Techniques to treat obesity and diseases associated with it

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Bariatric and metabolic surgery prolongs the life of obese patients by ten years, in addition to considerably improving their quality of life by managing to remit diseases such as hypertension, dyslipidemia or sleep apnea

 

Changes in lifestyle, sedentary lifestyle, lack of physical exercise and abandonment of the Mediterranean diet have led to an increase in overweight and obesity among the po[CENSORED]tion. The figures speak for themselves: Spain has 16.7% of its adult po[CENSORED]tion over 18 years with a Body Mass Index greater than 30 kg / m2; The EU average is 15.9%. Also, from 2008 to 2014, this percentage increased by 1% in Spain.

It is worth mentioning a fact that, at least, is alarming, and since 1975, people who are overweight and obese have almost tripled worldwide. In 2016, more than 1900 million adults 18 and over were overweight, of which more than 650 million were obese.

The consequences of obesity, also called the S.XXI epidemic, have associated serious health problems such as ischemic heart disease, high blood pressure, cardiovascular diseases, respiratory failure, osteoarthritis, the appearance of certain types of tumors and type 2 diabetes. Precisely , obese people are at three times the risk of diabetes than people who are not obese.

Diabetes, like obesity, can be cured with surgery and the data is clear: more than 80% of obese patients who undergo bariatric or metabolic surgery are no longer diabetic.
 

Endoscopic surgery: intragastric balloon
The intragastric balloon technique consists of a latex sphere filled with physiological serum that is placed endoscopically in the stomach under sedation and without the patient's admission. "Its main effect," explains Dr. Juan Antonio Casellas, specialist in endoscopic techniques of the Obesity Unit of Alicante, "is the decrease in stomach motility reducing the emptying time after food intake and causing, in most of cases, a feeling of early satiety during meals. "

This technique is indicated in those patients who are overweight or the so-called type I obesity, that is to say that their BMI is less than 29 and that they have already tried to lose weight with diets previously and have not achieved results. According to different studies, the average loss of a patient with a balloon is between fourteen and sixteen kilos after six months.

The specialist also warns that the weight loss achieved with an intragastric balloon is only permanent in those patients who have managed to change their eating and exercise habits in a sustained manner over time, without these two premises there is a high possibility of recovering the lost weight in less than three years, so Dr. Casellas recommends the continuous supervision of a team of professionals to maintain weight loss.

 

Bariatric and metabolic surgery as a solution
The disease that is most often associated with excess weight is type 2 diabetes, which appears in adults who are overweight and obese because the increase in body fat increases the resistance to the action of the insulin produced the pancreas, which has to work more than necessary in these cases, and eventually runs out.

The association of type 2 diabetes with overweight-obesity is so consistent that it has led to the definition of the concept of diabetes.

Bariatric and metabolic surgery prolongs the life of obese patients by ten years, in addition to considerably improving their quality of life by managing to remit diseases such as type 2 diabetes, hypertension or dyslipidemia, and reducing the risk of tumors, especially of the colon or breast, according to Dr. Carlos Sala, specialist in the Obesity Unit of the Quirónsalud Hospitals Alicante and Valencia.

Among the techniques that have demonstrated the most efficacy and safety to date are tubular gastrectomy and gastric bypass. "Both methods have already proven a low mortality, a small number of complications and a high efficiency in the resolution of diabetes and associated diseases," says the doctor.

These interventions are performed laparoscopically, through minimally invasive surgery, which reduces pain and possible complications. The patient is prepared to leave the hospital 48 hours after the intervention.

Both laparoscopic vertical gastrectomy and laparoscopic gastric bypass are effective against diabetes, which remits in 80-90% of patients, improving in the remaining 20%. however, the bypass seems more effective against hypertension and dyslipidemia. Both techniques also facilitate weight loss.

Currently, the best and most promising is laparoscopic vertical gastrectomy or gastric tube, which reduces the volume of intake and also causes a metabolic effect correcting diabetes. Since 2014 it is the technique that is most performed in the world. It is very physiological because it does not produce malabsorption, avoiding nutritional deficits.

It is indicated in patients with BMI between 35 and 45, with mild comorbidities, and with ease for dietary compliance. In patients with gastroesophageal reflux (heartburn) and severe esophagitis we preferably recommend bypass because it also corrects it.

In addition to reducing the volume of intake they associate a controlled malabsorption. The best and most accepted of all bariatric techniques against morbid obesity is laparoscopic gastric bypass. The Gold Standard or Gold Standard Technique is considered against which the other techniques are compared.

It is recommended, particularly, in patients eating candy, in patients with gastroesophageal reflux and esophagitis (heartburn), and in patients with Metabolic Syndrome.

These types of techniques are especially indicated in the treatment of patients with a body mass index greater than 35 or even if it is lower but it causes serious associated diseases, such as diabetes with poor metabolic control, high blood pressure, dyslipidemia or obstructive apnea syndrome. of the dream

These methods help reduce 70-80% of excess weight of obese patients and offer highly satisfactory results in patients suffering from type 2 diabetes, which allows them to completely abandon their medication, and prevents the onset of any type of associated disease.