Justification - Difficulty of the condition should be greater than that of the surgery.
Aim - Is not cosmetic, but reduce the complications of obesity.
Surgery provides effective long lasting weight loss in morbidly obese patients.
Obesity surgery is of low priority and of doubtful value.
Obesity is the fault of the patient. Ignorance surrounding this prejudice is astounding.
Efficacy of surgery
• Involves description of weight loss following the procedures
• Target weight loss: 50% of excess weight
• The good effects noted are
Reduction of various metabolic parameters
Long term control of diabetes
Loss of Lt ventricular mass
Improvement of functioning of heart.
Selecting for surgery
• Multidisciplinary team will select suitable patient for surgery.
• Pre operative briefing of situation is given
• BMI should be >> 40Kg/m2
• BMI >>35 with risk factors
• Age between 18-55 years
• Minimum duration of 5 years of obesity
• Failed conservative treatment
• No alcoholism/ Psychosis
• Those who agree for life long follow-up
Bariatric surgery procedures
Those that produce malabsorption that produce reduction of food intake.
• Jejuno ileal bypass
• Bpd
• Gastric bypass
• Vbg
