Obesity is dangerous. It is not just a cosmetic problem. It is a lifestyle disease. Obesity can lead to more than 65 types of other diseases including type 2 diabetes, hypertension, hyperlipidemia and obstructive sleep apnea. Total body fat stores are under control of several gut hormones and genes. They decide how much amount of fat to be stored in the body. They set a value for fat storage. This value is called set point for fat storage. Obese individuals have high fat set point. This means their body hormones and genes decided to store more fat in them. High calorie refined foods and lack of physical exercise influence these hormones and genes, and increase fat set point leading to obesity. In some individuals these get easily influenced because of genetic variations leading to excess weight gain.
Healthy diet and physical activity are necessary to prevent obesity. But these measures alone, almost always fail to induce permanent weight loss. 96% of the people fail to lose weight permanently with these methods alone, especially if body mass index is 30 and above. Diet control including low calorie weight loss diet, exercise, naturopathy, liposuction, cool sculpting and weight loss pills cannot alter this set point. If you try to reduce weight by these methods, you have to fight against your body to lose weight. If you fight, these hormones and genes don’t keep quiet. They fight back. Whenever you try to lose weight by these methods, these hormones and genes induce counter changes in the body and make sure to replace all the lost weight over a period of 6 months to 5 years. These hormones include Ghrelin, GLP 1, Peptide YY, Cholecystokinin and Amylin.
Laparoscopic Bariatric Surgery is a scientifically proven method for permanent weight loss. It is very safe and highly effective. Weight loss after bariatric surgery is not because of food restriction or mal-absorption. Bariatric surgeries induce hormonal and genetic changes in body which reset fat set point to a lower level. This means after these surgeries, body hormones and genes decide to get rid of fat and bring fat to the new lowered set value. Appetite comes down. Interest towards healthy food increases. Initially there is food restriction which disappears over a period of time. Still there is permanent weight loss.
Surgeries like sleeve gastrectomy and diversion procedures manipulate these hormones and reset fat set point to a lower level. So weight loss is significant and permanent. Diversion procedures include roux en y gastric bypass (RYGB), mini-gastric bypass (MGB), sleeve gastrectomy with loop duodeno-jejunal bypass (SG LDJB), bilio-pancreatic diversion with duodenal switch (BPD DS), single anastomosis duodeno-ileal bypass with sleeve (SADI S), sleeve gastrectomy with duodeno-ileal interposition (SG DII) and sleeve gastrectomy with jejuno-ileal interposition (SG JII). After bariatric surgery appetite comes down, outlook towards food is changed. Individuals start liking healthy food and hate unhealthy food. Unlike above bariatric surgeries, effect of gastric banding(LAGB), greater curve plication (GCP) and intra-gastric balloon (IGB) on fat set point is weak. These are mainly restrictive. After gastric banding, greater curve plication and gastric balloon appetite increases. Body tries to get back its weight. Ultimately either you get back all the lost weight or you will come back for band removal. Bariatric surgery also results in resolution of co-morbid conditions like type 2 diabetes, hypertension, hyperlipidemia, obstructive sleep apnea etc. If intention of surgery is to resolve type 2 diabetes, it is called metabolic surgery.
Metabolic Surgery cures type 2 diabetes in significant number of patients regardless of their weight. After metabolic surgery patient doesn’t need insulin or medications to control blood sugar levels. Diabetes complications don’t progress after surgery. If already developed there is a good chance of their reversal. Same hormonal changes mentioned above are responsible for the resolution of diabetes. Permanent cure of type 2 diabetes is possible in selected patients after metabolic surgery. Compared to sleeve gastrectomy alone, hormonal changes are more in diversion procedures. So if anyone is suffering from diabetes it is better to go for diversion procedures like SG DII, SG LDJB, BPD DS, SADI S, RYGB or MGB.
I performed bariatric surgery on my dad, Dr. Vennapusa Brahma Reddy and metabolic surgery on my brother Mr. K. Srinivas Reddy. Please check their images and my dad’s video feedback in gallery section.