Bariatric surgery is something other than a common term that is generally used for many types of weight loss surgery. These surgeries make changes in your digestive system to lose weight. They either limit the amount of food you can get or reduce your ability to absorb nutrients, and in some cases both.
These types of surgeries are performed when diets or exercise programs are not beneficial for the person and the person has a serious illness due to their weight. Gastric bypass is the most common type of bariatric surgery and is preferred by most surgeons because it usually has fewer complications than other weight loss surgeries.

These surgeries generally carry some risks and side effects, and the patient has to make permanent changes in their diet and plan a consistent exercise program to ensure the long-term success of bariatric surgeries.
Types of weight loss / bariatric surgeries
Biliopancreatic diversion with duodenal switch (BPD/DS).
Endoscopic sleeve gastroplasty.
Gastric bypass (Roux-en-Y)
Intragastric balloon
Sleeve gastrectomy

Biliopancreatic deviation with duodenal switch (BPD/DS).
It is said that this method or process of weight loss is less common and has two important steps.
The initial step is also called a sleeve gastrectomy, in which eighty percent of the patient’s stomach is removed and a much smaller tube-shaped stomach is created. The pyloric valve, which releases food into the small intestine, remains next to the part of the small intestine that normally connects to the stomach. The second and final step is bypassing most of the intestine to the duodenum, which is located near the stomach. These surgeries are performed once, reduce the amount of food you consume and also limit the absorption of nutrients, which generally include fats and proteins. This surgery is mostly done together, but rarely in some cases, as two major surgeries, first sleeve gastrectomy and after weight loss, intestinal bypass. This method has more risks even if the results are effective. Therefore, to avoid any adverse events, this surgery is recommended for patients whose body mass index (BMI) is more than 50.
Endoscopic sleeve gastroplasty
One of the latest types of weight loss surgery is endoscopic sleeve gastroplasty. In this method, the size of the patient’s stomach is reduced with the help of an endoscopic suture device. This surgery is recommended when a person’s body mass index is 30 or higher, and his diet and exercise plan have not yielded results. Significant weight loss is observed through the endoscopic sleeve gastroplasty operation because the surgery limits food intake, and in addition, the operation is less invasive and the rate of complications is also lower.
Gastric bypass: (Roux-en-Y)
Gastric bypass surgery is also called Roux-en-Y gastric bypass. In this procedure, a small pouch in the stomach is connected directly to the small intestine. And so the food once swallowed passes from the pouch of the stomach into the small intestine without passing through most of the stomach and the first part of the small intestine.
This method is the most common weight loss method followed worldwide and like any weight loss surgery, this method is also performed when the diet and exercise program are not suitable for the patient.
Intragastric balloon:
In this weight loss surgery, a balloon made of silicon is fixed in the stomach. This helps the patient to lose weight because the amount of food eaten is limited. And it makes a person feel full even by receiving small portions.

Sleeve surgery
Sleeve gastrectomy is a weight loss surgical procedure also known as vertical sleeve gastrectomy. This surgery is performed through a laparoscopic procedure, in which small instruments are used to make several incisions in the upper part of the stomach. In this method, about eighty percent of the stomach is removed. A small tube-shaped stomach that is the size and shape of a banana is created. In this method, hormonal changes are made to help lose weight. These hormones not only promote weight loss but also help relieve conditions such as high blood pressure or any common heart disease associated with weight problems.
Is bariatric surgery right for you?
Bariatric surgeries may not be suitable for everyone and therefore only performed if there is a serious health threat or obstacle to the patient due to their excess weight. This procedure is not recommended as a cosmetic procedure because it may cause serious risks and complications.
Biliopancreatic diversion with duodenal switch (BPD/DS)
This procedure is performed when a person is at risk of a potentially life-threatening health condition, such as:
Heart disease
high blood pressure
high cholesterol
severe sleep apnea
Type 2 diabetes
stroke
This procedure is not suitable for all obese people and therefore screening procedures are carried out to determine whether you are a suitable candidate for this surgery or not.
Endoscopic sleeve gastroplasty
This method is often used for candidates whose BMI is 30 and above. This method is recommended only in cases that have failed to control weight after trying to control weight through exercise and diet. A patient must be willing to maintain a healthy lifestyle and have regular checkups, as well as participate in behavioral therapy, to be considered a candidate for this surgery. This procedure is not suitable for someone who has had gastrointestinal bleeding or a hiatal hernia greater than three centimeters, or someone who has had previous abdominal surgery.

