Pregnancy can be a roller-coaster ride but the result is ecstatic. Women tend to get highly anxious during their pregnancy. Several questions are asked about safety-related issues in pregnancy post-bariatric surgery. This is because there might be some complications related to pregnancy. For example, around 10 % of women suffer from anemia after weight loss surgery. Are you thinking to conceive but concerned about the consequences of bariatric surgery that you have undergone already?

Weight loss surgery, also known as bariatric surgery is a procedure used to help in weight loss by making changes to the digestive system. For example, some form of surgeries cut out a portion of the stomach, which leads to less consumption of food and drinks at one time and makes the person feel full earlier. Other types of surgeries create changes in the small intestine, leading to lesser absorption of calories from food and beverages.

Different types of weight loss surgery are listed below:

1. Endoscopic sleeve gastroplasty

2. Gastric bypass

3. Sleeve gastrectomy

4. Intragastric balloon

5. Biliopancreatic diversion with duodenal switch

How does being obese or over-weight affects pregnancy?

Pregnant women who are obese or overweight, and have a BMI of more than 25 generally have a tendency for high-risk pregnancy. The risks usually include,

• Thrombosis (formation of blood clots)

• Hypertension

• Preeclampsia

*preeclampsia involves multiple symptoms such as raised blood pressure (more than 140/90), excess protein in the urine, kidney-related issues.

• Gestational diabetes

• Heavy bleeding after birth

• Premature birth

• Longer labor period

• Risk of miscarriage

• Sleep apnea

• Stillbirth

• High birth weight of the baby

• Risk of obesity and diabetes to the baby in later stages.

How much time after the weight-loss surgery, should one conceive?

Obesity-related risks in pregnancy are highly reduced after having bariatric surgery. Some of the top gynecologists in India usually recommend a gap of 12-18 months after the surgery to get pregnant in order to wait for the weight to stabilize. This is because rapid and continuous weight loss may lead to a deficiency of important nutrients required for the baby to grow. Moreover, when you plan a pregnancy, you must consult your physician so that he/she is able to meet the nutritional needs during pregnancy.

A few things to keep in mind during pregnancy after the weight loss surgery

• Regular health checkups at short intervals

• Active gastric band management

• A good diet as advised by a dietician.

• Food intake at regular intervals

Is it safe to have a pregnancy after bariatric surgery?

Yes. This is because women with high levels of BMI have more tendency to have complications like gestational diabetes, high blood pressure. Weight loss helps in reducing the chances of these risks. In fact, studies have shown that there is a positive effect at the hormonal level. Bariatric surgery causes a decrease in the levels of estrogen and testosterone and increases in the level of FSH, LH, and SHBG. Several patients have reported correction in irregular menstrual cycles, regular ovulation and also spontaneous conception. People having gonadal dysfunction before the surgery was also corrected by weight loss. Moreover, 96% of women had a reduction in signs of hyperandrogenemia and amelioration of menstrual anomalies after the surgery.

What is bariatric surgery?

It is a series of weight loss procedures done for weight loss by removing a portion of stomach.

It is usually recommended to individuals who are obese and have BMI between 35-40.

This is done in cases where exercise and other natural methods fail to fetch results. These surgeries not only help in weight loss but also reduce appetite. The person feels full after eating lesser food.

These surgeries work in 2 ways-

1. Create a physical barrier and and restricts the amount of food that the stomach can hold.

2. Shortens the part of intestine, causing limited absorption of the calories and the nutrients.

Types:

Benefits of Bariatric surgery

Bariatric surgery has heaps of advantages most of which remain unacknowledged many times. However, it is a boon to society. With the help of the best bariatric surgeons in India, the benefits are multiplied many folds.​ The procedure results in controlling and curing various ailments.

• Type 2 diabetes– this happens when the body cells fail to absorb insulin from the blood, resulting in high blood sugar levels. Mostly caused by obesity, high intake of artificial sweeteners, eating high carbohydrate food or lack of physical activity. Bariatric surgery helps in weight loss and reduces the hunger of the patient, which results in restoring the health.

• Cardio-vascular disorders– Bariatric surgery significantly helps in lowering of raised cholesterol levels, triglyceride levels and blood pressure of the body. This leads to prevention of heart related diseases such as coronary heart disease, heart stroke or peripheral heart disease.

• Psychological benefit– people often feel depressed or embarrassed about themselves when they are obese. The surgery boosts a great amount of confidence in them. They start living their lives happily and with positive attitude.

• Sleep apnea– bariatric surgery has reported to treat sleep apnea in many people. Most of them have stop using the cPAP machine.

• Joint pain relief– loss of weight by the bariatric surgery also reduces stress on the weight-bearing areas of the body such as knee joints. This provides a great deal of relief to people with joint pain.
  – this condition is eminently related to obesity. The bariatric surgery associated with hormonal changes can bring remarkable improvement in PCOS. This also boosts fertility of the patient. Studies have shown that women who underwent gastric bypass surgery, had restored menstrual cycles, reduction in excessive body hair and decreased level of androgen.

