Bariatric surgery (weight loss surgery) is performed on people who have obesity. It is performed by a specialised bariatric surgeon. Weight loss is achieved by reducing the size of the stomach with :

1. a gastric band 
2. removal of a portion of the stomach (sleeve gastrectomy or biliopancreatic diversion with duodenal switch)
3. resecting and re-routing the small intestine to a small stomach pouch (gastric bypass surgery)

Bariatric surgery should be considered as a treatment option for patients with a
1. BMI of 40 kg/m2 or greater
2. obesity-related comorbid conditions, such as -

2.Impaired glucose tolerance
3.Diabetes mellitus
5.Sleep disorders such as obstructive sleep apnea

Bariatric surgeon should discuss to patient about the long-term side effects, such as

1. Need for reoperation
2. Gallbladder disease
3. Malabsorption

Food intake after surgery

After bariatric surgery, the patient is advised to take a liquid diet, such as diluted fruit juices, sugar-free drinks and gelatin desserts. This diet is continued until the gastrointestinal tract has recovered from the surgery. The next stage provides a blended or pureed sugar-free diet for at least two weeks. This may consist of high protein, liquid or soft foods such as protein shakes, soft meats, and dairy products. Foods high in carbohydrates are usually avoided when possible during the initial weight loss period.

Post-surgery, overeating is restricted because exceeding the capacity of the stomach causes nausea and vomiting. Diet of the patient depends upon the type of surgery. Many patients have to take a multivitamin pill daily for lifetime to compensate reduced absorption of essential nutrients. As the patient cannot eat a large quantity of food, he is usually recommend to eat high protein diet and low in fats and alcohol.

Bariatric surgery – treatment for hypertension

Hypertension has long been associated with obesity, and weight loss continues to be a first-line therapy in the treatment of hypertension. Lifestyle modification and pharmacologic therapy, however, often meet with treatment failure. Bariatric surgery continues to be the most successful approach for weight loss. It is found that there is a significant improvement in hypertension due to obesity in patients who undergo surgical weight-reduction procedures.

Bariatric surgery – treatment for sleep disorders like obstruction sleep apnea

Obese people generally have sleep apnea. The more the body weighs, the greater the amount of fat pressing down on the chest and lungs. Also, having a larger neck, particularly in men, increases the risk of having sleep disorders. Some individuals with a greater amount of fat around the abdomen (the so-called apple shape) also are prone to having sleep apnea. Sleep apnea often is associated with metabolic syndrome, which is a combination of disorders related to obesity (diabetes, hypertension, hypercholesterolemia, etc.). Weight loss is a good treatment for sleep apnea and bariatric surgery is the most successful approach for weight loss.

In addition to improvement in health, bariatric surgery also improves overall quality of life. Bariatric surgery improves physical functions such as mobility, self-esteem, work, social interactions, and sexual function. Furthermore, depression and anxiety are also reduced after bariatric surgery.

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