There are risks of intolerance due to
the implanted material during a surgical procedure for morbid
obesity. There is no
phenomenon of intolerance connected with a problem of material or prosthesis,
although some prosthesis are made of silicone. However, there are obvious risks
due to the placement of a foreign body during surgical procedure: for example, an adjustable ring placed around the upper part of the stomach can erode the gastric wall, or more likely slip, both of which would require a further procedure to correct this. | | |
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Nowadays, the digestive surgery for obesity is always
performed laparoscopically. Theoretically all kinds of surgical procedure for obesity can
be performed laparoscopically (also called minimally invasive surgery, because
it is performed through very small incisions and because post-operative hospital
stay is shorter and recovery is quicker. However, only the adjustable gastric
banding is routinely performed using this approach.
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It is not possible to have babies after a bariatric surgery.
The gastroplasty, or any
kind of bariatric surgery, is not a contra-indication for pregnancy. In the vast
majority, pregnancy can go on without any problems. However, follow-up is
mandatory during the pregnancy, and the obstetrician should have any available
information about the previous bariatric
surgery. | | |
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Sport activities are very limited
after surgery.
There is no contra-indication to sport after surgery, after the usual recovery-time. However, the period of rapid weight-loss can decrease the physical capacities, whereas, in case of an adjustable band, the subcutaneous port can impede mobolity for a limited period of time. | | |
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There are aesthetic problems after bariatric
surgery.
Bariatic surgery entails often a huge weight-loss, that results in
melting of fat tissues and major skin folds, particularly on the abdomen,
thighs, arms and breast. All this can be improved by plastic surgery.
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A bariatric operation has immediate post-operative risks.
There are always risks, and this for two reasons: - Gastroplasties are designed for a population at high risk of serious illnesses, because of obesity. - Any abdominal operation performed under general anaesthesia necessarily carries risks. This is a main element for the patient when he opts for surgery, given the fact that surgery is not mandatory if one wishes weight-loss. | | |
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A patient having surgery should have a long-term medical
follow-up.
Surgery for morbid obesity requires a
long-run medical follow-up. Patients should submit to regular visits, and
possibly radiological and examinations. | | |
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A weight-regain is possible after
surgery.
The possibility of weight-regain always exists, for three reasons: | 1. | A technical failure : an impairment or a breakdown of the implanted material, a medical complication of the surgical setting, requiring the removal of the device. | | 2. | Dietary mistakes : Most common operations in Europe are restrictive, and do not prevent dietary indiscretions such as snacking of high-calorie food (junk food). | | 3. | A spontaneous weight-regain is very likely to happen in the long term (over five years), as has been shown from various studies on surgical patients. The medical follow-up and the support should minimize this regain. | | | |
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There is a limit in age for surgery.
Bariatric surgery is not
indicated for patients under 18 years and over 60
years. | | |
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| Digestive surgery for obesity involves only the stomach.
In Europe, most operations involve the stomach : gastroplasties (either with staples or with an adjustable band), whereas in the US, operations concern both the stomach and the small bowel: bypass procedures. | | |
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The stomach of an obese people is bigger than the average.
There is no correlation between the size of the stomach and the overweight. | | |
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There is no need for a
diet follow-up after bariatric surgery.
No operation can
be deemed completely successful in the long run. Besides, many diet mistakes can
be done if the patient doe not comply with simple and healthy
rules. | | |
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Some low-calorie diets
can provoke nutritional deficiencies.
If the diet is
imbalanced, too intense or too rapid, it can cause deficiencies in proteins or
trace elements for example. | | |
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Bariatric surgery never
causes nutritional deficiencies.
Some operations with
bypass require a very careful follow-up because they can cause possibly severe
deficiencies (in iron, calcium, etc.). Simpler operations, such as adjustable
gastric banding, can cause deficiencies as well if a technical complication
occurs combined with frequent vomiting. | | |
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Obesity affecting mainly the hips is less severe than obesity
affecting mainly the waist or upper part of the
body.
Although it is deemed less aesthetic, obesity of
the lower part of the body (affecting mainly women and called gynoid) is less
severe than obesity of the upper part (called masculine or android), which
causes more medical complications in the long
term. | | |
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A normal meal provokes calorie consumption.
Digestion entails a marked energy expenditure. However it is far less important than the basic metabolic rate or expenses due to physical activities. | | |
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Two-thirds of the daily energy expenditure do not depend on any
physical activity.
Basal metabolic rate, or resting
energy expenditure is responsible for survival. | | |
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Diuretics and thyroid hormones are
common anti-obesity drugs.
Diuretics
only relieve a body water excess, and thyroid hormones treat dysfunction of the
thyroid gland. Although these drugs have been widely used to treat obesity, they
do not have a successful effect in the long-term, and can even bee harmful in
this case. | | |
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Oral hypoglycaemic drugs for diabetes are common anti-obesity
drugs.
These drugs have an effect on diabetes, that is a
part of the complications of obesity. They do not treat obesity itself.
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The
intra-gastric balloon is a validated treatment for obesity.
Although a new generation of balloons has provided better efficiency and security than the previous balloons, which were tested and abandoned in the eighties, there is no evidence at present to support their use as sole obesity treatment. | | |
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