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  • Gleneagles Singapore

Bariatric and Metabolic Surgery

  • What is Bariatric Surgery?

    Bariatric surgery is a surgical intervention for obesity. This type of surgery has been proven to be more effective than lifestyle, dietary and medical interventions in the management of obesity.

    Metabolic surgery is a surgical intervention to improve the co-morbidities associated with obesity. These include conditions such as type 2 diabetes mellitus, heart disease, hypertension, obstructive sleep apnoea (OSA) and fatty liver.

    Bariatric and metabolic surgery involve making changes to different parts of the gastrointestinal (digestive) tract, such as the stomach and/or intestine, to bring about weight loss.

    There are many types of minimally invasive bariatric and metabolic surgery, and these are 4 of the most common types performed in Singapore:

    • Laparoscopic sleeve gastrectomy (LSG) is used to permanently reduce the size of the stomach to about 25% its original size, which then becomes like a sleeve or a tube.
    • Laparoscopic Roux-en-Y gastric bypass (LRYGB) is another type of bariatric and metabolic surgery. It partitions the stomach into a smaller pouch with a loop of the small intestine attached directly to it. Hence, bypassing the rest of the stomach and the first part of the small intestine. LRYGB works by not just reducing food intake, but also by limiting the body’s absorption of calories and fat, decreasing appetite, and also by resetting the body weight set point. Patients with diabetes may benefit from this type of procedure.
    • Intragastric balloon involves placing a saline-filled balloon in the stomach using an endoscope. This balloon induces a sensation of fullness so patients will be inclined to eat less. There are other intra-gastric balloons that can be swallowed and may not require gastroscopy-guided insertion.
    • Laparoscopic adjustable gastric banding (LAGB) is used to manage morbid obesity. This surgery involves reducing the size of your stomach by placing a silicone band around the upper end of the stomach. You will then feel full faster, eat less, and thus lose weight. This surgical option is being phased out in favour of the more effective LSG and LRYGB options.
  • Bariatric and metabolic surgery can successfully manage an obese patient’s weight and greatly improve obesity-associated disorders. However, a doctor will determine whether bariatric and metabolic surgery is a suitable treatment option for a patient. 

    Obesity is defined as a body mass index (BMI) of 30kg/m2, and it is usually linked with co-occuring conditions that lower life expectancy (lifespan). For Asians, Class 1 Obesity is defined as having a BMI of more than 27.5kg/m2. Bariatric surgery is usually medically recommended for patients with a BMI more than 37.5 without obesity related co-morbidities and who don’t suffer from any other co-occuring conditions. Metabolic surgery is also advised for patients with a BMI over 32.5 with obesity related conditions such as diabetes mellitus, high blood pressure, high cholesterol, obstructive sleep apnoea (OSA) caused by blockage of the upper airways, and fatty liver.

  • Studies have shown that patients typically lose the most weight after 1 – 2 years after bariatric and metabolic surgery. They are then able to maintain substantial weight loss with improvements in their associated medical conditions that required them to undergo the surgery.

    Patients may lose up to 60% of excess weight six months after surgery, and up to 77% of excess body weight as early as 12 months after surgery. However, this has to be accompanied with change in dietary and lifestyle modification with advice from dietitian and physiotherapist.

    Majority of bariatric and metabolic surgery patients with diabetes, hyperlipidemia, hypertension and obstructive sleep apnoea (OSA) experience complete resolution or improvement.

    Learn more about bariatric surgery and the post-surgery recovery process.

  • At Gleneagles Hospital, we are committed to giving you comprehensive care. Our multidisciplinary team of specialists, dietitians, nurses and therapists are here to guide you through the entire treatment and recovery process. Enquire to find out more from our general surgeons.

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