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¿Qué es la cirugía bariátrica?

As weight loss injections gain popularity, more people are looking at different ways to help manage obesity and improve their health. One method that tends to receive less attention is bariatric surgery - a medical procedure that can be just as effective as weight loss medicine in supporting long-term health and weight management.

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¿Qué es la cirugía bariátrica?

Bariatric surgery is a type of weight loss surgery that some people may be eligible for if they have obesity. This is usually when traditional lifestyle changes - such as diet and exercise - have not helped them lose weight.

Dr Peter Vasas, Consultant Bariatric Surgeon, Practice Plus Group Hospital, Barlborough, UK says that weight loss surgery can make a real difference to a person's life - not just as a weight reduction method, but it also has a positive effect on health conditions related to obesity.

"It has an amazing outcome on high blood pressure and type 2 diabetes," he explains. "Surgery should always be a last resort when diets and exercise have failed to help maintain weight."

Dr Peter Vasas, Consultant Bariatric Surgeon, Practice Plus Group Hospital, Barlborough, UK

Photo of Dr Peter Vasas

What are the 4 types of bariatric surgery?

There are four main types of weight loss surgery. Each is designed to either reduce the amount of food you eat or limit your calorie intake to support long-term weight loss.

  • Roux-en-Y (gastric bypass surgery) - a small stomach pouch is made and connected to the bottom of your small intestine. This effectively 'bypasses' a portion of your small intestine. As a result, you'll feel satisfied with less food, and your body will absorb fewer nutrients and calories from what you eat.

  • Gastric band - a silicone band is placed around the top of your stomach, creating a small pouch above it. This band can be tightened or loosened, acting like an adjustable belt to control how much food you can eat.

  • Gastric balloon - a soft balloon is inserted into your stomach, usually by swallowing it while it's attached to a thin tube. Once in place, the balloon is filled with salt water (saline) to partially fill your stomach and help you feel full more quickly.

  • Sleeve gastrectomy (gastric sleeve surgery) - makes your stomach smaller to around a fifth of its original size. This means you'll eat less and feel full faster.

What does bariatric surgery do to you?

Bariatric surgery is generally considered a lifelong intervention that, depending on your type of procedure, makes permanent changes to your digestive system. This approach is considered a more long-term measure compared to weight loss injections.

Vasas says that, after surgery, people tend to lose weight quickly.

"This is around a stone a month for the first nine months - and the total outcome is usually reached in 18 months," he explains. "It can reverse diabetes, improve high blood pressure, and help sleep apnoea. Emotionally, patients often feel able to do things they couldn’t before. It opens up a completely different lifestyle, from swimming to skiing."

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Where can you get bariatric surgery?

In the UK, bariatric surgery is available through both the NHS and private healthcare providers. If you're going through the NHS, your wait time can be anywhere from 1-3 years. However, if you choose private treatment, the procedure can often be arranged within a few weeks.

Do I qualify for bariatric surgery?

Vasas explains you must meet specific criteria outlined by the National Institute for Health and Care Excellence (NICE) to be eligible for weight loss surgery. You must also be ready to show you've tried loosing weight through more conventional meals - such as diet, exercise, and medicines - for at least 6-12 months.

"Everyone goes through a full pre-op assessment to make sure it's right for them," he says. "Typically, candidates are people with a body mass index (BMI) between 35 and 45, or down to 30 if they have weight-related medical conditions such as newly diagnosed diabetes."

Is bariatric surgery safe?

When carried out by accredited healthcare providers in a safe and hygienic environment, bariatric surgery follows a carefully structured and regulated process.

"Of course, there can be side effects - especially if the surgery is done abroad," Vasas warns. "I've performed emergency surgery on people who have had it done overseas. Flying soon after surgery can lead to infection, or even the stomach opening up."

Vasas advises that to prevent weight regain, you must follow a two-year aftercare program which includes support from a dietitian, nutritional guidance, and regular check-ups.

"Surgery gives long-term change," he adds. "But you must also follow the lifestyle and dietary advice to keep the results."

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Preparing for surgery and what to expect

Before weight loss surgery can be approved, you will undergo a pre-operative assessment that reviews your medical history, dietary habits, and overall suitability for the procedure. If you meet the necessary criteria, you will need to adjust your diet beforehand.

Vasas says: "After surgery, there’s a 6-8 week adaptation period. First comes two weeks of a liquid diet - soups and liquid yoghurt - then soft foods, and eventually you return to eating normal foods in smaller amounts.

"By 6-8 months, most people are enjoying their usual meals with reduced volume. Recovery begins quickly - many return to light activities within weeks. People are often surprised that they don’t vomit or feel ill - they just get full sooner and naturally eat less."

What care is needed after bariatric surgery?

After surgery, you'll need to make long-term changes to the way you eat - a commitment that lasts a lifetime. Your doctor will provide detailed guidance on how to eat and drink, including advice on alcohol consumption and portion control.

You’ll need to check in regularly with your weight loss clinic for at least two years and have a blood test once a year to monitor your health. It’s also really important to take your daily vitamin and mineral supplements - skipping them can lead to serious health issues over time.

"Regular contact with a dietitian can provide advice on nutrition, minerals, and vitamins," says Vasas. "You can still enjoy food - just in smaller amounts."

Vasas concludes by saying that though weight loss injections, such as Ozempic, have their place, he does not believe they are sustainable in the long term.

"After one or two years, the weight loss often diminishes, leading people to return in search of surgery," he explains. "Injections can be costly, and they are necessary for life if you don't change your lifestyle. In contrast, surgery alters your body and hormones permanently."

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