Bariatric surgery or Weight-loss Surgery

Bariatric surgery or weight-loss surgery helps people lose weight and lowers risk of medical problems associated with obesity such as Type 2 Diabetes, high blood pressure, and coronary artery disease. Obesity is a medical condition that has accumulated excess body fat to the degree that it can have a negative health effect.

There are a number of different ways to measure obesity. The most common method to measure obesity is the Body Mass Index (BMI). BMI is a measure of body fat in adults which is calculated by dividing a person's weight in kilograms by his/her height in meters squared (kg/m2).(BMI = kg/m2)

A BMI of 25.0 or more is overweight, while the healthy range is 18.5 to 24.9. Refer to the table below:

BMI (kg/m2) Classification
From - up to
18.5 underweight
18.5 to 25.0 normal weight
25.0 to 30.0 overweight
30.0 to 35.0 class I obesity
35.0 to 40.0 class II obesity
40.0 class III obesity

The other most common way to screen for obesity is to measure your waist circumference. To correctly measure waist circumference:

  • Stand and place a tape measure around your middle, just above hipbones
  • Make sure measuring tape is horizontal around the waist
  • Keep the tape tight around the waist, but not compressing the skin
  • Measure your waist just after you exhale

A man whose waist circumference is more than 40 inches or a non-pregnant woman whose waist circumference is more than 35 inches are at a higher risk of developing obesity-related conditions.

BMI and waist circumference are two measures that can be used as screening tools to estimate the status of weight in relation to the potential risk of disease. However, BMI and waist circumference are not diagnostic tools for risk of disease.

Obesity is mostly preventable through a combination of lifestyle and dietary modifications. Bariatric surgery or weight-loss surgery are typically done only after one has tried to lose weight by improving diet and exercise habits. Bariatric surgery or weight-loss surgery can help obese people shed extra kilos and also improves diabetes and hypertension.

Types of Weight-loss Surgery

Most weight loss surgeries are performed using minimally invasive techniques or laparoscopic surgery. Bariatric surgical procedures help in losing weight by limiting the amount of food the stomach can hold, causing malabsorption of nutrients or by a combination of both gastric restriction and malabsorption.

The two most common laparoscopic weight loss surgeries are Roux-en-Y Gastric Bypass and Sleeve Gastrectomy. Both can be performed by minimally invasive procedures. Both surgeries have their own advantages and disadvantages.

Roux-en-Y Gastric Bypass

The Roux-en-Y Gastric Bypass often called gastric bypass surgery is the most commonly used bariatric procedure worldwide in order to achieve weight-loss. The laparoscopic procedure to perform this surgery can be divided into two components. First, the laparoscopic surgeon shrinks the size of the stomach pouch by stapling part of the stomach together or by vertical banding. This limit how much food one can eat. Then the surgeon attaches a Y-shaped section of the small intestine to the pouch creating a bypass for food. By doing this, it skips part of the digestive system. As a result, fewer calories and nutrients are absorbed.

Sleeve Gastrectomy

Sleeve gastrectomy or vertical sleeve gastrectomy is a weight-loss procedure which is typically performed laparoscopically. The procedure involves removing of about 75% of the stomach and leaving a tube-shaped stomach about the size and shape of a banana. After surgery stomach can hold less food which induces rapid and effective weight loss. As no foreign body implanted (as with the adjustable gastric band) with sleeve gastrectomy, and there is no complex intestinal rearrangement (as with the gastric bypass), patients recover sooner.


Long-term studies show the weight-loss surgery or bariatric surgery causes significant long-term loss of weight, recovery from diabetes and improvement in cardiovascular risk factors. After recovery, patients are able to comfortably eat a wide variety of foods, including meats and fibrous vegetables.

Risks & Aftercare

All forms of weight-loss surgery, including gastric bypass or sleeve gastrectomy, are major procedures that can pose risks and side effects. Patients are at risk for nutrient deficiencies. One must make permanent healthy changes to diet and get regular exercise to help ensure the long-term success of weight loss surgery.

Before the procedure, Dr. Mir Asif Rehman, General & Laparoscopic Surgeon will evaluate medical history and perform a complete physical examination to minimize risks.

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