The ABCs of Bariatric Surgery
Obesity is a chronic disease of growing concern worldwide, according to the World Health Organization (WHO), and therefore requires specialized and effective care. Overweight and obesity can be defined as an abnormal or excessive accumulation of fat in the body resulting from an imbalance between energy intake and expenditure.
A simple tool to estimate whether a person is overweight or obese is the body mass index (BMI), which is the ratio obtained by dividing a person's weight in kilograms by the square of their height in meters (kg/m²).
According to Yovani Fontalvo, a nutritionist at the Serena del Mar Hospital in Cartagena de Indias, obesity presents in different degrees, classified according to each patient's body mass index, which is determined by the relationship between weight and height.
“We define obesity as the excessive accumulation of body fat. Grade one corresponds to a body mass index (BMI) of 30 to 34, grade two to 35 to 39, and grade three to patients with a BMI over 40,” Fontalvo stated.
For adults, the World Health Organization (WHO) defines overweight as a BMI of 25 or higher and obesity as a BMI of 30 or higher.
“Obesity has an economic impact on healthcare systems. According to recent data from the WHO, 39% of the global population is overweight and 13% is obese. In Colombia, between 52% and 54% of the population is overweight, and between 18% and 20% is obese,” highlighted Dr. Carlos Cruz, a bariatric surgery specialist at Hospital Serena del Mar.
Risk Factors
It is essential to recognize the risk factors that can contribute to obesity. Tatiana Navarro, a clinical psychologist at Serena del Mar Hospital, explained that in addition to eating habits and a sedentary lifestyle, psychological factors such as anxiety and stress can also play a significant role in weight gain.
“While obesity is a health problem associated with physical and caloric conditions, there are a multitude of risk factors associated with obesity. One of them is anxiety, a very important factor that can lead to a much greater appetite or an inability to regulate emotions, causing us to do so through food intake,” Navarro explained.
Likewise, Angélica Imitola, an endocrinologist at Serena del Mar Hospital, indicated that genetics also plays a fundamental role in obesity.
“There are genetic factors and medical conditions, such as polycystic ovary syndrome in women or hormonal deficiencies in men, that can influence obesity,” she emphasized.
Bariatric Surgery
According to Dr. Carlos Cruz, a specialist in advanced laparoscopic, bariatric, and metabolic surgery at Hospital Serena del Mar, bariatric surgery is a procedure performed primarily laparoscopically, which involves manipulating the stomach and/or intestines to achieve weight loss and better control of associated comorbidities.
“There are several types of surgeries that aim to achieve these goals, with the gastric sleeve and gastric bypass being the most common in our setting. However, there are also other options, such as the SADI-S (Stomach Alveolar-Diagnostic Intra-Expanded System) and intestinal bypasses, each suited to specific patients,” stated Cruz.
Gastric Sleeve
In this surgery, the surgeon removes a large portion of the stomach to reduce its size and food storage capacity. Thanks to the reduction in stomach size, the amount of hormones responsible for controlling appetite and insulin is also reduced.
Gastric Bypass
This is the most frequently performed type of bariatric surgery for the treatment of morbid obesity. Its purpose is to reduce the amount of food that can be ingested and the intestine's capacity to absorb nutrients. Therefore, it is necessary to reduce the size of the stomach, which is then connected directly to a more advanced section of the small intestine, using approximately 60% of it for food absorption.
SADI-S (Sleeve Gastric Bypass)
This is a simplified version of gastric bypass, achieved by creating a gastric sleeve and then shortening the section of small intestine to a fixed length, usually about 250 cm. This surgery significantly reduces the size of the stomach, leading to a greater feeling of satiety with smaller portions of food.
Interdisciplinary Team
Serena del Mar Hospital has an interdisciplinary team specializing in the comprehensive management of obesity. This team is comprised of professionals in internal medicine, endocrinology, psychology, psychiatry, nutrition, and, of course, the bariatric surgery team. Each patient receives personalized treatment and careful follow-up to ensure optimal results.
Successful cases.
“The choice of procedure is based on an interdisciplinary evaluation, taking into account factors such as the presence of hypertension, diabetes, fatty liver, and sleep apnea,” added Dr. Carlos Cruz.
Addressing obesity requires a comprehensive approach that combines different disciplines and strategies. The team of professionals at Hospital Serena del Mar evaluates each case individually, analyzing protective and risk factors, as well as the patient's motivation and available resources.
If you or someone close to you considers yourself a candidate for bariatric surgery or needs assistance in managing obesity, we invite you to schedule an appointment at Hospital Serena del Mar, where an interdisciplinary team is committed to providing compassionate, safe care focused on patient well-being, guaranteeing state-of-the-art technology and an environment conducive to recovery and care.
