Choosing to pursue weight loss surgery is never an easy decision, but for people who have struggled with strict diets, exercise regimens, and dietary supplements, and have seen no results, weight loss surgery is often seen as the only option. Also known as bariatric surgery, these procedures can limit your body’s capacity to eat (by removing part of the stomach) or by shortening the intestines, which can reduce calorie absorption by the body. This approach to rapid weight loss became popular following its first use in 1954, and to this day, more than 250,000 bariatric surgeries happen every year in the United States alone.
Most candidates for weight loss surgery have a BMI of 35-40 and their obesity hasn’t responded well to other weight-loss approaches, such as diet and exercise. Some experts say that people with a BMI of 30-35, in addition to co-morbidities or other health conditions, are also good candidates for bariatric surgery. In the short-term, weight loss surgery can often prevent cardiovascular complications and lower your risk of developing diabetes and atherosclerosis. Over the long term, research has found that those who undergo these procedures have up to a 40% reduction in mortality levels. However, there is no perfect weight loss surgery, as every individual has different desires, challenges, and medical histories, so it is important to speak with your doctor about your options. Chronic, long-term obesity can put your health in serious jeopardy, and for many people, weight loss surgery is the best option.
Types of Weight Loss Surgery
The major types of weight loss surgery include a gastric sleeve, gastric bypass, gastric balloon, LAP-BAND, duodenal switch, AspireAssist, and vBloc therapy, as well as certain combinations of the above procedures.
For someone who struggles to resist their cravings and often overeats, a gastric sleeve procedure removes a large portion of the stomach, changing its shape from a sac to a tube. This significantly lowers the capacity of the stomach, which means that you will feel fuller sooner. This procedure is known to reduce the habit of overeating and rapidly stimulate weight loss. This procedure is not reversible.
Bypass surgery is one of the most common forms of weight loss surgery, as it is extremely effective and delivers long-term results with a low risk of complications. Formally known as a Roux-en-Y bypass, this procedure consists of surgeons making a small pouch at the top of the stomach, which becomes the only space in your stomach for food storage and digestion. The small intestine is then attached to the pouch, thus shortening the length of the intestine. The reason this surgery is so popular is that it can limit food intake, stimulate satiety, and reduce calorie absorption by shortening the intestinal length.
Similar to the above strategies, a gastric balloon can be placed in the stomach and then inflated, which can limit the capacity of your food intake, or train you to eat smaller meals and get your digestive system accustomed to less intake. After six months, the balloon is removed, and regularly causes 5-8 point drops in a person’s BMI. Also, unlike the gastric sleeve procedure, this weight loss surgery is temporary, and can even be repeated more than once to continue benefiting from its effects.
Another very popular weight loss surgery, LAP-BAND surgery stands for laparoscopic banding surgery, which is a less permanent version of gastric bypass surgery. In this procedure, a band attached to a balloon is attached to the upper part of the stomach, creating a small pouch for food, as well as a small entrance to the remainder of the stomach. The tightness of the band can be altered by inflating or deflating the balloon through an exterior port, allowing you to regulate the amount of food you can consume.
This is a bit more of a complicated procedure but does include removing up to 70% of the stomach, as well as the majority of the duodenum. The small intestine is then re-routed to form two channels and a common channel. The shorter channel moves food from the stomach to the common channel, while the longer channel brings bile from the liver. When the food and bile meet in the common channel, it is then funneled into the large intestine. The purpose of this surgery is to reduce the capacity of the stomach, while also preventing full absorption of calories being consumed, leading to weight loss.
One of the less common examples of weight loss surgery, vBloc therapy comprises the use of a pacemaker-like device, but one that affects your nervous system, namely the transmission of hunger signals from the stomach to the brain. By regulating your hunger, this simple procedure can help you lose weight without changing much of your lifestyle or undergoing a more invasive operation.
This is another more recent advancement of bariatric surgery and consists of a small apparatus with a tube going into your stomach, attached to a small button on the outside of your abdomen. Following a meal, when your stomach is filling up with food before digesting it, you can aspirate (or eliminate) as much as 30% of the food in your stomach through a tube that you attach to the external button. This undigested food can be drained directly into the toilet, helping you avoid the intake of those calories, which can help with weight loss.
Pros and Cons of Weight Loss Surgery
Every surgery has its implicit risks and potential benefits, so choosing to go under the knife is always an important decision. Many of the surgical procedures outlined above also have certain pros and cons associated with them, and it is important to understand these before you choose which operation is right for you.
- Gastric Bypass – This procedure shows the fastest results, due to the immediate lessening of calorie-absorption by the body and the smaller capacity in the stomach. This approach is also associated with a rapid reduction in secondary health risks, such as diabetes and high cholesterol levels.
- Gastric Banding (LAP-BAND) – The advantage of this weight loss surgery is that it can be reversed whenever you want, and the surgery has a low level of risk associated with it. The customizable tightness of the band also provides more flexibility in terms of how much food you want to allow into your stomach.
- Gastric Balloon – Due to the short-term nature of this procedure, there is nothing permanent about altering your stomach’s capacity. Furthermore, if you like the results, you can repeat this procedure for additional weight loss.
- Gastric Sleeve – For extremely obese people, gastric bypass surgery can be very risky, as it causes very rapid weight loss. Gastric sleeve surgery is a good preparatory procedure for gastric bypass, helping the body adjust to less food intake before undergoing a full bypass. Another benefit of this procedure is that there is no external hardware left in the body, as there is in gastric banding, which can potentially cause infections, or it can slip and stop working properly, requiring another procedure to fix.
- Duodenal Switch – This procedure has been linked with extreme success in reducing co-morbidities, such as diabetes, hypertension, sleep apnea, and others. If your obesity is affecting other aspects of your health and behavior, this may be your best choice.
- Gastric Bypass – This is an invasive and permanent procedure, which always comes with more risks, and due to the nature of the surgery, the body will inherently absorb fewer nutrients. While calorie reduction will also drop, which aids weight loss, you also run a higher risk of developing anemia, jaundice, and other nutrient deficiencies, so supplements are required.
- Gastric Banding – Using a LAP-BAND works a lot slower than a gastric bypass, in terms of relieving the symptoms of obesity. Furthermore, this procedure requires internal hardware, which runs the risk of becoming damaged, slipping or ceasing to work, which can be painful and only remedied by emergency surgery.
- Gastric Balloon – Nausea, back pain, vomiting, gastric discomfort and a feeling of bloating/cramping can often accompany the use of a gastric balloon. While these side effects tend to fade after the first week or two, they can cause discomfort for longer periods in some patients.
- Gastric Sleeve – Choosing this surgery is a permanent choice, as the stomach is reduced drastically in size and then stapled back together. There is a risk of infection if these staples break, and also the chance that the effects of this surgery will be reduced if you continue to overeat since the stomach can stretch.
- Duodenal Switch – Nutrient deficiencies are common with this procedure, as you are not only limiting your calorie intake but also your body’s opportunity to uptake minerals and vitamins. This procedure is also associated with particularly foul-smelling stool, a higher risk of osteoporosis, increased flatulence and weaker bowel control.