Obesity is one of the most serious health problems in the world today. It affects a growing proportion of the population, negatively affecting physical health, mental health and quality of life. According to WHO data, more than 40% adults worldwide are living with obesity1. In Poland, the problem affects as many as 9 million adults, or around 24% of the population.2
Obesity is classified into three grades according to body mass index (BMI):
- BMI ≥ 30 - first degree obesity,
- BMI ≥ 35 - grade II obesity,
- BMI ≥ 40 - grade III obesity, also known as giant obesity.
Everyone can easily check their BMI using an online calculator. However, it is important to bear in mind that BMI is not always a reliable indicator and, if in doubt, it is advisable to consult a doctor who will assess your health individually.
Indications for bariatric surgery
Bariatric surgery, or metabolic surgery, is usually considered for patients aged 18-65 years with stage III obesity (BMI ≥ 40) or stage II obesity (BMI ≥ 35) with serious health complications such as type 2 diabetes, hypertension or sleep apnoea syndrome. It is an option for people who have not achieved sustainable weight loss despite attempts at pharmacological treatment and lifestyle changes.
Patients qualifying for bariatric surgery should begin the process by visiting their GP, who may make a referral to a surgical clinic. The qualification process includes a comprehensive health assessment, visits to a dietician and psychologist, as well as pre-operative preparation. This is all aimed at minimising perioperative risks and maximising the benefits of treatment.
Bariatric surgery methods
The most common methods of bariatric surgery are:
- Laparoscopic sleeve gastrectomy - It involves removing (cutting out) part of the stomach, which limits the amount of food consumed and reduces the feeling of hunger;
- Gastrointestinal exclusion - Alters the gastrointestinal tract by separating a small part of the stomach and connecting it to the intestine. This reduces the absorption of calories and nutrients;
- Application of adjustable gastric band - Reduces stomach volume, giving a quicker feeling of satiety.
Each method has its own unique characteristics, benefits and potential risks of complications. For example, sleeve gastric surgery is popular for its effects in reducing weight and reducing levels of the hunger hormone ghrelin, which directly translates into reduced appetite.
These operations introduce significant changes in the way the body processes food and regulates hunger, and this has a direct impact on the control of obesity and its complications. The decrease in ghrelin levels helps patients control their appetite and the amount of food they eat, which significantly facilitates sustainable weight loss.
Effects and benefits of metabolic surgery
Bariatric surgery has numerous health benefits. In addition to significant weight reduction, patients often experience improvement or complete resolution of obesity-related complications:
- reducing the risk of developing type 2 diabetes,
- reduction in blood pressure,
- improving sleep and reducing symptoms of sleep apnoea,
- increase mobility and reduce joint pain,
- improving quality of life and mental health.
Patients who have undergone bariatric surgery often also notice improvements in self-esteem and self-confidence. However, the success of the operation largely depends on adherence to post-operative recommendations, including appropriate diet and physical activity.
After bariatric surgery, patients need to change their eating habits and lifestyle. Regular medical check-ups and the support of a dietician and psychologist help to maintain health and achieve long-term benefits.
Bariatric surgery is an effective tool in the fight against obesity, especially in cases where other methods have failed. The decision to undergo surgery should be carefully considered and discussed with the doctor, taking into account the patient's individual needs and expectations. With modern surgical techniques and the support of a multi-specialist team, patients can expect a marked improvement in their health and quality of life.
1 https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
2 https://www.nik.gov.pl/en/news/obesity-prevention-and-treatment-overwhelmed-the-system.html