Weight Loss &
Bariatric Surgery
Safe weight loss solutions including gastric balloon and bypass surgery for lasting results.
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Best Weight loss Treatment in Bangalore
Intragastric balloon
Intragastric balloon treatment helps achieve better portion control by making you feel full after eating less food.
The intragastric balloon for weight loss has emerged as one of the most promising and efficient solutions for weight loss in the past few years. This non-surgical weight loss treatment in Bangalore offers an effective solution for individuals struggling with obesity.
It is also recommended for patients who are super obese and need to cut their weight to become fit to undergo bariatric surgery. Intragastric balloon is the most preferred option for obesity treatment without surgery.
Fig 1. Intragastric balloon
Benefits of an intra gastric balloon
Non-surgical approach : It is an entirely non-surgical procedure in which the balloon is placed endoscopically, or the patient has to swallow the balloon. The patient can return home within two hours of the procedure.
Reversible procedure : It is completely reversible. In rare circumstances, if the balloon does not suit your body, it can be easily removed through the mouth.
Reduced appetite and portion control : The intragastric balloon occupies almost 60% of the space in the stomach. As a result, even a tiny amount of food creates a feeling of fullness and reduces food intake. This controlled eating helps develop healthier eating habits and promotes weight loss.
Temporary intervention : Depending upon the balloon's quality and type, the balloon's life in the stomach ranges from 4 months to one year. During this golden period, individuals not only achieve significant weight loss but also have an opportunity to adopt sustainable and healthy lifestyle changes.
Ideal candidate for intra-gastric balloon
BMI requirement: An ideal candidate should have a BMI ranging between 30 and 40. It can be placed in super-obese patients who are unfit for surgery or as an adjunct to bariatric surgery.
Unsuccessful weight loss attempts: Candidates have tried various weight-loss options or medical weight-loss programs but have yet to achieve the desired results.
Willingness to commit to lifestyle changes: Individual commitments to adopt and maintain healthy eating and lifestyle habits form the core of a successful weight loss program following balloon therapy. Candidates should be motivated and prepared to make these long-term adjustments.
Absence of gastrointestinal disorders: Candidates should be free from active gastrointestinal disorders, such as ulcers, strictures, or bleeding disorders.
Types of intragastric balloon
There are a variety of balloons available in the market, but the best and most recommended intragastric balloons include:
Spatz balloon : It is one of the best and most popular balloons manufactured in the USA. The main advantage of the Spatz balloon is that it can be modified according to the patient's needs. It means the solution present in the balloon can be increased or decreased depending on the requirements of the patient. Another advantage of this balloon is the life span of approximately one year. However, Spatz balloon can be placed and filled in the stomach endoscopically.
Allurion gastric Balloon : Allurion balloon has gained widespread acceptance because of their ease of insertion. It has to be simply swallowed and no endoscopy needs to be performed during insertion. It has an AI-based program that tracks your weight loss and warns you if sufficient progress has not been achieved. After four months, the balloon burst on its own and expelled from the body through stools.
Fig 2. Gastric balloon
How does intragastric balloon work for weight loss?:
Reduced stomach capacity : The balloon occupies the majority of the space in the stomach. As a result, the patient experiences a sense of fullness with a small quantity of meals, which results in weight loss over time.
Increased satiety signals : Due to the inflated balloon, the patient always feels full. As a result, cravings for foods and sweets significantly decrease, and appetite is suppressed.
Behaviour modifications : Patients undergo several counseling sessions to adopt better lifestyle habits and eat healthy foods. This helps them maintain weight loss for an extended period, even after the balloon is removed.
How the balloon is placed?
The balloon is placed as a daycare procedure. The steps involved in the placement of the balloon are:
Through evaluation : A thorough patient evaluation is done to assess its suitability.
Anesthesia : Thepatient might require a bit of sedation depending on the type of balloon.
Insertion of the balloon : The balloon is inserted endoscopically through the mouth, or the balloon has to be swallowed depending upon the type of balloon
Confirmation : The conformation is done to determine whether the balloon is in the right place with the help of an endoscope or X-ray machine.
Inflation of balloon : the balloon is then inflated or filled with a unique solution. The volume of the solution depends upon the size of the stomach and the patient's weight loss goals.
Fig 2. Gastric balloon
Bariatric surgery
Obesity is a condition of excess body weight i.e., when a person is 20% or more above the ideal body weight. Obesity results from a chronic positive energy balance regulated by a complex interaction between endocrine tissues and the central nervous system.
