Of course, I wasnt going to give him a diet plan to make him lose 10 kilos (20 pounds!) in one month. Diet plans inducing rapid weight loss are against my professional and personal ethics. In case you are curious, a drop in body weight in the range of 2 kilos (4.4 pounds) to a maximum of 5 kilos (11 pounds) per month is the permissible rate of weight loss. Any technique causing a faster rate of weight loss is best abandoned.
Now, what my client meant by `operation' was Bariatric Surgery (BS), a surgical procedure performed with the motive of making an individual lose weight. Bariatric surgery is of many types but lets save that discussion for a later date.
Bariatric Surgery is the last line of treatment for obesity, but is mostly marketed as a weight loss option which is effective, simple and for everyone. Why, if a layperson were to read a promotional material on bariatric surgery, it would make them believe that its just a simple nip and tuck and that the only side effect is permanent happiness!
And, this is precisely the impression this client and many other clients of mine are under. Under, until I use my 'Dietitian Voice' and elaborate on all aspects of the procedure. Here is what I tell them in form of FAQs (frequently asked questions).
Q 1. When can you consider bariatric surgery as an option for losing weight?
Bariatric surgery is your option for weight loss only if-
a) you are morbidly obese i.e. your Body Mass Index (BMI) is greater than 40, or,
b) you have a BMI of 35 and above, accompanied with serious and/or life threatening comorbidities (diseases) e.g. diabetes mellitus, hypertension.
a) you are morbidly obese i.e. your Body Mass Index (BMI) is greater than 40, or,
b) you have a BMI of 35 and above, accompanied with serious and/or life threatening comorbidities (diseases) e.g. diabetes mellitus, hypertension.
But, that still does not qualify you as a candidate for surgery...
Even if you fulfill one of the above two criteria for `eligibility', it still has to concluded by a team of specialists that the first line of treatment has failed with you. In other words, all other options of making you lose weight namely calorie restriction, lifestyle modification, exercise, medication, psychological counselling and family involvement have failed.
Q 2. What should I know before undergoing the procedure?
If its been concluded by the team that nothing but surgery will work for you, then your surgeon needs to discuss the following with you, prior to the surgery-
a) Risks of the actual procedure. However non-invasive, all surgeries carry some amount of risk.
b) Physiological and medical side effects of the procedure which are for life e.g. malabsorption of nutrients, gastric dumping syndrome and more.
c) Access to life long postoperative followups.
d) Approximate cost involved, of not just the procedure, but also the postoperative care and followups.
Q 3. How does bariatric surgery make me lose weight?
There are many types of bariatric surgery and they aim to bring about weight loss in you by decreasing the amount of either-
a) food entering your gastrointestinal tract, or,
b) food absorbed in your gastrointestinal tract.
Q 4. What happens after the surgery? The good.
Yes, you lose weight. It not surprising considering your food intake and/or absorption, has been made to drop by a big percent. This loss in weight sees improvement in the symptoms of comorbidities like hypertension, diabetes mellitus, hypercholesterolemia etc.
Q 5. What happens after the surgery? The uncomfy and the bad.
There are side effects for life and no one should tell you otherwise. The only thing is these side effects will vary depending on the type of surgery performed.
Lets take some of the side effects of of a common type of bariatric surgery called Gastric Restriction (where a portion of the stomach is surgically removed or stapled)-
Side effect 1: Since the procedure has made your stomach smaller than normal, you will feel full after eating even small quantities of food, with symptoms like nausea and vomiting. You can never eat even normal amounts of food in one sitting again.
Side effect 2: Your stomach produces HCl (Hydrocholoric acid), a germicidal agent, amongst other things. Removing a portion of your stomach surgically, reduces HCl production, thus lowering your stomach and small intestines resistance to bacterial action. Result? Increased risk of gastritis and bacterial overgrowth in your small intestine.
This apart, you have to definitely go for postoperative followups which involves appointments with your specialists and consultations with a dietitian (as you cannot eat the same food you did before the surgery and you definitely cannot eat anything that you feel like).
As I finish my narration on Bariatric Surgery to my captive audience, I normally leave them with an increased determination to lose weight the way its best suited for most-by eating mindfully. And, that was the idea to begin with.
If you liked this post, you might also like:
Whats A Size Zero? How To Be A Size Zero? The Myth. The Truth. The Stupidity.
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