Gastric bypass
Gastric bypass surgery is generally for people who:
Body mass index is 40 or higher
A BMI of thirty-five to thirty-nine with health problems such as type 2 diabetes or high BP or severe sleep apnea
In some rare cases, surgery is performed if you have multiple physical problems even if your BMI is thirty to thirty-four
Intragastric balloon
This method is generally suitable for people who:
Have a body mass index between 30 and 40
Willing to adopt a healthy lifestyle and participate in behavioral therapy
They have not undergone previous gastric or esophageal surgery.
Sleeve surgery
This method is generally for people who:
Body mass index is 40 or higher (severe obesity)
A BMI of thirty-five to thirty-nine is associated with health problems such as type 2 diabetes or high BP or severe sleep apnea.
In some rare cases, surgery is performed if you have multiple physical problems even if your BMI is thirty to thirty-four
Risks and complications of bariatric surgery
Biliopancreatic diversion with duodenal switch (BPD/DS)
Risk factors for BPD/DS include the following

Excessive bleeding
infection
Adverse reaction to anesthesia
blood clotting
Lung or breathing problems
Leakage in the digestive tract

Long-term risks include:
Ileus
Dumping syndrome
Gallstones
hernia
Decreased blood sugar
Malnutrition
Stomach perforation
wound
Vomit

Endoscopic sleeve gastroplasty
This method is generally considered safer than other bariatric surgeries. Symptoms such as pain and nausea can be observed for a few days, which are easily resolved with anti-nausea and pain medications. Most people recover within two to three days. Although this procedure is not temporary, it is reversible. However, since this surgery is a completely new procedure, its long-term effects and risks are not known.
Gastric bypass
Risks such as excessive bleeding, infection, adverse reactions to anesthesia, blood clots, lung problems, and gastrointestinal leakage are short-term problems, while intestinal obstruction, diarrhea, nausea, vomiting, gallstones, hernia, hypoglycemia Blood, malnutrition, ulcers, stomach perforation are long-term health complications
Intragastric balloon
A third of people are affected by pain and nausea once after the operation. But these symptoms are only for a few days, which can be relieved by medication. Replacing the intragastric balloon and removing them is very rare. There is a chance that the balloon will deflate, which can become a hazard and cause a blockage that requires another surgery. Some rare possibilities such as ulceration or perforation of the abdomen may also occur.
Sleeve surgery
Excessive bleeding
infection
Adverse reaction to anesthesia
blood clotting
Lung or breathing problems
Leakage in the digestive tract
Ileus
Dumping syndrome
Gallstones
hernia
Decreased blood sugar
Malnutrition
Stomach perforation
wound
Vomit
What results can you expect?
For each type of bariatric surgery, the results are different as follows

Biliopancreatic diversion with duodenal switch (BPD/DS)
There may be seventy to eighty percent weight loss during the first two years. But weight loss is entirely dependent on personal lifestyle changes. In addition, other health problems that were related to obesity are resolved.

Endoscopic sleeve gastroplasty
This surgery may result in significant weight loss. And it has been shown in studies that 17.8 kg for a person with a body mass index of thirty-eight is reduced in just six months and nineteen kilos in about twelve months. and about thirty-three kilograms in a person who had a body mass index of forty-five in six months. (These results may vary in each patient).
Gastric bypass
This method helps in long-term weight loss. The amount of weight loss depends on the surgery as well as lifestyle changes. A person may show up to sixty percent weight loss in just two years after surgery.
Intragastric balloon
This surgery makes a person feel full even with very small portions. Therefore, the person tends to eat less than before. Hormonal changes caused by appetite are also controlled. Ten to fifteen percent of weight loss can be seen in just half a year.
Sleeve surgery
This surgery shows a major weight loss of up to sixty percent, which can be maintained if you change your healthy lifestyle, diet and exercise.
Are these surgeries covered by insurance?
Bariatric surgery is expensive. The cost depends on various factors such as the following
The type of surgery was selected
surgeon fee
selected hospital
Tools used
Counseling
anesthesia
Follow-up steps
Insurance coverage depends on the obesity method chosen by the person.
How can I maintain my weight after bariatric surgery?
The success of bariatric surgery largely depends on the behavioral and lifestyle changes that the patient uses after the surgery. Patients should carefully follow the diet plan prescribed by the nutritionist and also take action to change their attitude towards nutrition and exercise.
Diet before surgery
A bariatric surgeon may prescribe a weight loss goal and schedule to achieve before surgery. This weight loss helps reduce excess fat around the liver as well as in the abdominal area to reduce the possibility of complications. If you do not reach the prescribed weight goal, the doctor may decide to delay the procedure.
Diet plan (before surgery)
These instructions may vary from person to person and also depend on the type of surgery:

