What is bariatrics?
The field of bariatrics focuses on obesity. Obesity, which involves excessive fat storage in the body, is a complex condition. Being overweight is more than simply a cosmetic issue. It's a medical issue that raises the chance of contracting other illnesses. Among these are hypertension, diabetes, high cholesterol, liver disease, sleep apnea, and other malignancies.
There are many reasons why people find it hard to lose weight. Obesity is typically the result of a complex interaction of genetic, physiological, environmental, and behavioral variables and dietary and lifestyle decisions. These may include stress, poor sleeping habits, certain medications and diseases, age, and lack of proper movements and activities due to socio-economic factors.
Treating these issues is where the field of bariatrics comes in. If you're about to look up a bariatric doctor near you to book an appointment, consider reading this article first.
What are the qualifications of a bariatric doctor?
A medical degree is a prerequisite for practicing bariatric medicine. A medical doctor (M.D.) or doctor of osteopathic medicine (D.O.) degree involves completing a four-year undergraduate program plus four more years of study at a medical school. In the last two years of medical school, students undergo clinical rotations supervised by licensed physicians.
After completing medical school, the next step is passing the licensing exam in your chosen state. Subsequently, you have to finish a residency program, during which you will get instruction and supervised clinical experience in your desired field of medicine. Residency durations change depending on the chosen field of medicine.
To practice bariatric medicine, one must first become board-certified in an overarching medical specialty, such as internal medicine, family medicine, or pediatrics. A one-year fellowship in bariatric medicine is available to doctors who have already completed a residency in one of these fields.
Once you've earned your medical degree, you can take the exam given by the American Board of Obesity Medicine (ABOM), previously the American Society of Bariatric Physicians (ASBP), and become board-certified in obesity medicine.
The American Society for Metabolic and Bariatric Surgery offers fellowships for doctors interested in further training. A bariatric doctor's work and financial prospects may improve after completing the program and adding ASMBS Fellow to their list of credentials.
What is bariatric surgery?
Although there are non-invasive methods of treating obesity, some cases might demand bariatric surgery, which is an umbrella term for various forms of restrictive surgery for weight loss. These include:
- Gastric bypass: It is a procedure that creates a small pouch in your stomach and directly joins it to your small intestine. After doctors perform this surgery, swallowed food goes into this small pouch and then into the small intestine, bypassing most of the stomach and the first section of the small intestine. Doctors suggest a gastric bypass to reduce the risk of potentially deadly health conditions, such as heart disease, high cholesterol, and type 2 diabetes.
- Sleeve gastrectomy: During sleeve gastrectomy, doctors remove about 80% of your stomach, leaving a tube-shaped stomach that is about the size and shape of a banana. Limiting your stomach's size restricts the amount of food you can consume. Further, this procedure prompts hormonal changes that can aid with weight loss and help relieve conditions associated with obesity, such as heart disease and high blood pressure.
- Biliopancreatic diversion with duodenal switch (BPD/DS): A BPD/DS is a comparatively less common weight-loss procedure. It has two major steps. The first step is sleeve gastrectomy, and the second step bypasses most of your intestine by connecting its end portion to the duodenum near your stomach. A BPD/DS restricts how much you can eat and decreases the absorption of nutrients, including fats and proteins. While this procedure is very effective, it has several risks, including malnutrition and vitamin deficiencies.
Doctors might suggest bariatric surgery if your body mass index (BMI) is 40 or higher. They might also recommend it if your BMI is between 35 and 39.9 and you have a serious weight-related medical condition (severe high blood pressure, type 2 diabetes, etc.) However, bariatric surgery is not for everyone who is overweight. You must undergo an extensive screening process to see if you qualify. Additionally, patients must commit to lifelong lifestyle changes, including healthy eating, regular exercise, and medical follow-ups.
Bariatric surgery carries risks, both short-term (excessive bleeding, infection, blood clots, anesthesia reactions, lung or breathing problems, gastrointestinal system leaks) and long-term (dumping syndrome, hypoglycemia or low blood sugar, gallstones, ulcers, malnutrition, hernias, acid reflux, and the need for revision surgery). Rarely, complications can be life-threatening.
Preparing for bariatric surgery
If you qualify for bariatric surgery, your healthcare team will guide you through the required steps to prepare for your specific procedure. This may entail:
- Medical evaluations, such as lab tests and physical exams, to ensure you are ready for surgery.
- Dietary adjustments, including restrictions on eating and drinking before the procedure.
- Medication guidelines, as some medications may need to be adjusted or stopped temporarily.
- Lifestyle changes, such as starting a physical activity program and quitting tobacco use if applicable.
You should also plan for your recovery by arranging assistance at home, as you may need support during the initial healing period. Carefully following your medical team's instructions will help ensure a safe and successful surgery.
What to expect during bariatric surgery?
Bariatric surgery is performed in a hospital under general anesthesia. It means you will be asleep throughout the entire procedure. The exact approach depends on your specific case, the type of weight-loss surgery, and your surgeon's preferred technique.
Bariatric surgeons use laparoscopic surgery, the most preferred method today. In this procedure, they make small incisions and use a thin, camera-equipped tube (laparoscope) to perform the procedure. This minimally invasive approach typically leads to faster recovery, less pain, and shorter hospital stays, though it may not be suitable for everyone.
The surgery usually lasts several hours. After this, you will wake up in a recovery room, where medical staff will observe you closely for any complications. Depending on the procedure, you might need to stay in the hospital for a few days before being discharged.
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Essential facts about bariatrics
The Centers for Disease Control and Prevention, in 2015 and 2016, surveyed adults and found that about 40% were obese.
Your BMI range determines your level of obesity. Should your body mass index be 30 or higher, you might be considered obese and require treatment as a bariatric patient. Class 1 obesity includes people with BMIs between 30 and 34.9; Class 2 includes those with BMIs between 35 and 39.9; and Class 3 consists of those with BMIs of 40 and beyond. The chance of having chronic diseases increases as body mass index rises.
Patients often see the most significant weight loss and improvement in obesity-related diseases within the first year and a half after bariatric surgery. Six months following surgery, patients may lose as much as 60% of their excess weight and 77% of excess weight in the year following surgery.
Patients can keep off about half of their excess weight five years after surgery. Remission from obesity-related disorders such as diabetes, dyslipidemia, hypertension, and obstructive sleep apnea shows up in most individuals who undergo bariatric surgery. However, as the prevalence of obesity rises in the country, experts on the topic are expected to be in high demand.
For many people, the dangers of extreme obesity outweigh those of metabolic/bariatric surgery. Bariatric surgery carries a risk of death of roughly 0.1%, with an overall risk of significant complications of about 4%.
Sources
Mayo Clinic[1]
Mayo Clinic[2]
Mayo Clinic[3]
Mayo Clinic[4]
Mayo Clinic[5]
Penn Medicine
Chron
American Society for Metabolic and Bariatric Surgery
