Understand how bariatric surgery is performed – 08/08/2023 – Equilíbrio

In times of Ozempic, Wegovy and obesity treatments that promise weight loss without surgery, bariatrics was discussed again after singer Jojo Todynho warned that she would undergo the procedure.

A Sheet spoke with physician Luiz Vicente Berti, executive vice president of the Brazilian Society of Bariatric and Metabolic Surgery (SBCBM), to better understand how the procedure that emerged in the 1960s in the country is performed, for whom it is indicated and what its future looks like new slimming methods.

How is the surgery done

The word bariatric comes from the Greek “baros” which means weight. Since it emerged, the idea has been to be an intervention that produces rapid weight loss with long-lasting effects.

According to Berti, when surgery arrived in Brazil in the 1960s, the techniques were able to reduce people’s weight by reducing the stomach, but resulted in a poor quality of life, which gradually changed with the evolution of methods.

Surgeries began to be performed using cuts of up to 30 centimeters and are now mostly performed using laparoscopy —a small hole in the abdomen.

Today, two main techniques are used: gastric bypass or sleeve. The first reduces the stomach with cuts or staples and alters the intestine to connect it to the functional part of the stomach. The second keeps the intestinal tract intact and only removes part of the stomach. In Brazil, the bypass corresponds to more than half of the operations.

In a review of the main scientific studies on the subject, experts concluded that it is possible to lose about 30% of body mass using both methods.

The vice-president of the bariatric society says that there is a very high level of safety in the surgery, but warns: people need to look for specialist surgeons, who have certification.

Who is it for

People with more severe obesity, linked to comorbidities or morbid obesity, are eligible for the surgery. This is measured from a BMI (Body Mass Index) greater than or equal to 35 with associated disease, or for those with an index greater than 40.

Insurance companies are required to pay for surgery for those with a BMI above 40. It can also be done through the SUS (Single Health System).

Recovery

The surgery is performed between one and two hours. “If the patient arrives on Tuesday morning, on Wednesday after lunch he is already returning home”, says the doctor.

According to Berti, the level of postoperative pain is “very little”.

In the first 14 days, food should be based on liquids only, changing to soft foods in the third week and semi-solid foods in the fourth. At the end of 30 days, the diet is similar to that of the preoperative period. “But in a smaller amount because now he has a smaller stomach”, says Berti.

With two weeks, the person can already go back to work (if it does not require carrying heavy objects). With two months, doing bodybuilding. The slimming process continues for a year.

Hair loss, vitamin deficiency and anemia are some of the possible side effects.

“During the preparation, the patient is instructed to understand that the surgery is not a magic machine that is placed in his belly. It has the fundamental tripod of surgery: physical activity for the rest of his life, emotional treatment (we have an emotional relationship with food) , and food re-education (it’s not forbidden to eat a hamburger here or pizza there, but it can’t be all the food)”, says the doctor.

Future of method

A new treatment for obesity promises weight loss without the need for bariatric surgery and without the nausea associated with other weight-loss drugs. In addition, in the last year there has been a popularization of “slimming pens” – injectable slimming drugs.

Berti claims that this does not threaten the surgery. “In medicine there is no single type of treatment,” he says. “The surgery you do once and the medicine is for the rest of your life. Not to mention that prices are around R$ 700 per month, and how many percent of the Brazilian population is able to spend that during the month?”.