Surgery to fight obesity

This week, Kiko Rivera It has surprised us with a striking makeover and we have noticed a great loss of volume. His health problems with gout and overweight were already known. It seems that the DJ may have had surgery, not determined, to treat obesity. Also the Argentine star Diego Armando Maradona and the cook David de Jorge Similar techniques were performed to treat your problems with the scale.

If we turn to history, Sancho I, King of León and Navarra, in the tenth century, suffered a striking obesity that raised criticism and was rejected to occupy the throne. The treatments that his doctor applied were from sewing his mouth and feeding him with a straw to make him walk from Navarra, where the King lived, to Córdoba, where the doctor resided. History says he succeeded and was able to occupy the throneFortunately, the bullfighter's son has not had the same doctor.

Your diagnosis

He Body Mass Index (BMI) is often used to assess obesity. Not to be complicated, there are tables to calculate it automatically by entering the height in centimeters and the weight in kilograms in any of the multiple Internet pages or mobile applications. A person who has a BMI greater than 30 is considered obese. For example, a person who measures 1.65 m and weighs 82 kilos is considered obese since his BMI is greater than 30.

Nowadays, obesity is considered a serious social and health problem that is on the rise. Serve as an example that a person with a BMI above 40 has half the life expectancy of an overweight person. In general terms, Surgical treatment is advised in patients with BMI above 40 or with BMI between 35-40 who have diseases related to obesity, such as hypertension, type 2 diabetes or sleep apnea, in which other treatments have failed.

Although it is necessary to evaluate each case individually, it is preferable to reduce weight by low-calorie diet and a change in habits that include regular exercise and healthy diet. For obesities of lesser degree or as preparation for the surgery of large obese patients, there is the possibility of placing a balloon inside the stomach (gastric balloon) filled with serum using endoscopic techniques that can be had for approximately six months.

Surgical techniques

Usually three are performed and are usually done laparoscopically in most cases. The first is the gastric sleeve, which basically consists of the Stomach reduction by 70-80%, being this in the form of a tube, so that the patient quickly satisfies himself and reduces the amount of food he eats. The second is the adjustable gastric bands, which are silicone rings that are placed at the entrance of the stomach to reduce their capacity and that can be modified by filling or emptying a small tank of subcutaneous saline serum connected to them.

This technique achieves the same as with the previous one and it also has the advantage that a part of the stomach is not removed, It is reversible and safer. However, the long-term results are worse. The gastric bypass (gastro-jejunal bypass), consists in the elimination of three quarters of the stomach and the union of the part that is left with a more distant intestinal area (jejunum), thus skipping an important part of the intestine and avoiding the absorption of fats and other nutrients ..

It is a technique that adds an absorption deficit to the previous ones. These techniques are performed when they are indicated both in public health and through some medical insurance and in private hospitals.

Pros and cons

As seen in various studies, with the three techniques described, long-term weight is lost significantly. The one that produces the best results is the derivation, but it is also the one that can cause the most problems due to the poor absorption it produces of some nutrients such as vitamin B12.

Some patients will have difficulty adapting to changes in their diet after surgery and revisions, which are necessary to control some deficiencies in their nutrition. They should also know the adverse effects they may suffer, such as reflux, hypoglycemia, etc.

Is periodic medical check-up and nutritional re-education are necessary by a multidisciplinary team with a nutritionist, a psychologist, etc. If new nutritional habits are not acquired by incorporating physical activity as a daily routine, it is very likely that the lost weight will be recovered again.

David Saldaña Garrido. Thoracic surgery Nisa Pardo Aravaca Hospital. Vice President of NEUMOMADRID.