Other than these, there an extensive list of medical conditions, which are markedly improved by bariatric surgery.

• Migraine

• Pseudotumor cerebri (idiopathic intracranial hypertension)

• Asthma

• Non-alcoholic fatty liver disease

• GERD

• Metabolic syndrome

• Gout

• Urinary stress incontinence

• Venous stasis disease

Cost:

The cost of bariatric surgery in India is reasonable. However, it highly depends on the hospital and the location in India.

Obesity is not only just about heavy weight. It is also about the other medical conditions that gradually develop in ones body pushing them to their death. But surgical procedures, commonly known as weight loss surgery or bariatric surgery procedures help extensively to eradicate obesity along with their problems. Here are the most common bariatric surgery procedures and all the details that you need to know about them:

Gastric Bypass Surgery

Gastric bypass surgery is performed to reduce the patient’s appetite by cutting and connecting a small portion of the stomach to the small intestine.

Procedure

Gastric bypass surgery, also known as roux-en-Y, involves cutting out of the top portion of the stomach connected to the esophagus in the shape of a small pouch. The small intestine is further cut and then attached to the bottom of the roux limb.

Advantages of the procedure

With the help of gastric bypass surgery one can experience 60 – 70% weight loss. Some even loose weight for about 18 – 24 months.

As this surgical procedure cuts down the appetite and weight of the patient many of the other problems, which go hand-in-hand with obesity, like diabetes and high blood pressure are also reduced.

Cost

The cost of a gastric bypass surgery in India starts from USD 6,000.

Patient stay

• In Hospital: 3 days
• In India: 10 days

Know more:

• Bariatric Surgery Hospitals in India
• Bariatric Surgery Doctors in India

Gastric Sleeve Surgery

Like gastric bypass surgery, gastric sleeve surgery or sleeve gastrectomy helps one to lose weight and curtail a significant amount of their appetite.

Procedure

Gastric sleeve surgery is performed either with a laparoscopic approach or with the help of an open incision. Unlike gastric bypass, this procedure only concentrates on cutting down large portions of the stomach in the shape of a thin vertical sleeve or tube.

Advantages

Though regular follow up is necessary, gastric sleeve surgery reduces more than half of the patient’s body weight. As the ghrelin hormone is removed during the surgery, appetite of the patient is reduced and he or she can have any food in small quantities.

Cost

The cost of gastric sleeve surgery in India is approximately USD 5,300.

Patient stay

• In hospital: 3 days
• In India: 10 days

Laparoscopic Adjustable Gastric Banding

Gastric Banding is one such bariatric or weight loss surgery whose procedure can be reversed.

Procedure

After making small incisions (laparoscopy) on the belly, the bariatric surgeon would tie a silicone band around the upper part of the stomach that gives it a squeezed pouch-like form. The silicone band is connected to a device just under the skin with the help of a plastic tube. Doctor can change the tightness of the band by injecting or removing saline from the band with the help of the device.

Advantages of gastric band

Since it is a reversible procedure, it is less risky than the other bariatric procedures. In the first two years of the surgery, patients will experience 50 – 60% reduction in their weight.

Cost

The cost of laparoscopic adjustable gastric banding surgery in India approximately amounts to USD 5,000

Patient stay

• In Hospital: 1 day
• In India: 6 days

Duodenal Switch

Duodenal switch also known as biliopancreatic diversion with duodenal switch or gastric reduction duodenal switch is performed to reduce the span of time given to the body to absorb calories as well as to partially prevent the absorption of fat.

Procedure

A large portion of about 70% of the stomach is removed along with the duodenum while a longer portion of the small intestine is rerouted creating two separate paths and one common channel (the portion of the small intestine).

The shorter path is known as the digestive loop whereas the longer path is called biliopancreatic loop. Before travelling to the large intestine, the food content from the digestive loop and the bile from the biliopancreatic loop mix in the common channel.

This arrangement allows the body very less time to absorb calories and fat, thus, playing an important path in the reduction of weight.

Advantages

The advantages of duodenal switch include recovery from diabetes, cardiovascular diseases, sleep apnea, degenerative joint disease, depression, hypertension and many other health conditions. The surgery procedure though complex reduces the patients body weight almost by 80% in a year.

Cost

The cost of duodenal switch in India starts from USD 5,200.

Patient stay

• In hospital: 1 day
• In India: 15 days

Laparoscopic Biliopancreatic Diversion

Laparoscopic biliopancreatic diversion is another malabsorptive surgical procedure that checks the absorption of calories and fat in the bloodstream.

Procedure

The procedure initially involves the removal of two-third of the stomach. After that, the first two parts of the small intestine, the duodenum and the jejunam is bypassed to shorten it. Finally, the illium (later part of the small intestine) is attached to the remaining portion of the stomach. The surgery is performed laparoscopically.

Advantages

Laparoscopic biliopancreatic diversion improves health as well as mobility. This surgery procedure is also adjustable and partially reversible. Almost 75 – 80% of weight loss is maintained even after a decade post operation.

Cost

The cost of laparoscopic biliopancreatic diversion in India starts from USD 6,000.

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