Avoid overeating
Eliminate sugary drinks
Daily multivitamin supplements may be recommended
Protein supplements may be recommended
High carbohydrate foods should be avoided
Eliminate saturated fat from your diet
Diet plan (after surgery)
The post-surgery diet plan may have several stages that are provided by your doctor or dietitian.
Step 1: Liquid diet
Only a few ounces of clear fluids are allowed for the first few days after surgery. After that, these types of liquids can be consumed.
skimmed milk
Light soup and broth
Decaffeinated tea or coffee
unsweetened water
Gelatin without sugar
Step 2: Pure diet
Pureed food consists of food with a thick consistency, such as pudding. Spices may irritate the stomach, so it is better to avoid them altogether.
Most prefer seedless fruits and also avoid fibrous vegetables. In general, at this stage, fruits such as bananas, peaches, apricots, pears, pineapples, and melons are recommended. The nutritionist may also prescribe vegetables such as tomatoes, spinach, carrots and green beans.
Step 3: Soft diet
At this stage, the doctor suggests you to start with soft and easily chewable food. which may include the following:

Soft boiled egg
Minced meat
Cooked white fish
Canned fruits
yogurt
The white fish
Cheese
Beef
Chicken
Scrambled eggs
Step 4: Consolidation
At this point, we can reintroduce solid food into our diet. This stage basically starts only after 2 months. Food must be broken down and chewed into small pieces because your stomach is smaller. It is better to introduce food slowly so that the tolerance of your stomach is determined and the diet is adjusted so that it does not cause any discomfort.

Foods to avoid in stage 4:
pop corn
firm meat
fried food
Crispy food
dry food
Bread products
Postoperative diet guidelines
After surgery, you will need to follow some lifelong guidelines and adjust your lifestyle. It is better to prepare your meals at home and always have them with you to avoid unhealthy overeating.
Here are some guidelines to follow after the lifelong process.
Eat and drink slowly and keep your pace at each meal
It is necessary to control the amount of promises
If your body has signs of discomfort, pay attention to it
Eliminate foods rich in saturated fat
Avoid consuming especially sweetened drinks with meals
Stay hydrated throughout the day
Chew food thoroughly and break it into smaller pieces
Lifestyle changes after surgery
Do not start your exercise program immediately after surgery. Let your body heal and therefore go slowly. Gentle exercise including walking, swimming, simple yoga, stretching and deep breathing exercises are recommended in the early months.
Strength training and cardio exercises can be started only after consulting a doctor.
Even simple changes in everyday life can be helpful
walking
Avoid sitting for long periods of time
Stretching at work
Using the stairs instead of the elevator
How to deal with loose skin after surgery?
Maintain muscle mass: A better way to avoid excess skin is to build strength. Skin expands not only with weight gain, but also with muscle gain. Maintaining muscles can prevent the skin from becoming too loose. Exercises such as squats and deadlifts can help with this. (However, this should be done only after obtaining permission from the doctor).

Cardio exercise for fat burning: Once your surgeon gives you the go-ahead to exercise, start your cardio exercise right away. Walking is the best way to start cardio and your body will recover and move on to other exercises such as running, swimming or cycling.

Maintain a diet: Eat foods that help reduce excess skin growth. Healthy food helps to promote healthy skin and also helps in muscle growth. Focus on foods like cashews or almonds or Brazil nuts. Fruits like berries and whole grains can also help.
Stay out of the sun: too much sun is not good for people who want to work on sagging skin after surgery. Skin-strengthening proteins may be depleted by too much sunlight.

Surgical removal of excess skin: Several different surgical procedures are used to remove excess skin, these are purely cosmetic procedures and are at the discretion of the patient:

Face lift – helps to eliminate sagging skin in the middle of the face, jaw and neck.
Breast lift – the sagging breast is raised.
Abdominal movements – excess skin in the stomach area is removed.
Lower body lift – sagging skin in the stomach, buttocks, inner and outer thighs is removed.
Inner thigh lift – removal of excess skin in the inner thigh area.
Arm lift – hanging excess skin and fat from the upper arms.
These surgeries are purely cosmetic, however, it is important to consult with your doctor about whether these procedures are safe for you. Also, to build self-confidence and deal with body image issues, you should participate in psychological counseling and behavioral therapy.