Did you know that bariatric surgery can help you lose about 50% of your excess body weight?

What is bariatric surgery?

Bariatric surgery for weight loss, also known as metabolic surgery, offers obese individuals a realistic and sustainable alternative to other weight loss options.

Research shows that this surgery can help patients lose approximately 50% of their excess body weight compared to the 5-10% that can generally be achieved with the aid of traditional weight loss diet and exercise programmes.

How does bariatric surgery work?

The surgery is undertaken laparoscopically through small puncture holes in the abdomen to support weight loss by limiting your food intake. It also reduces the absorption of nutrients by the digestive system and stops the normal signaling from the stomach to the appetite centre in the brain, thereby effectively reducing food cravings.

The small pouch at the top of the stomach, created during the bariatric surgery, quickly fills and stretches. This activates signals to the brain to powerfully switch off appetite to prevent overeating. Bypassing the first part of the small intestine also causes dramatic changes in gut hormones secreted in response to food, thereby restoring the hormones to levels seen in lean individuals. You will generally find that you will feel satiated, or full, after eating smaller portions of food.

So much more than just a treatment for obesity

Though commonly regarded as a treatment for obesity, there are many health benefits associated with bariatric surgery.

So much more than just a treatment for obesity

Though commonly regarded as a treatment for obesity, there are many health benefits associated with bariatric surgery.

Benefits for associated medical conditions

Ongoing results demonstrate a high degree of success in bariatric surgery resolving associated medical conditions such as impaired glucose tolerance, metabolic syndrome and type 2 diabetes, hyperlipidaemia, blood pressure, fat infiltration of the liver, sleep apnoea and infertility. There is also some evidence of improved heart function with decreased ventricular wall thickness and decreased chamber size.

So much more than just a treatment for obesity

Though commonly regarded as a treatment for obesity, there are many health benefits associated with bariatric surgery.

Benefits of early surgical intervention

Early surgical intervention has shown outstanding results in preventing obese patients with impaired glucose tolerance – referred to as prediabetes – from progressing to type 2 diabetes.

So much more than just a treatment for obesity

Though commonly regarded as a treatment for obesity, there are many health benefits associated with bariatric surgery.

Benefits for type 2 diabetics

  • Improved glycaemic control
  • A reduction in the use of medication
  • A reduction in cardiovascular disease risk
  • A reduction in heart attack, stroke, cancers and in overall mortality rates
  • Improved weight loss and quality of life
  • Improved mobility and stamina

So much more than just a treatment for obesity

Though commonly regarded as a treatment for obesity, there are many health benefits associated with bariatric surgery.

Benefits for mental health and general wellbeing

The benefits of bariatric surgery are certainly more than just cosmetic as there is also considerable evidence of improved mood, self-esteem and overall quality of life. Furthermore, patients who have had bariatric surgery report improvements in their interpersonal relationships.

Why choose Netcare for your bariatric surgery?

  • There are currently five centres of excellence for metabolic medicine and bariatric surgery at Netcare hospitals. These are at Netcare Waterfall City Hospital in Gauteng, Netcare St Augustine’s Hospital in KwaZulu-Natal, Netcare Greenacres Hospital in the Eastern Cape, and Netcare Blaauwberg and Netcare N1 City hospitals in the Western Cape. Bariatric surgery is also offered at Netcare Unitas Hospital in Gauteng.

  • The internationally accredited centre at Netcare Waterfall City Hospital in Midrand, Gauteng – under the aegis of renowned endocrinologist Professor Tess van der Merwe, chairperson of the South African Society for Surgery, Obesity and Metabolism (SASSO) – is the principal centre for the four locally SASSO accredited bariatric centres located in Netcare hospitals.

  • Accreditation gives you the assurance that these centres of excellence adhere to best international practices to create a safe environment that supports patients with empathy and care. SASSO accredited centres also follow strict rules and regulations regarding patients’ dietary environment, as well as care in ICU and wards. To comply with international standards, a database with statistics on each patient’s progress is maintained.

