Even though weight loss surgery, or bariatric surgery is considered more of a last resort for most doctors and patients, it is still a viable option for those who need it. Obesity statistics have been on the rise for quite some time, and when all else fails, weight loss surgery can help to reverse the situation and restore a patient to better health. There are only a few real options for weight loss surgery, each with its good and bad points. Your doctor will present all the options and ultimately the choice is yours.
Reasons Generally, just being slightly overweight isn’t enough of a reason to pursue weight loss surgery. However, there are reasons why having a surgical intervention is your best or sometimes only option. Obesity may be the primary problem, but it does have the ability to spawn many additional health problems that are quite severe. Weight loss surgery can help you sustain a healthy weight so that you can improve or resolve some conditions that presented itself when you were at an unhealthy weight. Type 2 diabetes is one reason why someone would consider weight loss surgery. According to the American Journal of Medicine, up to 82% of weight loss surgery patients will see a reversal of Type 2 diabetes symptoms within two years. High blood pressure and heart disease, caused by obesity, are two other reasons that weight loss surgery is used. Inability to conceive, sleep apnea and severe joint pain are more of the effects that obesity can have and why bariatric surgery may be prescribed. A vast improvement in overall quality of life is a significant reason why someone would choose to have weight loss surgery. Just the ability to participate in regular activities and lead a normal life is more than enough reason for many people.
Adjustable Gastric Banding One of the main options for weight loss surgery is called adjustable gastric banding. Most people would recognize one of the more popular brands of gastric band, called the ‘Lap Band.’ In adjustable gastric banding, an inflatable band is placed around the stomach to create two sections. The upper section is smaller and the lower section is larger. The band creates a narrow channel between the two sections of stomach. This way, when food enters the top portion of the stomach, it empties into the lower section at a much slower rate. This means that the patient can only take in about one half to one full cup of food at a time, before feeling full. With the band in place, calorie consumption is greatly reduced and weight loss occurs. Adjustable gastric banding is a minimally invasive surgery, done by making tiny incisions and using a camera called a laparoscope to perform surgery. The recovery time is faster than other types of weight loss surgery and the band can be loosened or tightened if adjustments are necessary without further surgery. Some people who opt for adjustable gastric banding report slower weight loss if they are not involved in a proper post-operative program, that supports and monitors their progress along the way, than one with more invasive forms of weight loss surgery. Due to the small pouch at the top of the stomach, you also have to be coached as to how and what to eat so you don’t cause any complications that can be easily avoided.
Gastric Bypass Another weight loss surgery option that most people have likely heard of is called gastric bypass. This kind of surgery is usually more invasive than gastric banding, as the stomach and small intestine itself is actually rearranged. In a gastric bypass surgery, the surgeon divides the stomach into two sections and then seals the upper and lower section off from one another. Then, the upper portion of stomach is connected to the bottom part of the small intestine. This creates a shortcut for the food to take, because it bypasses the lower section of stomach after it is eaten. The fact that food misses a portion of the digestive tract means fewer calories and very important nutrients are absorbed by the body. Weight loss with gastric bypass surgery is usually quite fast and quite dramatic. The patient may continue to lose weight for up to two years, but most of the weight is usually lost in the first six to nine months. Studies have shown that the digestive tract usually becomes more efficient so after a 10 year period the weight loss is usually the same as what is lost with adjustable gastric banding without having a potentially dangerous intervention. One negative aspect of gastric bypass surgery is that just as the body is able to avoid calorie absorption, it also absorbs fewer nutrients. Patients usually have to take supplements to make up for the nutritional deficiencies that are created by the surgery. It’s also possible for the stomach to dump undigested food into the intestines and cause bloating, nausea, pain and diarrhea. Unlike
Sleeve Gastrectomy A lesser-known form of restrictive weight loss surgery is called sleeve gastrectomy. This is a relatively new laparoscopic surgery where roughly 75 % of the patient’s stomach is removed. The remaining 25% is in the form of a narrow sleeve that connects directly to the intestines. A lot of the time, sleeve gastrectomy is the first in a series of weight loss surgeries, but sometimes it’s used all on its own. Sleeve gastrectomy is often used when a patient is dangerously obese or too sick for one of the more complex surgeries. In many cases, a second surgery is scheduled down the road when some weight loss has occurred and the patient’s health has improved. Sleeve gastrectomy doesn’t interfere with the absorption of nutrients like with gastric bypass. Since sleeve gastrectomy is newer than other surgeries, the long-term benefits aren’t known yet, and the procedure is not reversible like adjustable gastric banding. Because of the size of the sleeve you may also run the risk of complication due to leakage if the surgical staples
Biliopancreatic Diversion Biliopancreatic diversion is basically a more drastic gastric bypass. With this surgery, up to 70% of the stomach is removed and the surgeon bypasses even more of the small intestine. Biliopancreatic diversion usually results in even greater weight loss than gastric bypass, with up to 80% of excess weight being lost. The remaining stomach is usually larger than what is formed with gastric bypass or gastric banding, so larger meals can be eaten. Of course, since it’s a more extreme gastric bypass, the nutritional deficiencies are also more severe. The dumping that occurs with gastric bypass is also enhanced, and ulcers or hernias aren’t uncommon.
Which Surgery Is Best? Choosing the ideal weight loss surgery depends on several different factors. Your current state of health, your past abdominal surgery history, and your weight loss objectives will all play a role. In some cases, minimally invasive surgeries like adjustable gastric banding won’t be possible, while in other cases it will be the only real option. It’s important to sit down with your doctor and discuss all of the options that are available to you. All types of surgery carry risks of infection and other complications, so it’s crucial that you are educated beforehand. Even though weight loss surgery will help you lose a lot of weight, you still have to commit yourself to change and a new lifestyle. Then and only then will you find long-term weight loss success.