There are established long term health problems for individuals who are severely overweight. These include:
- Cardiac disease
- Respiratory disease
- Joint problems
Due to these established long-term health problems, for individuals who have failed to lose weight with dietary changes and increasing physical activity restrictive operations may be considered.
Restrictive procedures are a group of operations that can be offered to individuals who are severely overweight to lose excess weight. This group of operations are termed restrictive as they aim to limit the amount of food that is able to be held by the stomach.
There are a number of slightly different restrictive procedures which can be provided. Some common restrictive procedures include:
- Vertical banded gastrectomy
- Gastric band surgery
- Sleeve gastrectomy
All of these operations, essentially, aim to reduce the size of the stomach. This has two effects. The first is that the receptors in the stomach which monitor fullness when eating food are stimulated very quickly. This significantly suppresses the need to continue eating at mealtimes.
Under normal circumstances, the stomach produces hormones which help to stimulate our appetite. Reducing the stomach’s volume also reduces the amount of these hormones produced further reducing the amount individuals eat at mealtimes.
There are some general risks and complications with any type of surgery which include:
- Anaesthetic risk
- Wound infection
- Blood clots (due to relative inactivity during recovery)
- Nausea and fatigue following the operation
There are also some more specific risks associated with restrictive operations. These can include:
- Deep abdominal infection sometimes leading to sepsis
- Leakage of the stomach contents in to the abdominal cavity
- Stricture (narrowing which does not allow contents to pass through) of the stomach
Restrictive operations are highly invasive procedures and patients will normally be monitored closely as an inpatient for a number of days. A strict post operative diet will need to be followed which will depend on the exact nature of the surgery performed.
Initially, patients will be required to eat an all liquid diet for a number of days. Following a successful trial with an all liquid diet patients will then be asked to progress for a number of days or weeks to a pureed diet prior to commencing a soft food diet.
For patients who do adhere to a new, balanced diet following a restrictive procedure, they can expect to lose upwards of fifty per cent of their excess body mass index (BMI).