Obesity: when does medicine recommend surgery? What are its benefits and risks?

Obesity: when does medicine recommend surgery?  What are its benefits and risks?

Obesity: when does medicine recommend surgery? What are its benefits and risks?

  • Sanaa El Khoury
  • BBC News Arabic

image rights Getty Images

There have been many questions over the past few days about the dangers of stomach surgeries following the announcement of the death of Wadih, son of artist George Wassouf, due to health complications that affected him days later after undergoing one of those surgeries.

Wassouf’s family has neither confirmed nor denied that a medical error led to the death of the Syrian singer’s eldest son. However, questions about the circumstances of the operation and its risks occupied the communication sites heavily, with some false health information being circulated about it.

Weight loss surgery has evolved greatly over the past two decades and has become part of the protocol doctors follow to help patients improve their health and quality of life.

But how does medicine determine its benefits or risks? What are the criteria that qualify a patient for gastric surgery? How do doctors assess his physical and psychological condition before and after the operation? How can complications be avoided?

BBC News Arabic in Beirut posed these questions to professionals looking for precise answers.

“It’s not plastic surgery.”

Stomach surgeries began in the 1950s, and with the development of medicine and surgical techniques, doctors see it as a relatively safe operation as the mortality rate ranges from 0.05 to 2.0 percent, according to the von Experts reviewed Obesity Surgery magazine, which specializes in publishing medical studies from around the world on the subject.

There are several types of gastric surgery that have been used over the past few decades, including gastric banding, gastric sleeve and gastric bypass, but the most common of these are gastric sleeve and gastric bypass, according to surgeon Georges El Khoury, head of the Excessive Laparoscopy and Bariatric Surgery Unit at Lebanese American University, which includes Rizk University Hospital in the capital Beirut and St. George University Hospital in the city of Jounieh.

Al-Khoury says bariatric surgery is divided into two parts, “a section for treating obesity and a section for treating diseases like diabetes and liver cirrhosis and their complications.” Al-Khoury explains that the surgeons who specialize in this type of surgery are not “plastic surgeons, rather we specialize in treating a disease called obesity, which is a chronic disease, just like diabetes and other chronic diseases .”

Al-Khoury explains that we need to differentiate between obesity and obesity because not everyone who is obese or overweight needs surgery when obesity becomes a threat to human life, meaning it can cause serious health complications like high blood pressure and Difficulty breathing, joint and back pain, diabetes, fats in the arteries, we call it excessive obesity and we recommend surgery.”

The surgeon, who has treated hundreds of patients throughout his career, says: “When we are visited by an obese person who does not suffer from serious weight-related complications, we do not immediately advise him to have an operation, but we ask him to make changes in it his lifestyle like healthy eating and exercise.”

He also explains that the surgery is performed to help people with diabetes or other diseases such as cirrhosis of the liver, regardless of weight, as it helps reduce the body’s absorption of sugar and prevents fat from accumulating and getting worse of the patient’s condition to prevent condition.

Comprehensive assessment and provision

Talking about the prevalence of gastric reduction surgeries, one might suspect that the decision to perform them is easier than it really is, with documentation of patient experiences suggesting that standards and procedures are sometimes messy or it’s easy to consult the surgical option, even if the patient’s condition does not warrant it.

How do specialists assess the situation before deciding for or against an operation?

Doctor George El-Khoury says bariatric surgery requires the consultation of an integrated medical team, in addition to a surgeon who specializes in laparoscopic and bariatric surgeries.

“The surgeon must have the necessary experience to select the operation that suits the patient’s condition, with the assistance of a gastroenterologist, a respiratory doctor, an anesthetist and a nutritionist, and a psychiatrist, to assess the patient’s psychological condition and ensure that there are no circumstances that could endanger him.” such as alcohol or drug addiction.

The doctor explains that the patient must be prepared by a specialized team before the operation and carefully followed up after the operation. “Every person has a different condition. We cannot generalize or categorize everyone. Every patient has a health condition that we assess based on their needs.”

Before the surgery, the doctor will explain to the person what to expect in terms of pain, lifestyle changes, the amounts of food they can eat and the types of foods to avoid. After the operation, the patient is asked to consume liquids for a certain period of time and then fragile and easily digestible foods for weeks, depending on the patient’s needs and the stomach’s reaction to the food.

