Bariatrics: How Weight Loss Surgeries Are Actually Performed

I often hear the same phrase from patients: "Doctor, I am afraid of bariatric surgery because I don't understand what exactly you will do to me." This is normal. Fear almost always arises where there is a lack of clarity.

What is Bariatrics in Simple Terms

Bariatrics is surgical treatment for obesity, not a "cosmetic procedure" or an "easy way to lose weight." This approach is recognized as an effective method of treating obesity by international professional communities, including the American Society for Metabolic and Bariatric Surgery (ASMBS).

We intervene in the function of the stomach and (in some cases) the intestines to:

• help the patient eat less
• achieve satiety faster
• change the hormonal balance that controls appetite
• reduce the risks of diabetes, hypertension, sleep apnea, and joint diseases

This treatment is performed strictly for medical indications, not just for the desire to "lose weight."

Preparing for Bariatric Surgery

Bariatric surgery is never done spontaneously. Preparation is a mandatory part of treatment and follows international clinical guidelines.

Before the procedure, the patient undergoes a comprehensive evaluation:

1. Diagnostics
   • blood laboratory tests
   • gastroscopy
   • ultrasound, ECG
   • consultations with a therapist, endocrinologist, and anesthesiologist
2. Body Mass Index (BMI) Assessment
   • BMI > 40 — direct indication for surgery
   • BMI > 35 — if accompanied by comorbidities
3. Surgeon Consultation
   • analysis of eating behavior
   • lifestyle assessment
   • discussion of realistic expectations

   I always emphasize: surgery is an effective tool, but not a magical solution.

How the Surgery is Performed

Modern bariatric surgeries are performed laparoscopically — this is the global standard used in leading clinics, including Mayo Clinic.

• without large incisions
• through 3–5 small punctures
• with minimal surgical trauma

The patient is under general anesthesia and does not feel pain during the procedure.

Main Steps of the Surgery

1. Insertion of the camera and instruments into the abdominal cavity
2. Performing the selected type of bariatric surgery
3. Checking the seams for leaks
4. Completing the surgery and closing the punctures

The average duration of the surgery is 60 to 120 minutes.

The Most Common Bariatric Surgeries

Sleeve Gastrectomy (Longitudinal Resection)

The most common bariatric surgery.

• up to 80% of the stomach volume is removed
• a narrow tube-shaped stomach is formed

This leads to quick satiety and reduced production of the hunger hormone — ghrelin. On average, patients lose 60–70% of excess body weight.

Gastric Bypass

An effective method for severe obesity and metabolic disorders.

• a small stomach pouch is created
• a part of the intestine is bypassed from digestion

This method often achieves remission of type 2 diabetes and significant weight loss.

Post-Surgery Nutrition

After bariatric surgery, nutrition is gradually restored and strictly monitored. Our clinic follows its own recommendations, developed based on clinical experience and international protocols.

Post-Bariatric Surgery Nutrition Guidelines (PDF)

Life After Bariatrics

Surgery does not remove the patient's responsibility but provides a real physiological tool to change life.

With adherence to recommendations:

• body weight decreases steadily
• quality of life improves
• risks of chronic diseases are reduced

The biggest mistake is fearing surgery more than the consequences of untreated obesity.