The so-called success in losing weight is not "losing 20 kilograms", but "how to maintain it after losing 20 kilograms". Keeping weight is a long-term war of resistance. Patients often use diet pills and lose 20 kilograms in a few months, but most of them will gradually return to their original weight, even heavier than their original weight, and fall into an infinite cycle of weight loss, weight gain, weight loss and weight gain.
In recent years, with the progress of laparoscopic surgery, weight-loss metabolic surgery has been able to give more help to obese patients.
What is "metabolic surgery"?
Dr Xu Guanghan explained that the purpose of "bariatric surgery" is to help patients lose excess weight. As for "metabolic surgery", it can not only solve the obesity problem for patients, but also improve many metabolic diseases. Obese patients often have a variety of complications, including hyperlipidemia, hypertension, hyperglycemia and other problems. If the purpose of surgery is to solve metabolic diseases, it is classified as "metabolic surgery".
"Weight loss surgery" is usually through gastrointestinal surgery to limit the patient's food intake, reduce calorie absorption, and then make the patient lose weight.
"Metabolic surgery" is similar to bariatric surgery, the main difference is that the purpose of the surgery is different. This is an unexpected discovery in the development of bariatric surgery. Many obese patients have diabetes, but after surgery and weight loss, diabetes has also improved. Some people can reduce their medication, and some people don't even need to take medicine.
At first, everyone thought it was the effect of losing weight, but gradually found that it was not just the relationship of losing weight, but because bypass surgery changed hormones in the body, which could reduce insulin resistance, reduce fat absorption and improve blood sugar and blood lipids of patients.
At present, the regulations of the Ministry of Health Insurance are based on the body mass index. When the body mass index is greater than 32.5 and accompanied by obesity-related complications, such as hypertension, sleep apnea, diabetes, etc. , you can perform weight loss metabolic surgery. The American Association for Weight Loss Metabolism suggests that if the body mass index is greater than 30, weight loss metabolism surgery should be considered.
What are the common methods of weight loss metabolic surgery? What situation does it apply to?
Dr. Xu Guanghan pointed out that there are two kinds of metabolic surgery to lose weight. One is to reduce food intake, which belongs to "restrictive surgery"; One is to make intestinal absorption worse, which belongs to "malabsorption surgery" and to lose weight by reducing calorie absorption.
Common restrictive operations, including stomach volume reduction surgery and stomach water polo surgery, all rely on reducing stomach capacity to reduce food intake and achieve the purpose of losing weight. As for gastric bypass surgery, in addition to reducing food intake, it will also make the food incomplete. Doctors will tell patients the advantages and disadvantages of these two operations. Although restrictive surgery can reduce stomach capacity, many patients will change their eating patterns after surgery and prefer to eat some foods with higher calories. Therefore, after several years of restrictive surgery, many patients gradually gain weight because they do not abide by strict dietary norms, and the probability of weight gain after malabsorption surgery will be lower. However, no matter what kind of surgery, if you can't control your diet for a long time, you will get fat.
If patients have diabetes or metabolic diseases, bypass surgery is usually recommended to improve metabolic diseases.
What is the expected effect of weight loss metabolic surgery?
Dr. Xu Guanghan explained that the first half year after operation is the "golden weight loss period". Because there is a big difference in food intake compared with before, the weight has been declining and the change is the fastest. After half a year, because the body gradually finds balance, the rate of weight loss will slow down.
After accepting "stomach reduction surgery", it is expected that you can lose 33-35% of your weight within one year; After gastric bypass surgery, it is expected to lose 35-40% weight within one year. For example, a patient with a weight of 100 kg will weigh about 65-70 kg one year after surgery, which is an effect that other weight-loss methods can't achieve, and the weight-loss effect can last for a long time.
What should I pay attention to after weight loss metabolism surgery?
Dr. Xu Guanghan emphasized that the most important thing to pay attention to after weight-loss metabolic surgery is "diet". We will teach some diet methods and ask them to strictly abide by them. We must cherish the remaining food intake and eat some foods with nutritional value rather than high calorie, so as to achieve a good weight loss effect and maintain it well.
At present, there are standardized procedures for the nursing of weight loss metabolic surgery. From preoperative evaluation, surgical process to postoperative care, very standard procedures have been established. If there is no accident, you usually only need to stay in the hospital for 2-3 days before you can go home. For doctors with rich experience in weight-loss metabolic surgery, the incidence of surgical complications can be less than 1.5%, and the common complications include bleeding, leakage and intra-abdominal infection. The mortality rate of surgery is about one in a thousand to three in a thousand.
Due to the change of gastrointestinal structure, some people will have "food dumping syndrome" after eating 10- 15 minutes, with symptoms such as abdominal distension, nausea, dizziness, fatigue and cold sweat. Avoid eating sweets or drinking sugary drinks.
What should I pay attention to in diet and life after operation?
Dr. Xu Guanghan reminded that the food intake after weight-loss metabolism surgery is much reduced. Only by making good use of the remaining food intake and eating more foods with high nutritional value can we be thin and healthy, and the medical team will continue to remind the importance of postoperative diet. It is recommended not to do exercise within one month after operation, and start light exercise one month later. Regular exercise habits can maintain muscle strength, because muscles will also be lost during weight loss, and moderate exercise helps to maintain muscle mass. If there is a birth plan, it is best to get pregnant one year after the operation, and it is more appropriate to get pregnant in two years.
In the face of weight-loss metabolic surgery, the patient's psychology is sometimes very complicated, because he used to be able to eat and drink, but after the operation, he became unable to eat, became depressed and unhappy, and needed the company and support of family and friends. The medical team can provide all kinds of assistance to help patients lose weight smoothly and live a healthy life!