Morbid obesity is a condition when the body mass index of the person is ≥ 40 Kg m². Usually these people have associated complications like breathlessness, diabetes, high blood pressure, arthritis or cardiovascular diseases. Their body becomes a burden to them. They may find it difficult to do routine activities like getting up, standing, walking, driving and so on.
Exercise and diet may be their worst nightmares as their body may not cooperate to do both of them.
The causes for morbid obesity may be due to hormonal imbalance, childhood obesity, extremely poor physical activity, heredity and so on. Since it is very difficult to treat them with conventional methods, bariatric surgery is a surgical option for them to lose weight.
Weight loss is achieved surgically by reducing the size of the stomach by stapling and banding a section of it as well as meshing the leftover opening. This is called band gastroplasty. Sometimes the stapling technique is followed by rerouting a part of small intestine to a small stomach pouch with the help of an intestinal loop.
This is called gastric bypass surgery. When the stomach size is reduced to 15% of its original size by removing a part of the stomach it is called sleeve gastrectomy.
These surgeries reduce the eating capacity and give early satiety as the size of the stomach is reduced. Patients who have undergone surgery may have nausea, vomiting, bloating, vitamin and mineral deficiencies, mal absorption of foods, loose motion or precipitation of co morbid conditions.
A clear liquid diet of clear fruit juices, clear cereal or vegetable broth in small quantities has to be started post surgery. Depending on the tolerance level of the patient, pureed foods, full fluids, soups, mashed potatoes and sugar free drinks can be given. Once the patient recovers, small frequent easily digestible meals are recommended.
Vitamin and mineral supplementation is compulsory to compensate insufficient nutrient intake and mal absorption. Patient must never be loaded with food or encouraged to fast, as body takes time to adapt to new capacity of stomach.
Moral support, encouragement and education is crucial to ensure speedy recovery and sustenance of weight loss without complications. New bariatric procedures aim at reducing risk of post surgery complications and adverse side effects so that risk of mortality is low and such surgeries become a more reliable solution for morbid obesity.
