Dedicated to the individual. On Fridays, continuation of the story.
For those who are tired of controlling their diet, calories consumed, and physical activity. For those who have lost faith in diets and the help of various specialists. However, he...
What we are researching: What is the effectiveness of bariatric surgery in the long-term follow-up period?
What's New: Why is long-term observation of the efficacy of bariatric surgery important?
What we will learn: What can help obese patients avoid grasping at straws?
1. Bariatric surgery (BS) results in rapid and massive weight loss, often leaving patients with excess skin that can be aesthetically disappointing and impede physical and psychosocial functioning (Steffen KJ, Sarver DB, and al. 2011) [1].
2. Unfortunately, WR [weight return, ed. author] is associated with relapse [disease relapse, ed., author] of previously controlled T2D [type 2 diabetes, ed., author], hypertension, and other weight-related comorbidities, with reduced quality of life and emotional health" (Noria S .F. et al. 2023) [2].
3. Aesthetic disappointment. It's no secret that many patients expect bariatric surgery to improve more than just their weight loss and associated health. Research has shown how important it is for people who have undergone bariatric surgery to have an aesthetic perception of their body image (fr. 26.16).
• "Weight loss is usually associated with improved body image. Unfortunately, some patients who lose significant weight report, most often after bariatric surgery, residual body dissatisfaction associated with loose, sagging skin on the chest, abdomen, hips, and arms" (Sarver D.B., Polonsky H.M. 2016) [3].
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The study authors found two barriers to quality of life after surgery. One of them creates physical difficulties in their life. Another barrier relates to psychosocial difficulties. Let's look at them briefly.
4. Physical difficulties. Excess skin after bariatric surgery results in dermatitis (inflammation of the skin). Dermatitis causes itching and irritation in the folds of the skin. There are also functional difficulties associated with daily physical activity, difficulties with finding and choosing clothes, and tension in intimate relationships [4].
5. Psychosocial difficulties. Another obstacle relates to the lack of harmony in the individual and social spheres. Harmony in the individual sphere is disrupted due to external and superficial perception of the image of one's body (fr. 21. 10, 12). Harmony in the public sphere is disrupted due to social stigma, discrimination, shame, and anxiety, including depression. As a result, patients are isolated from a social group that could support them (fr. 26.10) [4]. The vast majority of patients see a way out of this situation by resorting to plastic surgery to correct their figure [5]. With all of the above in mind, let's summarize the effectiveness of bariatric surgery (BS).
6. BS effectiveness results. Numerous studies have shown that bariatric procedures, depending on the type of surgery, lead to an overall weight loss of 20% to 36%. This weight loss is accompanied by a significant reduction in signs of associated diseases. Complication rates range from 13% to 25.7%. However, these studies are short-term in nature and expert conclusions are based on the period when patients achieve maximum weight loss 1–2 years after surgery [6]. Can this approach be considered evidence of the effectiveness of treatment of morbid obesity, given the chronic nature of the disease?
