The decision to proceed with bariatric surgery is made collaboratively, following comprehensive discussions and multidisciplinary evaluations. It applies to adult patients who meet the following criteria:

• Patients with a BMI of 40 kg/m2 or those with a BMI of 35 kg/m2 who have at least one comorbidity likely to improve post-surgery. These comorbidities may include cardiovascular conditions (such as hypertension), sleep apnea syndrome (SAS), severe respiratory disorders, severe metabolic disorders (especially type 2 diabetes), disabling osteo-articular diseases, and non-alcoholic steatohepatitis.
• Bariatric surgery is considered as a second-line treatment after an unsuccessful attempt at well-conducted medical, nutritional, dietary, and psychological interventions spanning 6 to 12 month.
• Patients who have not achieved sufficient weight loss or have been unable to maintain their weight loss despite prior efforts.

Dr. Amit Garg, best weight loss surgeon in Panchkula, recommends the following preoperative assessments:

• Calculation of body mass index (BMI) and waist circumference.
• Determine the nutritional and vitamin status of patients by assessing parameters such as albumin, hemoglobin, ferritin, iron saturation coefficient of transferrin, calcium, vitamin D, vitamins B1, B9, B12. Additional tests may be conducted based on clinical or biological indications.
• Evaluate the patient’s eating behavior and screen for the presence of eating disorders, as well as any associations with mental disorders. This information is important for both surgery candidacy and pre-and postoperative multidisciplinary care.
• Assess and manage any cardiovascular or metabolic comorbidities, such as hypertension, type 2 diabetes, and dyslipidemia.
• Screen for endocrine diseases that may contribute to obesity.
• Evaluate the risk of thromboembolism.
• Identify and address conditions such as obstructive sleep apnea or hypopnea syndrome, smoking habits, or other respiratory issues, following current guidelines.
• Conduct hepatic assessments, including liver enzyme measurements (transaminases and gammaGT) to check for non-alcoholic steatohepatitis. Consultation with a hepato-gastroenterologist may be necessary when needed.
• Consider performing esophageal manometry if there are clinical or paraclinical suspicions of esophageal motor disorders before gastric band placement.
• Assess musculoskeletal and joint health.
• Evaluate the patient’s masticatory coefficient and dental condition.

These comprehensive assessments ensure that patients receive the best care and preparation before undergoing weight loss surgery in Panchkula.

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