Cut it out

When all other methods fail to rid oneself of morbid obesity BMI>40 Kg/m2, bariatric surgery is the viable way out.

When all other methods fail to rid oneself of morbid obesity BMI>40 Kg/m2, bariatric surgery is the viable way out.
Who needs it?
If BMI > 40.
If BMI > 35 and you have associated conditions like hypertension, diabetes, heart disease or joint problems.
If you8217;re unable to reduce or maintain weight under a medically supervised program
If you have been obese for at least five years

The two most common procedures involved in the surgery are gastric banding reducing stomach size by creating a smaller upper stomach or 8220;pouch8221; and gastric bypass creating a pouch and connecting it to a shortened section of small intestines. Reducing the size of the stomach decreases the food intake and bypassing the upper part of the small intestine reduces digestion and absorption of caloric foods.

Fifty to 60 per cent of excess weight can be lost within the first two years of the surgery. Although weight loss plateaus 18-24 months after surgery, it is not unusual for patients to maintain a 50 per cent loss of initial body weight after five years. A study at the University of Minnesota reported effective weight loss in morbidly obese patients after bariatric surgery. Patients with diabetes, high cholesterol levels, heart and blood vessel disease, high blood pressure and sleep apnea experienced complete resolution or improvement.

For the first three post-surgery months, carefully follow diet and exercise guidelines and minimize stress on surgical sites. For a day or two, consume liquid or semi-liquid foods like broth, juice, milk and soups. For the following four weeks, take pureed foods. For the next eight weeks, take soft foods like fresh fruit and cooked vegetables, before progressing to foods of regular consistency.

Once you get back to the normal diet, include the following lifestyle changes:
Fill your tiny, 8220;new8221; stomach with nutrient-dense foods.
Don8217;t nibble through the day. To avoid impulse eating, eat three to four times a day and have a routine eating schedule. Constant nibbling or snacking may lead to weight gain.
Don8217;t swallow. Take small bites and chew each bite thoroughly. The new opening that leads from your stomach into your intestine is very small, and larger pieces of food can block the opening, thus causing vomiting and abdominal pain. Also, eat and drink slowly.
Limit high-sugar, high-fat foods, which provide many calories but few nutrients.
Don8217;t drink anything for 30 minutes before or after each meal as the stomach isn8217;t big enough to hold both food and liquids.
Consume water, skim, low fat or soy milk, low calorie beverages or tea through the day to stay hydrated. Drink enough fluids through the day to prevent constipation, a common fallout of bariatric surgery.
Take recommended supplements of calcium, iron, vitamin B-12 and vitamin D.
Exercise regularly for at least 30 minutes everyday.
Follow up regularly with the doctor to review progress and rule out any vitamin or mineral deficiencies.

Patients can defeat the surgery by consuming high8211;calorie drinks, alcohol or semisolid foods that overcome stomach size. With time, the pouch stretches, allowing more solid foods, but by then, doctors hope that the patient has established healthy eating habits. Also, the resting metabolic rate an estimate of the number of calories burnt while at rest can decline significantly after gastric surgery.