Key point :
- More than 20.8 million Thai people are ‘obese’, which has a huge impact on the country’s health system. It also causes various health problems.
- for some patients Alone, just exercising and food control Often unable to lose enough weight to recover from various underlying diseases Gastric surgery is another treatment option.
- However, before surgery, it is necessary to understand that Who is this method suitable for? Preparedness, results, and risks before making decisions
Obesity is a condition in which the body hasaccumulated fatabnormally much, which will cause problems such as diabetes, high blood pressure fatty liver disease sleep apnea Cardiovascular disease or cerebrovascular disease gastroesophageal reflux disease Spine or knee osteoarthritis, etc. It also increases the risk of breast cancer, colon cancer as well.
Currently, from the information of National Tea Health Promotion AgencyIt was found that there are more than 20.8 million Thai people who are obese, which has a huge impact on the country’s health system. from comorbid disease data arising fromobesity point out the importance of prevention and treating obesity clearly But drug treatment Exercising or eating a low-energy diet can lose weight but unable to maintain or maintain the patient’s weight all the time
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Patients tend to gain weight again. Therefore, there is a surgical treatment. which can reduce more weight and result in being able to maintain weight for a period of more than 7-10 years in patients with low body mass index can considerlose weightby diet and exercise But if the patient has a very high body mass index, there is often a limitation in exercise due to congenital disease associated with obesity.
In addition, alone, just exercising And dieting is often unable to lose enough weight to recover from various underlying diseases. associated with obesity, such as diabetes, high blood pressure sleep apnea osteoarthritis hyperlipidemia Fatty liver disease, etc.
Therefore, in patients withbody mass indexObesity treatment with surgery is therefore the right choice to lose weight. and treating obesity-related congenital diseases as well as helping reduce the risk of other diseases that will be in the future, such as breast cancer, colon cancer, etc.
What is bariatric surgery?
gastric surgery to shrinkstomachto be smaller, along with reducing the absorption of the stomach or small intestine. In addition, the hunger hormones produced in the stomach are reduced after surgery, so post-surgery appetite is also reduced. Purpose of surgery to treat obesity and treating joint diseases that come with obesity such as diabetes, high blood pressure fatty liver disease sleep apnea, etc., making postoperative patients healthy, strong and able to live normally.
Who is bariatric surgery suitable for?
stomach surgery tolose weightNot suitable for all overweight people Before the surgery, the doctor will provide detailed information to the patient. physical examination to see readiness and screening appropriate patients which has an indication For those who lose weight by other methods that do not work as follows
1. Body mass index (BMI) > 27.5 kg/m2 with uncontrolled obesity
2. Body mass index (BMI) > 32.5 kg/m2 with obesity related diseases such as diabetes, hypertension, hypercholesterolemia, sleep apnea, fatty liver, etc.
3. Body Mass Index (BMI) > 37.5 kg/m2
Prepare and assess before surgery
Dr. Satianpong Chantawiboon, surgeon specializing in laparoscopic surgery and weight loss surgery Obesity Clinic, Rajavithi Hospital Said that patients who want surgery for bariatric treatment need to be prepared. and assessment before surgery, including the patient and the patient’s relatives must understand what the surgical treatment will be expectation of possible weight loss and chances of recovering from obesity-related congenital diseases What should be done after surgery? including possible complications
How is weight loss surgery performed?
1.Sleep surgery (Laparoscopic Sleeve Gastrectomy) islaparoscopic surgery Cut some parts of the stomach to be smaller to 15-20%. Reduce appetite hormone (Ghrelin) to eat less. Good weight loss with excess weight reduced by 60-70% at a period of 6-12 months.
2.bypass surgery (Laparoscopic Roux-en-y gastric bypass) is endoscopic surgery. Part of the stomach is cut to a smaller size in conjunction with duodenal bypass gastrointestinal to make eating less and adjust the body’s satiety hormone balance to increase By stimulating the small intestine to produce satiety hormones (GLP1, PYY), which can reduce excess weight by about 70-80% at a period of 6-12 months.
3.Sleep plus bypass surgery (Laparoscopic Sleeve Gastrectomy Plus Proximal Jejunal Bypass) is an endoscopic surgery. Cut some stomachs to be smaller to 15-20%, reduce appetite hormone (Ghrelin), make eating less. together with the bypass through the middle intestine to stimulate the production of satiety hormones (GLP1, PYY), which can reduce excess weight by about 70-80% at a period of 6-12 months.
Other surgeries
for other surgeries such asinsert a gastrointestinal loop(Laparoscopic Gastric Banding) is no longer used due to poor weight loss. And found a problem with gastric bands tightening the stomach until it becomes a wound
How does weight loss surgery help me lose weight? What is?
Mechanisms that make sleep after surgery help reduce weight are as follows.
1. Reduce the size of the stomach reduce food intake
2. Reduce the area to absorb food.
3. There are changes in hormones controlling hunger and satiety.
4. Changes in gastrointestinal motility
5. There are changes in the bacteria in the intestines.
6. Reduce inflammation in the body.
What was the result? how long does it take Before you see a clear result?
From information and current medical research, it was found that after weight loss surgery
- Patients will lose up to 60-80% of their excess weight by 6-12 months after surgery.
- As for diseases related to obesity, such as recovering from diabetes. or improvement >80%
- 60-70% cured from hypertension
- 80-90% cured from hyperlipidemia
In addition, losing weight will help prevent osteoarthritis, spinal degeneration, reduce the risk of colon cancer, breast cancer, stroke / heart disease.
Is weight loss surgery dangerous?
Nowadays, with modern surgical equipment technology And the expertise of surgeons with high surgical experience and graduated in bariatric surgery, it was found that the risk of surgery was very low. The wound size is about 5-10 mm. The wound is sutured with dissolving sutures and waterproof wound closure So the patient can recover quickly. Very little pain and able to stand up and walk 1-2 days after surgery
In addition, in the preparation process before surgery, there is a multidisciplinary team working together to take care of the patient in detail so thatweight loss surgerysuccessful and reduce possible complications to a minimum
Symptoms to watch out for after weight loss gastric bypass surgery ?
Common risks after gastric bypass surgery are:
- Abdominal bleeding
- leaky stomach
- venous thrombosis, etc.
which is generally found in less than 1% in skilled surgeons If there is a fever, abdominal pain, abnormally fast pulse Constantly vomiting after eating immediately contact the doctor and nurses immediately
in summarySurgery for obese patients (Bariatric Surgery) in patients with indications can reduce the patient Weight loss is better than other treatment methods. and also make patients recover from comorbidities with a better quality of life Which type of surgery to choose depends on the specialist surgeon together with the patient on which type of surgery to choose. to get the best treatment results
For patients can receive a consultation at obesity clinic Surgical Outpatient Examination Room, 9th Floor, Chalermprakiet Building Rajavithi Hospital Every Thursday, 1st, 3rd, 5th week of each month from 1:00 PM to 4:00 PM. and book an appointment to see a doctor via the page obesity clinic Rajavithi Hospital
Proofread…. Suree Silawong
2023-04-25 08:30:00
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