What are the advantages and disadvantages of stomach reduction?

We see it more and more often: success stories of people who have lost dozens of kilos in a short time. I can hear you thinking: how is this possible? Besides a lot of exercises, portion control and a healthy diet there is another possible tool that you have, probably heard of: a stomach reduction. In this article I explain to you what it is, who is eligible and what you should pay attention to after this operation.

Note: these tips can never be a substitute for sound medical advice. It is only meant to raise awareness and learn about the phenomenon of stomach reduction. In the case of (morbid) obesity, we recommend contacting your (house) doctor or a specialized dietitian.

What is a stomach reduction?
A stomach reduction falls under bariatric surgery. This includes surgery for people with (morbid) obesity. In this process, part of the stomach and/or intestines is diverted with the aim of reducing food intake, facilitating weight loss and improving health.

There are many types of gastric reductions - this article focuses on the Roux-en-Y gastric bypass, the most commonly performed bariatric procedure.

During this procedure, a small stomach is created and the small intestine is (partially) diverted. The result: a stomach with the volume of a small coffee cup. To give you an idea; a full stomach of the average adult can store about three liters of content.



Requirements
Some conditions are linked to a bariatric procedure. This makes it impossible for everyone to undergo this. This is how you:

between 18 and 60 years old
have a BMI ≥ 40, or a BMI of ≥35 with comorbidity such as cardiovascular disease, sleep apnea or diabetes
have not achieved (desired) results with a lifestyle intervention .
Why a stomach reduction?
Nowadays, there seems to be more attention to nutrition and sport than ever before. In addition, many lifestyle interventions have started to reduce overweight and obesity in recent years.

Results of these interventions are not always promising for everyone. A stomach reduction is a good outcome for people with morbid obesity (BMI ≥40 or ≥35 with health problems) in which lifestyle interventions do not work.

What are the effects of a stomach reduction?
Little or no hunger
As stated at the beginning, the content of the stomach is extremely reduced after a stomach reduction. You can imagine that because of this you also eat (much) less and get fewer calories.

Furthermore, the body secretes (temporarily) the hunger hormone ghrelin to a lesser extent. These gastric receptors are mainly in the other part of the stomach that is separated from the small stomach. As a result, the appetite or appetite often remains away, reducing the need for (a lot of) eating.

A healthier body
Less hunger means eating less in many cases, with the result that you lose weight. This has a positive effect on health. For example, it appears that the health of many people with type II diabetes and / or hypertension significantly improves after a gastric reduction.

According to research, 82-98% of diabetes type II patients no longer need to use medication. In the other cases, medication use can often be reduced. In 69% of cases, patients with increased blood pressure can also leave their medication.

Finally, a reduction in stomach also has beneficial effects on other disorders that are related to (heavy) obesity, such as: 

the sleep apnea syndrome: 74-98% of the cases were cured after the procedure
high cholesterol levels: in 63% of cases this was resolved after the procedure
non-alcoholic fatty liver disease: 90% reduced after the procedure
In addition, complaints of migraine, depression, asthma, gout and heartburn can also decrease.
Do I have to adjust my diet after a stomach reduction?
So, there are many advantages, but do you have to do something yourself? The answer is yes. A stomach reduction is not a lazy solution to obesity, as is often thought. Important dietary advice is therefore attached to a stomach reduction. The dietary advice is for life, but can sometimes differ per institution / hospital.

The most common dietary recommendations for the (Roux-en-Y) gastric bypass are listed below:

Attitude and pace
After the operation it is important that you do not throw your plate on the couch and let your attention drop off to the television during dinner.
On the contrary: eat at the table with attention to what is on your plate. It is important to sit in a straight position and to eat quietly. If you eat too quickly or you are not in a straight position you have a chance of complaints such as vomiting.
In addition, for both people with and without stomach reduction, it is important to eat consciously and quietly. This makes you feel better when you are satisfied.
Eating and drinking moments
With a stomach capacity the size of a small coffee cup you can imagine that the meals you are used to are no longer possible. Your portions will therefore be smaller. At the beginning, a cup of yogurt may still be a task, but as time goes by the portions will become (slightly) larger. Make sure, however, that your portions are not too large. A dietitian can help you with this.

It is also important not to eat and drink at the same time. This can cause complaints and make you get hungry faster.

Protein, protein and even more protein
The intake of sufficient protein is very important for this group, because you will lose a lot in the initial period. The proteins ensure that less muscle mass is lost during weight loss.

Good (protein-rich) snacks are important because the intake of food, and nutrients, is reduced.

Supplementation
Finally, it is advisable to use multivitamins . This prevents deficiencies as a result of the reduced absorption of nutrients. If you have had or want to undergo a gastric bypass, always consult the doctor / dietitian of the relevant institution for appropriate and personal nutrition and tailored supplementation advice.

Is a stomach reduction reimbursed?
It is best to always contact your health insurer first to find out what their conditions are and whether your health insurance has a contract with the relevant hospital or institution.

Does your health insurance contract and do you meet the conditions? Then a stomach reduction is usually reimbursed from the basic insurance. Does your health insurer not have a contract? Even then, part of the costs are often reimbursed.

How effective is a stomach reduction?
Unfortunately, many people think that the operation itself is sufficient to lose weight. An American study shows that 75% of the cases after 20 years again 20% of the lost weight has been added.

In addition, there is also a small group of 2-10% of the cases that exchange the food addiction for another addiction. Nevertheless, gastric reductions produce better results compared with diets and lifestyle changes in this weight class.

Conclusion
A stomach reduction is certainly not an easy solution. Naturally, there are risks involved in the procedure, there are, in addition to advantages, also disadvantages and there are nutritional advice that must be adhered to.

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