WA Weight Loss Centre

Weight Loss Surgery

Weight Loss Surgery

Weight Loss Surgery2024-05-14T19:24:09+08:00

What is Weight Loss Surgery?

Weight Loss Surgery, otherwise known as Bariatric surgery, is the most effective way to lose excess weight and keep it off in the long term. At this point in time, surgery offers the only realistic hope of sustained, long term weight loss for the severely obese.  Although by no means perfect and not for everyone, bariatric surgery works.

Over the last 15 years or so we have developed a deepened understanding of how obesity surgery works. Fundamentally obesity stems from a derangement of biology that controls the amount of energy store in the form of adipose or fat tissue.In other words a  derangement of physiology that controls the fat mass setpoint (Set Point Theory). The gastrointestinal tract plays a critical role in regulating most of the physiological functions controlling body weight. Bariatric surgery is shown to reverse this physiological disarrangement back towards a more normal functioning state, making the weight loss more natural and much easier. We now know that the effects of bariatric surgery go beyond portion control and malabsorption as we once thought. In fact, the major effect of bariatric surgery is the resulting changes in body chemistry and physiology, ultimately directing existing regulatory mechanisms to drive to a lower body weight set point.

What is Set Point Theory?

Set point Theory is an idea that the human body has a specific predetermined weight that it wants to maintain. With weight gain and loss the main change is in the amount of fat mass we carry as energy store. Specific weight set point means a specific fat mass set point. Over the last 15 years there is a body of scientific evidence accumulating in favour of this theory.

It is thought that factors like your diet, exercise, stress level, sleep, day night pattern, medication etc. influence this through epigenetic phenomenon.


Would weight loss surgery benefit you?


BMI is one of the leading ways of measuring obesity,
find out if you’re a candidate for surgery.

cm
kg
Your BMI is

  • UNDERWEIGHT
  • NORMAL
  • OVERWEIGHT
  • MORBIDLY OBESE
  • SUPER OBESE

YOUR CURRENT
WEIGHT

40kg

BMI 40.0

HEALTHY BMI
WEIGHT

88kg

BMI 24.9

WEIGHT LOSS NEEDED TO
ACHIEVE A HEALTHY BMI

24kg

or 28% of your overall body weight

Your Expected weight loss in 1 year

With the most common treatment options

3.5kg

or 3.2% of your overall body weight 1

Lifestyle Changes

3.2 - 6.7kg

or 5 - 10% of your overall body weight 2,3

Prescription Medication

22 - 37kg

or 20 - 33% of your overall body weight 4

Weight Loss Surgery


Percentages are based on the weight loss averages

1) Sumithran P and Proietto J. The defence of body weight: a physiological basis for weight regain after weight loss. Clin Sci 2103; 124: 231–41.RACGP. Obesity prevention and management position statement 2019. Available at https://www.racgp.org.au/FSDEDEV/media/documents/RACGP/Position%20statements/Obesity-prevention-and-management.pdf, accessed September 2022. 2) Pilitsi E, et al. Pharmacotherapy of obesity: Available medications and drugs under investigation. Metab Clin Exp 2019; 92: 170–92. 3) Lee PC, Dixon J. Pharmacotherapy for obesity.Aust Fam Phys. 2017; 46(7): 472–7. 4) NH&MRC (2013) Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. Available at https://www.nhmrc.gov.au/about-us/publications/clinical-practice-guidelines-management-overweight-and-obesity, Accessed September 2022.

Your Expected weight loss in 1 year

With the most common treatment options


Percentages are based on the weight loss averages

1) Sumithran P and Proietto J. The defence of body weight: a physiological basis for weight regain after weight loss. Clin Sci 2103; 124: 231–41.RACGP. Obesity prevention and management position statement 2019. Available at https://www.racgp.org.au/FSDEDEV/media/documents/RACGP/Position%20statements/Obesity-prevention-and-management.pdf, accessed September 2022. 2) Pilitsi E, et al. Pharmacotherapy of obesity: Available medications and drugs under investigation. Metab Clin Exp 2019; 92: 170–92. 3) Lee PC, Dixon J. Pharmacotherapy for obesity.Aust Fam Phys. 2017; 46(7): 472–7. 4) NH&MRC (2013) Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. Available at https://www.nhmrc.gov.au/about-us/publications/clinical-practice-guidelines-management-overweight-and-obesity, Accessed September 2022.

At your BMI, the Australian Obesity Guidelines(9) recommend my target weight loss should be:


No recommendation based on your BMI.

