Bariatric Surgery procédure

Reducing by surgery the size of the stomach in prescription to control hunger.

The concept of an empty or full stomach controlling hunger is wrong.

Physiologists have proven that the mechanisms involved in the feeling of hunger are located in the hypothalamus gland in the brain. A number of elements influence the hypothalamus that controls the feeling of hunger or satiety. These are activated according to the rate of sugar in the blood. If the sugar level is low, hunger is triggered, if the level is high, then satiety is activated. There are other elements involved but this particular one is essential.

There are receptors in the stomach lining which does play a limited role in hunger/satiety. It is the brain that controls the feeling of hunger.

Reducing the size of the stomach by surgical means is of limited use yet in patients with morbid obesity (BMI > 40 kg/m2) or in individuals with BMI from 35-40 kg/m2 with serious co morbidities such as type 2 diabetes or obesity-related joint disease, the most successful approach to weight loss may be bariatric surgery.

Bariatric Procedures are discussed when:

· Obese patients of which IMC are higher than 35

· If there are complications threatening the such diabetes

· obesity evolving since at least 5 years

· Failure of the traitements

· Age between 18 and 65 years

· Acceptable risk

· no dependence with alcohol or drugs

· No affection of order psychiatric

Procédures are refused :

· Standard food behavioral problems compulsions compulsive eaters.

· P ; psychiatric delirium

· obesity recent and accessible to dieting

· Alcoholics, drug addicts, dependence

· Important operational risk

· bulky hiatale hernia

Result:

According to several studies the average loss of 45 to 50% of the initial weight is stable for 10 years.

A new drug coming out this year is most probably more efficient than this surgery.

Ozempic, already out and Wegovy (will come out in September) will cut down considerably the number of procedures.

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