Bariatric Surgery: A Medical Solution for Obesity with Comorbidities

Extreme obesity is no longer merely a matter of appearance but a serious threat to metabolic health. Dr. Errawan Ramawitana Wiradisuria, a consultant digestive surgery specialist, says bariatric surgery is now a medical solution increasingly relied upon to treat obese patients with comorbidities.

In a medical briefing in Jakarta on Wednesday 20 May, Dr. Errawan clarified the public perception that bariatric surgery is a cosmetic procedure. He said the operation is metabolic, aimed at restoring the body’s normal function.

Not all individuals with excess weight are eligible for this procedure. Patient selection is based on the Body Mass Index (BMI).

Primary comorbidities considered include hypertension, diabetes mellitus, extreme sleep apnoea, chronic knee pain, and hormonal disorders in women. The procedure can be performed on individuals aged 15 to 70 years, provided vital organs are in good condition.

Bariatric surgery is not a shortcut. Dr. Errawan emphasised the importance of multidisciplinary collaboration involving surgeons, nutritionists, and psychologists. Psychological evaluation is crucial because patients must be prepared to change their lifestyle for life.

Patients with severe, unstable psychological disorders, such as bipolar disorder, are not advised to undergo surgery due to the risk of post-procedure non-adherence.

After surgery, the stomach’s capacity is drastically reduced to about 30 percent. This necessitates a very strict change in eating patterns. In addition to dietary management, patients must adhere to four fixed protocols: taking vitamins for life, maintaining hydration by drinking water regularly, nutritional discipline, and regular exercise. Family support becomes a decisive factor to prevent patients from returning to their former lifestyle, which could trigger weight regain in the future.