The simplest way to decide when bariatric surgery is indicated is by calculating Body Mass Index (BMI) – People with BMI exceeding 35 (with co-morbidities ) or above 40 without any comorbidities are candidates for weight loss surgery . Recent studies now is allowing to lower the threshold of surgery indications to 30 – 35 respectively.

The Multiplicity of bariatric procedure (more than 6 kinds of procedures are available) is a good indicator that there is no “one size fit all” in bariatric surgery – each individual patient should be carefully assessed regarding: Degree of obesity, Existing accompanying Health conditions or diseases, Eating Habits, history of previous bariatric surgeries, expectations, compliance …..etc. Then patient should be informed and empowered to collaborate in choosing the suitable kind of surgery for him or for her.

Generally speaking Bariatric Surgery when done by an experienced surgeon to a compliant patient should give impressive sustained results. Failure to loose weight or weight regain after weight loss surgery is related in most of the cases to attitude of the patient. Good surgery of course is a must to achieve good results but it is not sufficient alone. Patient commitment to change his or her life style, sugar free diet, proper eating habits is as important as having a good surgery by an experienced surgeon. Patients are expected to lose around 75% of their excess weight in the first year following surgery.

من المتوقع أن تؤدي معظم جراحات السمنة بالمنظار إلى فقدان 75% من الوزن الزائد.

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Although Bariatric Surgery will reduce energy intake from the external source by either reducing the amount of food or ability to absorb nutrients from it. But it is not expected at all that the patient will feel any fatigue or lethargy. The body will compensate the lack of energy by depending on the internal resources of stored energy (Burning the fat). That’s why the body will not be deprived from energy. Only the source of energy is modified to depend more on internal source. Anyhow patients may feel a degree of fatigue, but this will happen only when they neglect drinking enough liquids as instructed, that will induce a degree of decreased blood volume (Hypovolemia).

Patient will be able to move out of the bed at the same day after surgery. And the postoperative pain is mild short lasting and will be well controlled by pain killers. Oral liquid diet will be started after 16-24 hours of surgery. And all diet instructions will be given to the patient on the day of discharge. It is highly recommended to spend the first 10 postoperative days at home to implement the intensive liquid diet schedule which cannot be followed at work.