Bariatric surgery helps treat obese patients with complications
Jakarta (ANTARA) - Dr Errawan Ramawitana Wiradisuria, a consultant surgeon specialising in digestive surgery, said that one medical solution increasingly relied upon to tackle extreme obesity with comorbidity is bariatric surgery.
In a medical briefing in Jakarta on Wednesday, Dr Errawan emphasised that bariatric surgery is a metabolic medical procedure aimed at restoring normal body function, not merely for cosmetic or aesthetic needs.
‘This metabolic bariatric surgery is a measure to restore normal functions or reduce comorbidity. So it’s not for cosmetics, that’s wrong. If someone loses weight and becomes more attractive, that is a side effect. The main effect is to eliminate comorbidity,’ said Dr Errawan.
He explained that not all people with excess weight can immediately undergo this operation. He explained that the main indications for bariatric surgery are based on the calculation of Body Mass Index (BMI) of the patient.
The comorbidities referred to include hypertension, diabetes mellitus, extreme sleep disturbances ( obstructive sleep apnea/OSA ), severe knee pain due to bearing weight, and hormonal imbalance in women. Meanwhile, if the patient’s BMI is above 50, additional procedures beyond gastric reduction are required, such as intestinal bypass.
This bariatric procedure has age limits; it can be performed on patients aged 15 to 70, provided vital organ conditions meet medical eligibility after stringent examinations.
The path to the bariatric operating table is not an instant and easy shortcut. Dr. Errawan emphasised the importance of multidisciplinary collaboration involving surgeons, nutritionists, and psychologists or psychiatrists to ensure safety and long-term success of the patient.
Before the operation is performed, the patient’s mental state must be assessed by a psychologist/psychiatrist. Patients with severe psychological disorders such as bipolar that is unstable are not advised to undergo surgery because the post-operative commitment requires strong mental stability. Patients must be mentally prepared to change their lifestyle totally for life.
In the first week, patients only consume liquids; in the second week semi-liquid foods; in the third week semi-solid foods (porridge); and eventually return to solid foods but in very small portions (3–4 tablespoons per meal) with a frequency of 6 to 8 times a day.
‘After the operation, eating must be phased. Even with the freedom to eat, it remains only 3-4 spoons; meals must be regular. Communication with a nutritionist must be intensive, especially for anything where the food is questionable,’ added Dr Errawan about the importance of post-operative nutritional guidance.
Additionally, patients are required to comply with four mandatory post-operative rules: take vitamins for life due to reduced nutrient absorption, drink plenty of plain water regularly (not all at once), follow the nutrition guidelines, and Exercise regularly to firm up sagging skin after drastic weight loss.
Family support is also a crucial pillar to prevent patients from returning to old lifestyles that could trigger weight gain of up to 30 percent in the future.