Bariatric surgery is a symptomatic treatment of a disorder of eating behavior. In the surgical choice, we must think about the consequences of morbid obesity:
- Medical
- Psychological
- Social and economic
Bariatric surgery is for patients from 18 to 60 years old, having a stable obesity for more than 5 years, with failures of diets and medications for over a year.
The goal of this surgery is to achieve weight reduction through two mechanisms:
- By decreasing the gastric reservoir (volume restriction)
- Either by acting on the absorption of food by the digestive tract
The expected result of the surgery is to obtain a 50% loss of excess weight compared to the theoretical ideal weight.
Forced food restriction
This principle allows the reduction of the volume of the stomach and therefore the food intake, hence the disappearance of the sensation of hunger.
This restriction is obtained by three surgical methods:
- Sleeve gastrectomy
- Annuloplasty under laparoscopy (Adjustable gastric band)
- The plication of the stomach
Malabsorption
This principle involves shorting a segment of the digestive tract to reduce the absorption of food. This method is obtained by Gastric bypass or pancreatic bilio. But these methods are to be used only for “super-obese” patients or in second-line surgery for failures of other interventions. They are recommended for sugar eaters.