Answer the questions below, and we can contact you to discuss your treatment options

Tell us about any other health issues

If you do not meet the BMI or weight criteria, you still may be considered for surgery if your BMI is over 30 and you are suffering serious health problems related to obesity.

Do you have either of these serious health concerns?

Have you experienced any of the following Health Risks Associated with Obesity?

BMI is not the only criteria

Something here about lifestyle or how long you’ve been trying to lose weight and what you’ve tried.

Tell us if any of these apply to you

What is your outlook on weight loss?

Readiness to begin your weight loss journey is important.

How committed are you to your weight loss journey?

Fill in your details to have these results sent to you.

If you choose, we can share information about your health, medical history and lifestyle with our team who will determine whether you are a candidate for weight loss surgery.

Complications of bariatric surgery

As with any surgical procedure , complications can occur after bariatric surgery. You may have even heard the occasional horror story and you may have some concerns. It’s true, the risks of bariatric surgery were much greater when it was first developed than it is now. However the latest data suggests that currently bariatric surgery is safer than having your gallbladder removed. This is mainly due to the advent of minimally invasive techniques and the experience we have gained with these procedures.

Bariatric operations are major surgeries involving division and joining of stomach and intestine. The human body is wired in such a way that injury to an internal organ is not readily felt. Most of the pain associated with abdominal operations come from the cut in the body wall used to gain access to the internal organs. Laparoscopic surgery removes the pain of a large body wall cut and allows patients to recover faster, giving them the impression of having had a less serious operation and a sense of safety.

Fortunately, the risk of serious complications after bariatric surgery is very rare.

You should go into any surgery with confidence. Speak with your doctor about the known potential risks and complications of the weight loss surgery of your choice, as well as any surgical alternatives that are worth considering.  This is so you can make the most-informed choice for yourself.

You are going to be in the hospital for up to three days after surgery. Most of the acute complications that can happen occur during the first four weeks after surgery. If there is a concern from your side as to the possibility of an acute complication, you should make timely contact with your surgeon. If the situation demands urgent and prompt action please contact Dr. Werapitiya on his mobile 0438967237.

Surgery involves incisions and cutting that can result in bleeding, which can vary  from minor to major bleeding. Bleeding ,if excessive, may require blood transfusion or emergency surgery and may even lead to death in extremely rare circumstances. Bleeding is most serious if it is within the abdominal cavity and the bleeding can also occur into the intestine from the bowel joint.

For patients on blood thinners and or blood pressure medication – Blood thinners can lead to a higher chance of bleeding after surgery and hence the need for stopping such medication prior to surgery under medical supervision. Uncontrolled high blood pressure is another factor that increases the risk of bleeding, hence the importance of taking blood pressure medication on the day of surgery as usual.

Chemical irritation of the belly cavity with stomach / intestinal fluid and the resulting serious infection leads to severe pain. This is pain in the upper part of the abdomen tat gets referred to the back or left shoulder. Pain gets worse with breathing, movement or drinking. You feel sick and anxious, and your heart is raising and may be having fevers with chills. You are most likely having a leak.

If a leak is suspected, you may have to undergo further tests including x-rays and emergency surgery. Initial steps in emergency surgery are aimed at controlling infection and inflammatory reaction. We do this by cleaning out the leaked content with abdominal cavity washout and diverting further leakage by placement of multiple drain tubes. Complete resolution of a leak can take a long period of time, usually requiring you to have in hospital care for a long period of time, sometimes weeks or even months. In the process, you may also require intensive care treatment or transfer to a different hospital for optimal care.

Leak after a sleeve is almost always at the upper end of the staple line. The sleeve tube has a high pressure build up within it compared to the stomach tube of a gastric bypass, which explains why a sleeve leak is generally more difficult to treat.

Also called deep vein thrombosis (DVT) and pulmonary embolus (PE). Although this is an exceedingly rare complication, it can possibly lead to death. PE is still the most common cause of mortality after bariatric surgery, with most occurring in the first 3 weeks after the procedure. Blood thinning medications will be administered while you are in hospital to minimise the risk of blood clotting, and calf compression stockings will be used to prevent blood pooling in leg veins. From your part, it is important that you get out of bed as early as possible and move your feet and legs to try and help prevent blood clots. It is also very important keeping up with your fluids to prevent dehydration.

Long term complications of bariatric surgery

There is a valve or sphincter mechanism built into the lower end of the oesophagus to prevent stomach content flowing back. When the valve mechanism is not working properly the result is reflux. After bariatric surgery, reflux can be a troublesome problem in the long term and it may be difficult to treat.