Fig 3. Obesity
Obesity pathology
- Energy intake
- Binge eating
- Food addiction
- Energy expenditure
- Resting metabolic rate
- Activity related energy expenditure
- Thermogenesis
- Gut microbiota
- Dysbiosis
- SCFAs
- Hormone imbalance
- Neurotransmitters
- Leptin
- Ghrelin
- Peptide hormones
- Genetic disorders
- Polygenic obesity
- Leptin melanocortin pathway
- Epigenetic disorder
Outcome of weightloss:
- Diet-Induced Weight Loss
- Hormonal changes (with weight loss):
- Ghrelin ↑ (increases hunger)
- GLP-1 ↓, PYY 3-36 ↓, Leptin ↓ (satiety hormones decrease)
- Bile acids ↓
Gut microbiota changes
Perceptions:- Hunger ↑
- Satiety ↓
- Food aversions ↑
- Body activates homeostatic mechanisms to defend higher weight
- 80% regain of lost weight in 5 years
- Hormonal changes (with weight loss):
- Bariatric Surgery-Induced Weight Loss
- Hormonal changes :
- Ghrelin ↓ (reduces hunger)
- GLP-1 ↑, PYY 3-36 ↑, Leptin ↓ (but in a different pattern)
- Bile acids ↑
Gut microbiota shifts (favorable)
Perceptions:- Hunger ↓
- Satiety ↑
- Food preferences change
- Resets body weight “set point” to a lower weight
- Average sustained weight loss of 18% even after 20 years post-RYGB (Roux-en-Y Gastric Bypass)
- Hormonal changes :
Dieting alone triggers biological mechanisms that favour weight regain. In contrast, bariatric surgery leads to favourable hormonal and metabolic changes that help maintain long-term weight loss by resetting the body's weight set point.
For those peoplewho have not responded to diet, physical activity, and other non-surgical means of weight loss, bariatric surgery is the last resort
Bariatric surgery alters the gut-brain axis and allows one to lose a substantial amount of weight and at the same time switches off the hunger
Bariatric surgery together with a comprehensive assessment support and follow-up program allows patients to achieve their target weight
Many of the hormonal signals that cause weight gain or inability to lose weight are affected by these procedures, and it becomes easier to lose weight. But this still requires a healthy diet and a good exercise routine. These procedures are tools to treat a chronic disease, and cannot work alone.
Bariatric surgery in Bangalore is the last line of treatment for obesity and related diseases along with increased life expectancy and enhanced quality of life.
Patients suffering from morbid obesity should undergo Bariatric Surgery to -
- Reduce life-threatening risk factors
- Improve self-esteem
- Enhance the quality of life
Mechanism of bariatric surgery
- Boosts Metabolism : Bariatric surgery leads to hormonal changes that can increase your resting metabolic rate. The body burns more calories even at rest, helping maintain long-term weight loss.
- Reduces Hunger Hormones : Surgeries like gastric bypass or sleeve gastrectomy lower levels of ghrelin, the hunger hormone. You feel full sooner and reduce calorie intake naturally.
- Improves Insulin Sensitivity : It helps reverse Type 2 Diabetes by improving how your body processes insulin. Stabilizes blood sugar levels more effectively than diet or exercise alone.
- Long-Term Weight Management : Helps lose 60-80% of excess body weight. Prevents the body from regaining weight by altering the digestive system’s absorption capacity.
- Resolves Obesity-Related Health Issues : Reduces the risk of heart disease, sleep apnea, hypertension, and joint problems. Improves overall quality of life and mental well-being.
Fig 4. Vertical Sleeve Gastrectomy
Types of bariatric surgery
- Sleeve Gastrectomy.
- Roux-en Gastric Bypass.
- Mini Gastric Bypass.
- Single anastomosis sleeve ileal bypass (SASI).
- SADI- S or SIPS Surgery.
- Endoscopic Sleeve Gastroplasty (ESG).
Fig 5. Bariatric surgery procedures
Investigations before surgery
- Complete blood count.
- Renal function test.
- Liver function test.
- Lipid profile.
- Thyroid profile.
- HbA1c
- Vitamin B12 and folic acid.
- ECG and 2D Echo.
- Pulmonary function test.
- Sleep study.
- Upper GI endoscopy.
- Chest X-ray.
- Ultrasound abdomen.
- In order to exclude contraindications, to understand the pros and cons of the procedure
- To know the post procedure management, expectations, and post operative follow up protocol
- Surgeon should know the medical history and associated disease condition, so that procedure should not be affected by these conditions.
- It is essential to exclude any psychiatric illness, eating disorder or substance abuse
- To evaluate the willingness of the patient for lifestyle modifications to enhance the efficacy of the procedure
- To learn the healthy way of eating, portion size , requirements of energy and protein
- As this is a restrictive procedure so patient counselling is essential to avoid deficiency of any micro nutrients
- Similar to any bariatric procedure, the patient should learn to do mindful eating, regular follow up for nutrition monitoring, regular physical activities and behaviour modification.
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ABOUT DR.
Dr. Uday Ravi is a renowned consultant General, Laser, Laparoscopic, Robotic and Bariatric surgeon practising in Bangalore since 15 years. He completed his MBBS from VIMS Bellary and MS from prestigious Bangalore Medical College, Bangalore. He has many fellowships FARIS, FMAS, FALS, FIAGES, FISCP and DMAS(France).
Dr. Uday Ravi is a highly skilled professional with a vast experience of 15 years. He brings a wealth of knowledge to ensure that your weight loss journey is guided by expertise at every step.
Dr Ravi offers a state-of-the-art program to monitor and track your weight loss journey. This program provides real-time insights and personalized recommendations to optimize your results and help you achieve the best results.
A best weight loss program, requires a multidisciplinary approach to achieve the best results. Dr Ravi has designed a highly professional team of nutritionists, physicians, and endocrinologists. They synchronize to tailor the best treatment plan to your unique needs
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