Bariatrics – the surgical treatment of obesity

Bariatrics is a branch of medicine that deals with the treatment of class I, II, and III obesity by making surgical changes to the gastrointestinal tract in order to reduce the amount of food that can be consumed by the patient.

Many obese people, despite several attempts to lose weight with non-surgical methods, i.e. by limiting the food intake or with the help of exercising as well as various diets, are still unable to achieve their goals on their own. Bariatrics is designed to enable such patients to achieve a healthy body mass by shrinking their stomachs, which enforces a reduction in the amount of food they can take in. What does it look like in practice? Who qualifies for bariatric surgery? What treatment methods are used within this field of medicine?

What does a bariatric surgeon do?

Bariatric doctors work with the diagnosis, prevention, and treatment of obesity. This branch of medicine is often associated primarily with surgical methods of shrinking the stomach capacity in order to reduce food intake. In fact, bariatrics also includes non-surgical methods, and the field itself focuses to a large extent on finding the causes and substrate of obesity, not only on its treatment.

Bariatric methods have been developing for the past 70 years, but due to the obesity pandemic, the progress of this field has significantly accelerated in recent years. Nowadays, patients can choose from a variety of surgical and non-surgical methods available to them.

Overweight and obesity – when is a bariatric consultation necessary?

The terms “overweight” and “obesity” are often confused with each other because both of them refer to excessive body weight and the amount of adipose tissue in the body. In practice, these two terms do not have the same meaning. Being overweight should be considered a warning sign prior to obesity, while obesity itself is a disease that poses a serious threat to the patient’s health and life.

An important factor regarding the overweight and obesity diagnosis is the BMI expressed in a unit kg/m2. This indicator is calculated by dividing a person’s weight (in kilograms) by their squared height (in metres). If a patient has a body mass of 60 kg and their height is 1,65 m, their BMI is 22.03 kg/m2, which is, according to the World Health Organisation WHO, a normal body weight.

Anyone who would like to calculate their BMI should note that:

• BMI < 18,5 kg/m2 indicates underweight, 
• BMI between 18,5-24,9 kg/m2 means normal weight, 
• BMI between 25,0 and 29,9 kg/m2 means overweight, 
• BMI ≥ 30 kg/m2 is constitutes obesity, which is further divided into three classes:
  • Class I – BMI between 30,0-34,9 kg/m2,
  • Class II – BMI between 35,0-39,9 kg/m2,
  • Class III (extreme or severe obesity) – BMI ≥ 40.0 kg/m2.

Interpretation of BMI is not sufficient to diagnose obesity, because it does not allow an estimate of the proportion of adipose tissue, muscle, bone, and water in the total body weight. For this reason, if the BMI calculation indicates a problem with excess body mass, it is advisable to consult a specialist such as a dietitian or a medical doctor. They have the proper knowledge and experience to determine which treatment plan would be the best for an individual patient.

Surgical and non-surgical treatment methods in the bariatric centre of the KCM Clinic

During bariatric consultation, the doctor selects a treatment method optimally adjusted to the needs, health condition, and capabilities of the obese patient. Available surgical techniques include minimally invasive procedures that allow for a short hospital stay and quick recovery. As an experienced medical center with a specialisation in bariatrics, KCM Clinic offers access to all clinically tested surgical and non-surgical methods of treating obesity.

Surgical methods for treating obesity

The most commonly performed types of bariatric surgeries are:

• Laparoscopic gastric reduction (sleeve gastrectomy, gastric sleeve),
• Gastric bypass (Roux-en-Y gastric bypass),
• Mini gastric bypass (one anastomosis gastric bypass),
• Gastric banding,
• Gastric balloon.

The most popular type of bariatric surgery in the world is the sleeve gastrectomy. It carries very little risk in comparison to the spectacular results it can produce.

Non-surgical and less invasive methods of treating obesity

Aiming at reducing the risk associated with surgery that involves opening the abdominal cavity, less invasive and non-surgical methods have also been introduced to the catalog of bariatric procedures. It is worth mentioning that doctors in KCM Clinic use minimally invasive laparoscopic techniques for sleeve gastrectomy, Roux-en-Y Gastric Bypass, and One Anastomosis Gastric Bypass.

In some clinical situations, namely when a patient is too obese to undergo bariatric surgery, a doctor migtht decide to use a gastric baloon. It is an elastic ball filled with saline that can be placed inside a person’s stomach for up to 12 months. During that time, the capacity of a patient’s stomach is greatly reduced so that they can only consume little portions of food. It causes a weight loss that makes it possible for them to have the surgery that they need.

Qualifying a patient for bariatric surgery

Once a patient decides to visit the bariatric clinic and consult an experienced bariatric surgeon, he is first thoroughly checked and diagnosed. The specialist does not only rely on BMI indicator. He conducts additional tests to verify the proportion of adipose tissue to the total body weight and its distribution. Furthermore, the doctor always asks his patient all about diseases that he might suffer from apart from obesity.

The bariatric surgeon usually qualifies for surgery patients with a BMI of more than 40 kg/m2. In most cases, patients with BMI of over 35 kg/m2 are also accepted for the operation if their previous conservative treatment has resulted in a return to excessive eating and weight gain, or if they have any comorbidities such as diabetes, hypertension, or atherosclerosis. Bariatric surgery is considered to be the only effective treatment for obesity in patients for whom lifestyle changes fail to produce adequate and lasting results.