FAQ Weight Loss Surgery

Dr Michael Devadas is a Master Surgeon in Metabolic & Bariatric Surgery. He shares his extensive knowledge and experience to answer some of the most common questions asked about obesity and weight loss surgery.

What is obesity?

The Body Mass Index (BMI) is a practical way to evaluate the degree of being overweight. It indicates whether your weight is appropriate for your height.

Overweight is a BMI between 25 and 30

Obesity is a BMI above 30

Severe obesity is a BMI over 35

What causes obesity?

Behaviour is not the sole determinant of obesity, which explains why lifestyle changes, including diet and exercise, can be ineffective. There are many complex factors underlying weight gain:

• Genetics: There’s a strong inherited component that influences weight gain and studies have identified variants in genes that predispose someone to obesity.
• Appetite and Energy Intake: Appetite is very hard to control and the biochemical pathways regulating appetite are complex.
• Calorie Absorption: People prone to obesity absorb more calories from their diet. This is affected by factors such as a person’s gut flora (the micro-organisms found in the gut) and their hormone response to food.
• Energy Expenditure: Activity and exercise account for about 20% of the energy a person expends. Around 70% of energy is expended through metabolic processes and another 10% through the processing of food. Energy expenditure varies between people.
• Life Events: Certain life events can trigger weight gain such as pregnancy, menopause, sleep deprivation, giving up smoking and when beginning or changing medications.

Why is overcoming obesity such a challenge?

For some reason, some of us just keep putting on weight. Obesity is complex and not simply due to poor choices in life to satisfy cravings and urges. To understand why someone gets to a stage where they are considered obese, an understanding of the connection between weight gain and how the stomach digests food is needed.

Digestion is a complex process. Food gives the body energy by turning what you eat into nutrients. Food also repairs your cells to help your body survive and creates waste to be eliminated. Poor sleep, eating too many processed or sugary foods (like soft drinks – even diet ones – ice cream, chocolate), portion size, sedentary activities, alcohol and the time of day you eat are just some of the habits that may increase your risk of weight gain.

A calorie deficit is a good start to helping you lose weight. This means that you need to consume fewer calories from the food and drink you have than your body needs. If you eat more energy than you need (over eat), you gain weight. If you eat less energy than you need, you lose weight.

What are the health risks associated with obesity?

The medical problems associated with obesity are referred to as co-morbidities. Eight out of 10 people who suffer from obesity will develop one of the following co-morbidities; six out of 10 will develop at least three: -  type 2 diabetes, heart disease, stroke, high cholesterol and abnormal blood lipids, high blood pressure, chronic kidney disease, respiratory disease, sleep apnoea, polycystic ovarian syndrome, infertility, osteoarthritis, fatty liver disease and liver failure, heartburn and reflux, cancer, depression, blood clots, gall stones and hernias.

Fortunately, obesity can be treated and weight loss reverses most of the damage. For example, weight loss surgery resolves type 2 diabetes in 80% of people with obesity once the excess weight is lost.

Why should I consider weight loss surgery?

If you have tried diet and exercise, medications and other programs to lose weight and have not been able to obtain long-term results, then surgery could be the answer for you. Successful weight loss surgery can help you lose and keep off an average of 50-70% of your excess body weight. This leads to an increase in energy levels, a boost to your self-confidence and better overall health. It can also help to significantly decrease weight-related illnesses.

What kinds of weight loss surgery are available?

Weight loss surgery is also known as bariatric and metabolic surgery. Bariatric surgery provides an alternative option for weight loss for people who meet the appropriate medical criteria, and for whom diet and exercise have proven ineffective.

There are different types of weight loss surgery available, and only a qualified and accredited metabolic surgeon, can help choose the right one for you.

Will bariatric surgery help me?

Bariatric surgery is a long-term decision, not a magic fix. After surgery, you need to change your diet and behaviour for the long-term. It’s also important to remember that despite the excellent success rate of weight loss surgery, it does not substitute the need to eat healthily. Everyone’s needs and goals are different, so success becomes a term relative to you but if you want to live a better, longer life, then you should consider it.

Who is eligible for bariatric surgery?

In my practice, there are set criteria that must be met to have bariatric (weight loss) surgery. These criteria are:

• No smoking
• BMI (Body Mass Index) over 35 with two weight-related co-morbidities or BMI 40 or higher
• Follow our weight management program and diet plan for three (3) weeks
• Be ready to take on a lifestyle change
• Be prepared to engage in our follow-up program after surgery

With the right help, you can achieve life-long sustainable weight loss, to improve the quality of your life and overall health.