BATRIATRIC SURGERY & THE NECESSITY OF LONG-TERM FOLLOW-UP

Bariatric surgery, globally acknowledged for its effectiveness in treating morbid obesity, stands as a transformative solution, promising substantial weight loss and an enhanced quality of life. However, the profound impact of these surgical interventions necessitates a specialized and prolonged follow-up to address potential complications and ensure the enduring benefits of the procedure.

Why is it important to have a rigorous medical follow-up?

Bariatric surgery is the ideal solution for important weight loss and the prevention of several diseases related to obesity. However, it is all-important that the patient commit to regular medical follow-up to make sure that there are no complications after the procedure. Indeed, it is estimated that unmonitored patients throughout the years following bariatric surgery are likely to develop serious sequela. A regular medical follow-up will, therefore, ensure that the patient is responding well to the procedure. In addition, the patient will be well surrounded, advised, and receiving precise instructions to avoid possible complications. If the surgeon notices any side effects posing a risk to the patient’s health (weight gain, nutritional deficiency, digestion problems, diabetes, hypertension, and hyperlipidaemia. etc.), s/he may propose adequate solutions to remediate the problem.

What is the impact of medical follow-up?

Obesity is a chronic disease, and the risks of losing and gaining weight are elevated, thus the importance of regular medical follow-up. Monitoring will help the patient maintain good habits, stabilize their ideal weight, and adopt a healthy and positive lifestyle after surgery. Specialists will also make sure that such problems as nutritional deficiencies do not occur as they can cause serious complications to the patient’s body and nervous system. Such nutritional deficiencies can either be a lack of magnesium, or a deficiency in vitamins like B1, B9, and B12 for instance. Regardless, our nutritionists will set a detailed food programme that the patient is ought to follow to the letter. Embarking on the journey of bariatric surgery holds numerous advantages, and the subsequent medical follow-up contributes to a comprehensive well-being overhaul. As patients shed excess weight, they not only witness a remarkable physical transformation but also reconnect with an enriched sense of overall well-being. This transformative process alleviates the physical burdens of obesity, fostering heightened energy levels, improved mobility, and an amplified sense of vitality. Additionally, the positive impact on self-esteem and body image fosters a more optimistic outlook on life.

Beyond the aesthetic and psychological aspects, weight loss achieved through bariatric surgery plays a pivotal role in preventing the onset of diabetes and sleep apnoea. The link between obesity and type 2 diabetes is well-established, and the associated weight loss often improves insulin sensitivity, reducing the risk of diabetes. Similarly, excess weight contributes to sleep apnoea, a condition characterized by interrupted breathing during sleep. Bariatric surgery, by facilitating weight loss, can ameliorate or completely eliminate sleep apnoea, enhancing sleep quality and overall health. Post-bariatric surgery life introduces a transformative shift, allowing individuals to seamlessly incorporate physical activities into their daily routines. The newfound weight loss and improved mobility enable patients to engage in activities that were once challenging. Regular exercise not only aids in maintaining weight loss but also contributes to enhanced cardiovascular health, muscle tone, and mental well-being. The integration of physical activities reinforces the positive lifestyle changes initiated by the surgery, promoting a sustainable and healthy way of life.

In essence, the advantages of weight loss and medical follow-up extend beyond the physical realm, encompassing a holistic improvement in well-being. This comprehensive approach addresses the prevention of obesity-related comorbidities and empowers individuals to lead active, fulfilling lives. By combining medical oversight, psychological support, and lifestyle adjustments, patients can navigate the post-bariatric journey with resilience, embracing a healthier and more promising future.

How does bariatric surgery affect long-term cancer risk and health outcomes?

Delving into the realm of long-term health outcomes following bariatric surgery, it becomes apparent that a comprehensive understanding of potential risks, including cancer, is paramount. While the efficacy of bariatric surgery in treating obesity-related disorders is celebrated, it is crucial to examine the nuanced interplay between weight loss, metabolic changes, and cancer risk. In the realm of cancer risk reduction, research suggests that bariatric surgery may contribute significantly. Notably, there is a observed decrease in the incidence of breast cancer, endometrial cancer, and colorectal cancer among individuals who undergo successful weight loss post-surgery. The mechanisms behind this risk reduction involve not only the direct effects of weight loss but also alterations in hormonal balance and metabolic improvements.

A proactive approach to monitoring and prevention is imperative for long-term health outcomes. Endoscopic surveillance plays a critical role in post-bariatric care, especially in mitigating the risk of gastrointestinal cancers. Regular screenings and examinations enable healthcare providers to detect and address potential issues such as Barrett's oesophagus or oesophageal adenocarcinoma, preventing the progression of these conditions to more severe stages. The management of Gastro-oesophageal Reflux Disease (GORD) is another facet of post-bariatric care. Bariatric surgery often alleviates GORD symptoms, linked to an increased risk of oesophageal adenocarcinoma. Effective GORD management through surgical interventions contributes not only to an improved quality of life but also to a reduced risk of associated cancers. Considering the role of antireflux medication in long-term follow-up is pivotal. Patients who have undergone bariatric surgery may still benefit from such medications to manage residual reflux symptoms and further mitigate the risk of Barrett's oesophagus and its potential progression to cancer.

What is the psychological assessment of the patient?

During the preliminary consultation, the surgeon has to make sure that the patient’s expectations are realistic, and that they have enough determination to face the surgery’s sequela. Indeed, post-bariatric years can be psychologically draining: strict diet, food selection, regular physical activity, reduction of food quantity, elimination of fatty and sugary food, and the breaking of certain habits like drinking in between meals or snacking. Some of the latter habits, having lived with the patient for most of their life, cannot be simply broken. Some patients will feel frustrated for not being able to lose as much weight as they wish. That is why consultations with psychologists play a pivotal role in helping patients navigate these challenges, fostering a serene and balanced psyche. The psychological support aids in addressing potential frustrations, ensuring realistic weight loss expectations, and helping patients adapt positively to post-bariatric lifestyle changes.

The holistic approach to bariatric surgery involves not only the physical aspects of weight loss but also a meticulous and sustained medical and psychological follow-up. Through continuous monitoring and support, patients can achieve lasting benefits and lead healthier lives, mitigating the risks associated with obesity and its related disorders. This commitment to comprehensive care underscores the significance of medical and psychological collaboration in the post-bariatric journey, paving the way for enduring success and improved well-being.