Bariatric surgery is a modern surgical approach used for the permanent solution of treatment-resistant obesity. These minimally invasive procedures, carried out under the supervision of a multidisciplinary team, allow patients to lose 60-70% of their excess weight within 24-36 months. Depending on the type of surgery, these procedures, which last between 45 minutes and 2-3 hours, work on the principle of reducing the stomach volume or restructuring the digestive system.

Reduction of Stomach Volume

With modern bariatric surgery techniques, the stomach volume is reduced to 100-150 ml in sleeve gastrectomy and 30-50 ml in gastric bypass surgery. The healing process is gradual: for the first 2 weeks, liquid foods are consumed, followed by puree foods for the next 2 weeks. From the 6th week, patients transition to normal eating with portions of 150-200 calories.

Modification of the Digestive System

Each technique involves a different restructuring of the digestive system. In Roux-en-Y bypass, a 150 cm segment of the intestine is isolated from the food flow, while in mini-bypass it is 180-200 cm. In duodenal diversion, 75% of the small intestine is bypassed, reducing nutrient absorption by 20-30%. In malabsorptive procedures, vitamin and mineral supplementation is required.

Metabolic Effect

Bariatric surgery reprograms the body’s neuroendocrine system. After the operation, the basal metabolic rate increases by 20-25%, and the appetite hormone ghrelin is suppressed by 60-70%. Blood sugar control is achieved in 80% of diabetic patients
(HbA1c <6.5%) and 65% can discontinue antidiabetic medications within the first 6 months.

LongITerm Solution

In 5-year follow-ups, 85% of sleeve gastrectomy patients and 90% of bypass patients achieve permanent weight loss. In the first 6 months, 70% of patients see improvement in hypertension, 80% in sleep apnea, and 60% in reflux. 95% of patients reach their target weight within 18-24 months and show over 80% improvement in quality of life scales.