Best Bariatric (Weight Loss) Surgery in Delhi, India

The term “bariatric surgery” encompasses weight loss procedures such as gastric bypass and gastric sleeve. The goal of these procedures is to alter the structure of the digestive tract to treat obesity. This alteration in the digestive system, in case of some procedures, influences hunger hormones and appetite, reducing the amount of food one can comfortably eat. For other procedures, the body’s ability to absorb fats and calories is reduced. Bariatric surgery is an option for people with a BMI over 40 or those with serious weight-related conditions, such as type 2 diabetes.

Obesity caused by chronic conditions can be tackled with the help of bariatric surgery. These conditions include:

• High cholesterol: Bariatric surgery significantly improves lipid profiles; thus, it can drastically reduce high levels of cholesterol in obese patients.
• High Blood Pressure: Many patients experience a significant reduction in high blood pressure following bariatric surgery.
• Type 2 Diabetes: Bariatric surgery may lead to type 2 diabetes remission and enhanced blood sugar control.
• Heart disease: Bariatric surgery reduces the risk of heart disease, and at the same time facilitates drastic reduction in excess weight, generally improving heart health in obese patients.
• Fatty liver: Bariatric surgery reduces body weight, which can help reverse fatty liver disease and slow its progression.
• Sleep apnoea: Most patients experience relief of sleep apnoea symptoms after undergoing bariatric surgery, which helps them sleep more soundly.
• Some cancers: There is some evidence that bariatric surgery may reduce the risk of developing certain obesity-related cancers through weight loss and improved metabolic health.

There are various types of bariatric surgery, each with its own set of advantages and disadvantages. The doctor will recommend the one that best suits your specific needs. The most common ones include:

Gastric Bypass

Gastric bypass is a type of weight loss surgery wherein a small section of the stomach is cut off, creating a small pouch. This pouch is then directly connected to the small intestine. Through this method, food bypasses most of the stomach area and directly reaches the middle part of the small intestine. This surgery is also known as Roux-en-Y gastric bypass.

Sleeve Gastrectomy

Sleeve gastrectomy is a procedure that removes about 80% of the stomach, leaving behind a small tube-like pouch. The food-containing capacity of the stomach is greatly reduced with this procedure, as well as the production of the appetite-regulating hormone. This leads to a reduced desire to eat.

Gastric Band Surgery

Gastric band surgery involves placing a band around the top of the stomach that creates a small pouch where food is stored. As the area for food storage is decreased, the overall calorie and nutrient intake is also restricted. It is the least invasive option compared to other types of bariatric surgery.

Biliopancreatic diversion with duodenal switch (BPD/DS)

This is a two-part surgery that involves performing a sleeve gastrectomy in the first step. For the second step, the middle section of the intestine is closed off, and the last part is attached directly to the beginning of the intestine, the duodenum. The separated section of the intestine is reconnected to the end of the intestine. This allows the digestive juices i.e., the bile and the pancreatic juice to flow directly into this section. With BPD/DS surgery, both food intake and nutrient absorption are significantly reduced.

Before bariatric surgery, you’ll have a consultation with a nutritionist, who will prescribe a liquid diet to minimise stomach size before surgery. Apart from that, there are restrictions on alcohol and tobacco consumption.

Lab tests and exams will confirm whether you qualify for the surgery. Proper guidance will be provided about the procedure details, post-surgery guidelines and recovery time expectations.

The surgery will start with the administration of anaesthesia. The specifics of the procedure will vary depending on your case and chosen type of weight-loss surgery. There are two ways of performing the surgery, either as open surgery, which involves larger incisions or laparoscopic surgery, which uses small incisions. The duration of the surgery is usually several hours.

The length of your hospital stay will depend on the type of bariatric surgery. The first few days following surgery will involve a gradual and restful recovery, with most of the time spent resting.

As before surgery, a liquid diet will be recommended post-surgery, which will gradually transition to semi-solid or puréed food within about a week. A very specific diet is given, and there still might be restrictions on the amount and content of food and drinks.

Frequent medical check-ups in the first few months will monitor your body’s response to the new adjustments. 

Like any other surgery, bariatric surgery also has risks and complications associated with it. These include bleeding, infection, blood clots, hernia, small bowel obstruction, and diarrhoea.

Due to alterations in the digestive system, bariatric can sometimes lead to certain digestive complications, including:

• Dumping syndrome: Dumping syndrome is characterised by symptoms such as diarrhoea, nausea, and tiredness, resulting from rapid movement of food from the stomach into the duodenum.
• Bile reflux: Sometimes after bariatric surgery, the valve between the stomach and small intestine can be affected, causing it to malfunction. This allows bile from the intestine to flow back into the stomach and oesophagus, potentially causing inflammation and tissue damage.
• Nutritional Deficiencies: Certain types of bariatric surgery reduce the absorption of nutrients and calories, which can eventually lead to nutritional deficiencies.
• Gallstones: Rapid weight loss can send a significant amount of cholesterol into the liver. This excess cholesterol, along with the bile, accumulates in the gallbladder. As a result, gallstones composed of cholesterol may develop in the gallbladder.

How soon can I resume going to work after bariatric surgery?

In general, most people can return to work within 2–4 weeks. Regardless of the time required for you to fully recover, you should always follow your doctor’s guidance.

Can bariatric surgery help with mobility issues?

One of the many advantages of bariatric surgery is that it relieves stress on the joints, particularly the knees, hips and lower back, due to excess weight. Many patients experience improved mobility and ease in performing daily activities.

Is it possible to gain weight again after bariatric surgery?

Yes, it is possible to regain weight after 12–18 months following the surgery. This can occur due to multiple reasons, such as overeating or lack of regular exercise.

Are there age restrictions on bariatric surgery?

Adults between the ages of 18-65 are generally considered suitable candidates for bariatric surgery. For adolescents, the surgery is only considered in cases of severe obesity or when other treatment options have failed to achieve desirable results.

Post-surgery, for how long will a special diet need to be followed?

After surgery, a special diet that is easy to digest is recommended. During the first couple of weeks, a liquid diet including clear broths, protein shakes etc., is advised

Weeks 2-4: Puréed foods such as soft proteins, blended vegetables, and yoghurt are gradually introduced.

After 4 weeks: Solid foods, including cooked vegetables, soft fruits, and tender meats can begin to be incorporated.

Post 8 weeks: Patients can start eating regular solid foods that are protein-rich and low in fats and sugars.

Does bariatric surgery affect metabolism in the long run?

Yes, bariatric surgery affects the metabolism in the long run. As the digestive system is altered, it changes how the body processes and absorbs food. Initially, these changes can boost metabolism, but over time, as the body adapts, metabolism may slow down due to lower calorie intake and reduced body mass.

Are there non-surgical alternatives to bariatric surgery?

Yes, there are non-surgical alternatives, such as medical weight loss programmes and endoscopic procedures like intragastric balloon placement. Weight can also sometimes be managed with lifestyle changes and weight loss supplements.

Can I drink alcohol after bariatric surgery?

Alcohol consumption is generally not recommended after bariatric surgery, especially during the early recovery phase. Alcohol can lead to rapid intoxication and increase the risk of complications. It is best to avoid consuming alcohol for at least 6 months post-surgery.

Reviewed by Dr. Bachan Singh Barthwal - Senior Director - General Surgery, Laparoscopic / Minimal Access Surgery, Robotic Surgery on 11 Dec 2024.