Al-Khoury says: “If someone suffers from alcohol or drug addiction, for example, we ask the psychiatrist to help them solve these problems before the operation, to ensure that they break habits that threaten their life , and if we If you have any doubts, let’s wait for the operation.”

After the operation, the patient is closely monitored to measure blood pressure, breathing technique, and body temperature, in addition to the administration of blood-thinning needles to prevent blood clots.

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The doctor says the goal of these surgeries is to help patients, not put them at risk, and “any patient who prepares well and follows instructions is at reduced risk of complications, and prevention remains a priority.”

It is true that the risks of complications after gastric surgery are the same as with any other surgical procedure. Al-Khoury explains that there are several scenarios that can be fatal, such as the patient not following the diet prescribed for them after the operation and the consumption of food or drink is prohibited.

Added to this is the negligence of some doctors who lack experience and who ignore some serious symptoms such as tachycardia or high temperature in the days following the operation.

He says: “If a patient calls me and says they have a fever after the operation, I ask them to come to the hospital immediately and refer them to the X-ray department. I’m not just telling him to take two painkillers. There.” is a protocol to follow when experiencing similar symptoms to avoid complications. “Thank you.” Therefore, patients are advised to choose the appropriate hospital equipped with an integrated work team capable of containing complications as soon as necessary.

Obsession with weight and shape

The specialist surgeon emphasizes the importance of a psychological assessment of the person before bariatric surgery, which is also agreed by psychotherapist Melissa Rizk, who specializes in eating disorders.

Rizk says that the societal and media obsession with the image of the body we live in today “has had a major impact on how people relate to their bodies and to food. We live in an age where appearances are revered and connects it to beauty, will, and the individual’s ability to control themselves, and sometimes even status. “Social, which puts pressure on us all to be in a certain shape and lose weight.”

Rizk notes that the issue of losing weight has become a constant discussion in our lives, whether we’re shopping, going to the movies, or being invited to a social event, “the issue of weight remains present.” But on the other hand, “there is it’s always advertising for food and the food industry that spends billions of dollars promoting junk food and we see it all over the place on our phone screens, on TV and on billboards.”

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In addition to making the necessary health preparations before any bariatric surgery, the therapist says, one should make sure the person does not have an eating disorder.

She tells us, “The most common eating disorder among candidates for bariatric surgery is ‘bulimia’ or ‘binge eating disorder,’ meaning a person experiences an episode of overeating that can last about two hours during which they everything loses control and then feels remorse and guilt he tries to eat less.”

People with bulimia disorder live in a state of constant dieting, but they don’t lose weight because they experience binge eating that gets out of control and need the intervention of a specialized therapist to resolve them.

The therapist says there are a number of different eating disorders, but in general what they have in common is an obsession with weight and shape and trying to control it. “There are obese people who don’t have an eating disorder, and they may see a doctor out of concern for their health if they experience joint pain or if their heart and artery health is deteriorating.”

She explains, “Not every obese person has bulimia, but when we notice a problematic relationship between them and food and an obsession with weight and shape, we suspect they have an eating disorder that needs resolution. Many of them have bulimia, don’t eat all day, or they overeat, for example. Too little, and when they come home tired and hungry after a long day, they indulge in non-stop overeating. ”

Melissa Rizk oversees the cases of a number of patients who need obesity surgery and says working on solving the eating disorder problem if it existed before surgery is a better option to help the person control their eating habits to regulate.

She says she clearly explains to each patient that they will not be able to eat the amounts of food they were used to before surgery and helps them understand what types of foods to avoid, such as chocolate, ice cream , alcohol and potato chips that do this can prevent him from losing weight in the long term.

The therapist points out that society’s obesity phobia and the bullying and taunting of overweight people have counterproductive consequences, “particularly for those who suffer from the emotional eating problem, as the increased pressure makes them feel anxious and angry feel, so eat more.”

She says, “There’s a beautiful trend that started in the United States called ‘Health in Every Way’, and its goal is to break away from the obsession with weight and shape and move towards healthy habits of all sizes focus by stimulating the senses Eating natural, organic and preservative-free foods and building a long-term balanced lifestyle that includes good sleep, exercise and healthy eating, rather than obsessing over the idea of ​​dieting, being thin and in shape to be.”


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