Understanding both metabolic and bariatric surgery

Written by: Mr Sanjay Agrawal
Published: | Updated: 03/03/2020
Edited by: Laura Burgess


What is metabolic surgery?

Metabolic syndrome is the name given to a cluster of conditions that occur together, which thereby increase the risk of developing heart disease, stroke and type 2 diabetes mellitus. These conditions include high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels

In contrast to bariatric (weight loss) surgery for those with morbid obesity, metabolic surgery is an effective option for patients with type 2 diabetes mellitus. 

Why is it needed?

Losing weight, exercise and dietary changes can help prevent or reverse metabolic syndrome. However, if this fails then metabolic surgery is the next and only option to reverse metabolic syndrome, mostly with type 2 diabetes mellitus.

Is metabolic surgery the same as bariatric surgery?

Bariatric surgery encompasses metabolic surgery. Bariatric surgery is for all patients with a very high weight who need weight loss surgery. Metabolic surgery is used with the specific intent to address diabetes and metabolic dysfunctions that have failed to respond to lifestyle and medication changes as opposed to obesity per se.

Is there a difference in BMIs that metabolic and bariatric surgery can be performed on?

Metabolic surgery can be performed on any patient with a Body Mass Index (BMI) of 30 in the presence of type 2 diabetes mellitus. Bariatric surgery can only be performed on someone who has a BMI over 35 and obesity-associated comorbidities, or on a patient who has a BMI of 40 without any co-existing health conditions.

What techniques are used for metabolic and bariatric surgery?

The operations are the same and there are three surgical options that can be used depending on the individual case. These are either gastric band, gastric bypass or the sleeve gastrectomy.

What are the expected outcomes of metabolic surgery?

The outcomes in metabolic surgery depend on the associated conditions in the metabolic syndrome. For example, the best outcome is expected in patients with newly diagnosed, or small duration of type 2 diabetes mellitus.


If you would like to discuss your weight loss surgery options, you can book an appointment with Mr Agrawal via his Top Doctor’s profile.

By Mr Sanjay Agrawal

Mr Sanjay Agrawal is one of London's leading consultants in the specialty of bariatric, laparoscopic and upper GI Surgery and is certified as a 'Master Surgeon in Metabolic and Bariatric Surgery™ (MSMBS™)' by American Surgical Review Corporation. He is one of the country's prominent experts in obesity and weight loss surgery, with one of the procedures that he is most experienced in being the gastric sleeve procedure for weight loss. 

Mr Agrawal has undergone extensive training in the UK, Belgium, Japan and India and has undertaken more than 2,000 general surgical procedures so far. In addition, he has experience in over 1,750 laparoscopic bariatric procedures to date.

Mr Agrawal is Editor of the textbook titled "Obesity, Bariatric and Metabolic Surgery: A Practical Guide" which has achieved more than 190,000 individual chapter downloads worldwide so far. He is also Director of London International Bariatric Surgery Symposium (LIBSS).

Mr Agrawal is a well-respected and very active member of the medical community, dividing his time between consultation and surgery, teaching, committee membership, publishing books and articles and even finding time for television appearances as an expert in his field. 

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