The many benefits of metabolic surgery

Posted on 30 January 2020

A group of surgeons at Mediclinic Bloemfontein are helping obese patients find a way back to health by making strides in metabolic surgery.

Our understanding of weight-loss surgery is expanding. While the various forms of bariatric surgery were named back in 1953, after the Greek word for weight, experts now refer to these procedures as varieties of metabolic surgery.

Why? Because they offer patients so much more than weight-loss solutions, explains Dr Geofré Heyns, a specialist surgeon at Mediclinic Bloemfontein.

Dr Heyns is a member of Bloem Bariatrics, an accredited Centre of Excellence for Metabolic Medicine and Surgery, as certified by the South African Society for Surgery, Obesity and Metabolism situated at Mediclinic Bloemfontein.

Bariatric surgery is commonly performed in order to help obese patients lose excess weight, says Dr Heyns. This in turn reduces their risk of potentially life-threatening, weight-related health issues, or comorbidities. However, its usefulness extends beyond those who suffer from obesity, he explains.

“Typically, bariatric surgery is recommended for those with a body mass index (BMI) of over 40, or with a BMI of between 35 and 40 and accompanying comorbid diseases, such as chronically high blood pressure,” he says. “However, we are seeing that this surgery is also very effective in helping to treat patients with a lower BMI but who suffer from Type 2 diabetes.”

This is why experts now prefer to label the procedures as metabolic surgery – recognising that they have a profound effect on how the body’s cells process food and energy.

Bariatric surgical procedures work on a principle of causing either a restriction in the calories you take in, or malabsorption of the nutrients you consume, or a combination of these. In South Africa, general surgeons at accredited centres perform two types of bariatric surgery.

In performing a Roux-en-Y gastric bypass, a surgeon creates a small pouch at the top of the stomach, which is drastically smaller than the average stomach – while a sleeve gastrectomy involves removing part of the stomach and altering the remaining section into a tubelike structure. Each of these change how the body absorbs nutrients.

“People become obese for different reasons,” he explains. “Some patients have inherited the condition. Others don’t consume huge meals regularly, necessarily, but snack constantly on sugar- or carbohydrate-heavy foods. Then, there are bingers: people who sit down to regular meals, but take in excessive amounts of calories at a time.”

Many of these patients have what is known as metabolic syndrome: a cluster of conditions that occur together and dramatically increase your risk of heart disease, stroke, type 2 diabetes and other life-threatening health problems. Metabolic syndrome presents with a combination of increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels and strain on all the metabolic and structural systems and conditions affected.

It is for these patients that bariatric or metabolic surgery is so useful, says Dr Heyns. “Most good candidates for surgery go on to enjoy drastic and sustained weight-loss. But that’s not all they are good for. For those with Type 2 diabetes, high blood pressure or chronic heart disease, this surgery can cure what is otherwise a chronic, life-long and crippling condition.”


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