We sat down with Dr Cha Kar Huei, Consultant General Surgeon at Subang Jaya Medical Centre, to find out more about bariatric and metabolic surgery and how it is different from the more popular gastric bypass surgery for weight loss and better health.
How is bariatric surgery different to gastric bypass surgery?
Gastric bypass is actually a type of bariatric surgery. Other types include sleeve gastrectomy or popularly referred as stomach stapling and gastric banding. All the different types of surgery will help to bring down your weight – the difference is in how it affects your hormones after surgery. Gastric bypass will help diabetic patients achieve better glucose level even without weight loss, due to hormonal changes. The stomach becomes smaller and small intestines are rerouted. Your intestines actually produce hormones that reduce blood sugar level, helping to achieve better glucose levels.
When does it become necessary for someone to get bariatric surgery?
There is a guideline by the National Institute of Health, USA that the patient’s BMI should be more than 35, the patient is diabetic or has metabolic problems, or has a BMI of more than 40. However, Asians tend to get metabolic problems at a lower BMI. Hence, there is a consensus among Asian surgeons that a lower BMI of 32 is considered appropriate for surgery especially those with obesity related medical problems.
The age limit is between 18 to 60 years old according to the guidelines, but we routinely do surgery on those above 60 depending on their health as long as they are cleared by their cardiologist.
I do not perform surgery on kids younger than 18 years old due to their immaturity. They might not understand what to do and why they cannot eat certain foods anymore after the surgery and so on. In the case of any underage patients who need to have it done, it needs to be done in specialised centres because there is a need to handle the mental part of it as well.