Who could qualify for bariatric surgery?

Various criteria are taken into consideration before a patient is accepted for
bariatric surgery:

Patients between the ages of 18 and 65 years with a body mass index (BMI) score of 40kg/m2 or more

Patients with a body mass index (BMI) score of 35kg/m2 or more and at least 2 serious comorbid conditions

  • SASSO accredited centres also require you to undergo a thorough physiological and psychological evaluation to ascertain your suitability for bariatric surgery.

  • You must have made multiple attempts, in good faith, to achieve weight loss through conservative means such as dietary or pharmacological weight loss programmes before you will be considered by the multidisciplinary team for bariatric surgery.

  • As there can be numerous highly complex physiological and psychological causes of obesity, and each person has a completely different constitution and metabolic makeup, every case is unique and not everyone can have, or will respond well, to the treatment.

  • Bariatric surgery is not a quick fix solution. It is important that you fully understand what the procedure will entail, the implications thereof, and are able to commit to long term lifestyle changes and medical follow ups.

Types of bariatric procedures and their application

Several types of bariatric surgery are offered by the SASSO accredited centres at Netcare hospitals. To ensure optimal long term resolution of diseases such as diabetes, it is important that the right procedure is selected for the right patient.

The surgeries offered are either restrictive or malabsorptive in nature, or a combination of both.

Restrictive procedures

Restrictive procedures include adjustable gastric banding (AGB) and gastric sleeve (GS).

Malabsorptive procedures

Biliopancreatic bypass procedure (BPD) and biliopancreatic bypass with duodenal switch operation (BPD-DS).

Learn more

Combination procedure

The Roux-en-Y gastric bypass procedure (GBP) is the most commonly performed bariatric procedure.

Learn more

Your bariatric surgery journey

The multidisciplinary team follows a comprehensive process to evaluate and treat candidates before bariatric surgery will be confirmed.

Before surgery

01

Complete documentation

The first step is to complete documentation that will be provided to you.

Before surgery

02

Psychologist evaluation

After completing your documentation you will usually meet with a psychologist — who is a member of the multidisciplinary team — for an evaluation. Where appropriate, the psychologist may refer you to a psychiatrist for treatment. Family sessions are an essential part of this process.

Before surgery

03

Dietician evaluation

In line with the multidisciplinary approach, you will also be seen by a dietician who will evaluate your dieting history and will prepare a special eating plan taking your cultural requirements and dietary preferences into consideration.

This is an essential step to foster some of the routines that you will have to adhere to after surgery. It is also an essential part of improving your physical health and nutritional education.

Before surgery

04

Endocrinologist evaluation

Next, you will be seen by the specialist endocrinologist for a comprehensive evaluation and initiation of a treatment protocol before your eligibility for surgery can be confirmed.

Before surgery

05

Surgeon consultation

Prior to surgery you will consult with the surgeon so that various investigative tests can be done as prescribed by the endocrinologist. These may include a gastroscopy, relevant blood tests, a lung function test and echocardiogram. If you have comorbidities such as diabetes or hypertension, these would need to be understood and adequately treated before surgery can be approved. The specialists will discuss all possible complications with you during face to face consultations.

During surgery

06

Day of surgery and thereafter

You will be admitted to hospital on the morning of the surgery. Patients are not routinely admitted to the intensive care unit after surgery. You will usually be discharged from the hospital on the third or fourth day after surgery. The recuperation period ranges from four to six months.

After surgery

07

What now?

In most cases, where patients are treated and properly supported before and after surgery by a multidisciplinary team and the surgery is safe for the patient, life changing results are achievable if you follow a special post-operative diet and adhere to lifelong medical follow ups and vitamin replacements. To help ensure lasting, quality outcomes, the healthcare team remains in contact with patients and encourage them to attend monthly support group meetings.