Acid reflux- The stomach lining secrets strong hydrochloric acid which can burn and injure the oesophagus when exposed. It is now known that acid reflux can be a common long term problem after sleeve gastrectomy. The small stomach tube after sleeve gastrectomy has a high pressure within it that overcomes the resistance of the lower oesophageal valve, which leads to higher chance of reflux. Acid reflux usually manifest as heartburn and is treated with strong medications that suppress the acid production. After sleeve gastrectomy, it is more common to develop a hiatus hernia and distension of the thin walled top end of the stomach tube. These factors together increase the chance of fluid reflux ,commonly leading to throat and chest symptoms due to aspiration. It is now recognized that bile reflux can also be a common occurrence after sleeve gastrectomy, which explains why there is sometimes poor response to anti acid medication.

Long term reflux can also lead to a changes on the surface of the lower oesophagus called Barrett’s change. This is a precancerous condition. There is some concern of chronic reflux increasing the chance of Barrett’s and hence, the very rare possibility of oesophageal cancer after sleeve gastrectomy.

Fixing the hiatus hernia, if there is one, and a great deal of technical precision at the sleeve operation, are important factors to prevent reflux.

It is observed that reflux after SADI-S operation is not as common compared to sleeve. Both OAGB and Roux-en-Y gastric bypass, have a lower pressure within the newly created stomach tube and have very low risk of acid reflux. While sleeve is expected to make the preexisting reflux symptoms worse, gastric bypass operation will generally make the reflux better.

Bile reflux – Bile reflux is a well recognized but rare problem after OAGB. Due to loop configuration, bile can enter the stomach tube that can reflux into the oesophagus. It is expected around 1% of people with OAGB may end up having further surgery due to bile reflux.

With the introduction of OAGB, a major concern amongst the opponents was the possibility of bile reflux leading to an increased chance of oesophageal cancer in the long term. Over the last 20 years, no case of oesophageal cancer has been reported after OAGB. However it still remains a theoretical possibility.

There is a great reduction in the food consumption after bariatric surgery which exposes to the risk of vitamin and mineral deficiencies. With intestinal bypass procedures there is an additional risk of malabsorption which increases this risk even further. To prevent this it is important that you comply with your bariatric dietitian’s recommended daily nutritional supplementation regimen. You are also required to monitor nutritional health with annual blood tests. Most commonly observed deficiencies are Iron and Vitamin D.

This is a unique complication associated with up to 5% of gastric bypass surgeries. Smoking, non-steroidal anti- inflammatory medications (Aspirin, Ibuprofen, Voltaren etc.) heavy alcohol use and H pylori infection are risk factors for ulcer formation. proportion of ulcers can go onto have further serious complications like perforation and severe bleeding which are surgical emergencies.

With sleeve gastrectomy, stomach tube dilatation at the top end with resultant pouch migration into the chest in the for of a hiatus hernia can occur. This commonly leads to reflux and regurgitation symptoms. Mid stomach tube narrowing, kink or a twist can lead to after meal obstructive symptoms. With gastric bypass narrowing of the connections between stomach tube and small bowel can lead to obstructive symptoms. Internal herniation of small bowel is a problem after Roux-en-Y gastric bypass.

Dumping syndrome is caused by rapid emptying of stomach with dumping of its content into the small bowel. symptoms of dumping syndrome include abdominal pain, weakness, sweating, nausea, diarrhoea, palpitation and dizziness soon after a meal especially high in sugar. This occurs commonly after gastric bypass surgery.

Gallstones are more common after significant and rapid weight loss like after bariatric surgery. Gastric band related complications are not discussed here as this is not an option we offer.

Gastric band related complications are not discussed here as this is not an option we offer.

A more comprehensive and a detailed list of complications will be provided to you once
after you have selected a procedure.

Request a
consultation

MM slash DD slash YYYY

Weight loss surgery Info pack

Download our free info pack to further understand the weight loss surgery process.

  • Learn more about obesity
  • Understand your procedural options
  • Prepare for surgery

Safe and effective weight loss surgery specialists.

Book a Consultation

Weight loss surgery with over 16+ years experience. We are here to help people live their best life. Get in touch.

Bunbury Practice

Suite 3,
Corner of Roberston Drive
and Bussell Highway,
Bunbury WA 6230

All Appointments

P: 08 9722 1700

F: 08 9722 1699

E: reception@countrysurgical.com.au

© WA Weight Loss Centre . All Rights Reserved. Privacy Policy.

Ask Dr Werapitiya a question

Go to Top