to the desired weight reduction.

What are the risks of obesity surgery?

It is important for Prof. Schlumpf to emphasize that gastric bypass surgery is not a wellness surgery that you perform once you have increased your clothes size. “Every surgical procedure has its risks. The mortality rate is well below 1 percent. But with these interventions, the seams on the stomach and small intestine are particularly important, as they have to be airtight and fluid-tight. Complications can occur here in around 2.5 percent of patients. "

The reconstruction in the abdomen also sometimes creates gaps between the intestinal loops. In rare cases, this can lead to an intestinal obstruction. Patients are informed in detail about these risks and their warning signals in advance of the operation. In order to speed up the healing process after the operation and to keep the burden as low as possible for those affected, Prof. Schlumpf operates in 98 percent of all cases with a minimally invasive technique using the so-called keyhole technique. "Normally we can discharge our patients after four to five days and working people can go back to work after two to three weeks."

How quickly do you lose weight after obesity surgery?

After about two years, Prof. Schlumpf's patients have reached their constant weight, which they usually maintain. In the beginning, the kilos tumble relatively quickly, after a few months the curve then flattens out. “A patient who is 1.60 m tall and weighs 102 kg can easily reach a weight of 70, maybe even 65 kg. The ideal weight is of course an ambitious goal. Most are around 10 percent higher in the end, ”says the obesity specialist.

In most patients, diabetes 2 and high blood pressure, as well as back and knee joint problems, go away very quickly. What can remain, for example, is an annoying fat apron on the stomach or excess skin on the thighs and upper arms. Any plastic corrections are not necessarily covered by the health insurance.

What aftercare is required after obesity surgery?

Before the procedure, Prof. Schlumpf's patients must give their consent to lifelong medical follow-up care. Most of them are very disciplined and do well, so the visceral specialist concluded. Many would have to learn again to eat appropriate amounts and to eat healthily. Due to the reduced food intake and digestion, it is necessary to take vitamins for life. Nevertheless, most of his patients are extremely happy after the operation, according to Prof. Schlumpf: “Many people ask themselves in retrospect why they did not take this step earlier. Often they no longer need to inject insulin. They feel more comfortable without being extremely overweight, can move around normally again, find partners, new jobs and start families. "