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Filed on August 20, 2020

A bariatric surgery is just one part in your complete weight loss journey. Once you've undergone a weight loss surgery, there will be certain aspects you will keep in mind - your diet, exercise regime and your mental readiness. Be sure of a successful weight loss program if you adhere to the key expert advice. Read on to know more from Dr. Nafad Mohamed Lotfy Elhadidi, Consultant General Laparoscopic and Vascular Surgeon at Zulekha Hospital Sharjah and Dr. James Zachariah Pulimuttil, Specialist General Surgeon at Zulekha Hospital Dubai.

What can I expect after I have a weight loss/bariatric surgery?

After weight loss surgery expect a new lifestyle, new shape and body changes. Many medical problems related to obesity diabetes, hypertension, high lipid level, and sleep apnea will improve. 95 per cent of individuals undergoing the procedure say their quality of life improved.

How much weight can I expect to lose? How can I maintain a healthy weight?

You will lose 40 to 60 per cent of extra weight after a bariatric surgery. This is more in a bypass and faster compared to a sleeve surgery. On an average 6 to 7 kgs per month is lost. Usually rapid weight loss happens in the first few months after the surgery and then slows down. So we must track the progress over a period of six months and not monthly. In order to maintain a healthy weight, the person should understand that the surgery is just one part of the whole process. One must stay disciplined and follow a healthy lifestyle including healthy eating habits with regular follow up with a dietitian and exercise regularly.

What kind of mental preparedness must one and their families have before and after the surgery?

It is true that patients with good pre-operative counseling and family support are the ones who do very well and benefit from the procedure. The preparation starts before any operation. Those who have a high BMI ( >50) are advised to go for a 2 week - pre- operative weight reduction diet which helps with mental preparation as well as helps the surgeon with a reduced liver size to deal with during the operation. We also recommend patients to "practice" pre-operative-liquid-only-diet for few days than to enter the "last supper syndrome" before a weight loss surgery. The latter is binge eating before the surgery, after which it is forbidden. We give them educational material / information that they may read and understand post-operative stages of diet, so that they are mentally and physically prepared for the changes in diet and have it all ready.

Can a woman still get pregnant after a weight loss surgery? What are some precautions to be kept in mind?

Yes, a woman can conceive successfully after bariatric surgery. It also improves the fertility for both sexes. It is recommended to delay conceiving until one or one and half year after surgery to allow the body weight to stabilize in order to avoid nutritional problems. After a bariatric surgery especially bypass, Anemia is corrected and iron, vitamins and calcium levels are stabilized with supplements before pregnancy.

What amount of exercises is considered good and for how long should one do the exercises to maintain a healthy weight after surgery?

One can do up to 150 minutes of moderate-intensity aerobic activity, 75 minutes of vigorous-intense aerobic activity, or an equivalent mix of the two each week. Strong scientific evidence shows that physical activity can help you maintain your weight over time. Generally 30 minutes each day is very good to keep you healthy and active.                  

What are some advises/services you offer to a person considering a weight loss surgery with you?

Weight Loss Surgery is the most reliable weight-loss option available today with a host of health benefits when used with clinical judgment and well-informed choices. We would always re-iterate the positional statement of various global authorities on this subject as well as the DHA that this option is not to be considered for a 'cosmetic' transformation but a 'metabolic' transformation. The latter means that the surgical procedure is being offered to correct the dysfunctional metabolic status causing life threatening conditions like diabetes, hypertension, heart disease, kidney issues, respiratory issues ( sleep apnea) along with the more obvious Obesity.  Hence operations like Sleeve gastrectomy, Minigastric Bypass (MGB), RNY gastric bypass (RYGB), revision bariatric surgeries are all offered by us after a minimum of two-three counseling sessions with the patient and relatives, explaining the indication, benefits and side-effects of the procedure. Patients who have diabetes will benefit more with a bypass operation (MGB or RYGB) than a sleeve gastrectomy. They also would be explained about the mandatory lifestyle modifications and regular follow up after weight-loss surgery to ensure a smooth and pleasant recovery with weight loss.

What are the risks with weight loss surgery?

We must first emphasize that a weight loss surgery has now become as safe (if not safer) as a gall bladder operation. However having said that though the procedure is not complicated, the patients (who undergo the surgery) are at high-risk to begin with, because of obesity and its co-morbidities. Hence the risks of their individual pre-operative health add to the operative risk. The risks include both during the operation and after that. As we take extreme caution at every step to screen these patients and take preventive precautions we are able to reduce the risk to a minimum, once the surgery is offered. The risks are vomiting, bleeding, leak, malabsorption of nutrients and vitamins, etc. Thankfully they are rare when the surgeon takes all the preventive measures. This is why patients need to be in regular follow up and compliant to the advice given to them.

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