What is the advantage of Bariatric Surgery?
Apr 05 , 2016 10 am

What is the advantage of Bariatric Surgery?


Morbid obesity is chronic and difficult to treat. If not treated, Patients will suffer from sickness arising from obesity and finally it will lead to premature death. Morbid obesity patients have a body mass index (BMI) greater than or equal to 40, meaning that the patient is weighted as twice of ideal body weight. 

Drug therapy, exercise or low-calorie diet can help patients to lose weight but cannot treat or maintain the weight for patients throughout. Usually the patients will gain weight again. Therefore, Bariatric Surgery exists. It can reduce the patients’ weight better and the weight can be controlled for long term and lasting, besides making the body look good. It also reduces the disease and danger of obesity as well as reducing the cost of health care.

Based on statistics, If found that symptoms of Hypercholesterolemia, Diabetes, Hypertension, Arthritis and osteoporosis and Sleep Apnea are improved significantly by an average of 70-80 percent. It also reduces risk of stroke, heart disease and cancer. In addition, the disappearance of various diseases are found after Bariatric Surgery



Indications for surgery

• Patient with Body Mass Index (BMI) greater than or equal to 40

• Patient with Body Mass Index (BMI) greater than or equal to 35 with comorbidities

(As Asian patients are smaller than American or European, the indication for BMI is  > 37.5 kg/m2 or > 32.5 kg/m2with comorbidities)  

• Patient with history of longer term obesity and failure to control weight themselves.

• Patient who can comply or provide cooperation for treatment


Currently, there are 2 groups of Bariatric Surgery that are widely accepted.

1. Restrictive procedure such as Gastric banding และ Laparoscopic Sleeve Gastrectomy

2. Combined Restrictive and Mal-absorptive procedure such as Roux-en Y Gastric bypass, Biliopancreatic diversion (BPD), and BPD with duodenal switch


There are 2 Laparoscopic Bariatric Surgeries that are widely used and accepted.

1.Sleeve Gastrectomy: 85% of the stomach will be remove. 


Laparoscopic Sleeve Gastrectomy is simple, safe, and gives good outcome. It can reduce 30-50% of the excess weight within 2-3 years. It is suitable for all kind of obesity, in particular those with high risk of surgery. 

2. Roux-en Y Gastric Bypass



This is suitable for Patient with Body Mass Index (BMI) greater than or equal to 40. The weight can be reduced by 50-60% of the excess weight within 2-3 years. However, this operation causes many amaslomosis in the intestine. There may be more chance of having complications such as leaking, infection, and malabsorption. In long run, there may be nutrition deficiency, vitamin s, calcium, and iron deficiency. Therefore, patient who is operated by this method must take the supplement of nutrition and vitamin. 


Postoperative treatment

What should the patients do after operation?

• Exercise when feeling better. There is special exercise program for the patients in this category.

• After being discharge, the patients should take the food at home as instructed by nutritionist.


It is important to:

1.Drink a lot of water to prevent  dehydration

2.Take enough protein.

3.Take all meals, but eat slowly but often

4.Chew the food well and long time before swallow 

5.Stop eating when feel full

6.Drink water 30 minutes before and after meal

7.Do not drink soft drinks or beverage with high sugar



Before and After Laparoscopic Sleeve Gastrectomy