The decision to have weight loss surgery should never be taken lightly. Contrary to popular perception, it is not “the easy way out” and won’t instantly cure the emotional and physical issues which lead one down the path to obesity.
All of the regularly performed types of weight loss surgery require lifestyle changes to be effective in the long run. If you can not or will not commit to healthier eating practices and regular exercise, the surgical weight loss will be temporary, the complications painful and the impact on your well-being could be extremely unpleasant.
Once you’ve decided to make the commitment, choosing the right surgical approach can be difficult. Each form of weight reduction surgery has its own benefits and disadvantages. We strongly suggest you have a thoughtful and thorough discussion with your personal physician, your bariatric surgeon and, if possible, other people who have experienced the surgery you are considering before making your final choice.
We’ve put together this overview of the most popular types of weight loss surgery as a starting point for your research.
Gastric Bypass Surgery, most often performed as the Roux-en-Y procedure, is the most common form of weight loss surgery performed in the United States.
In simple terms, the surgeon cuts and staples the top of the stomach which creates a small pouch about the size of an egg. This pouch is then connected directly to the middle portion of the small intestine. This procedure bypasses most of the stomach and the upper portion of the small intestine; areas where many vitamins and minerals are absorbed.
After gastric bypass surgery, patients need be sure they get enough magnesium, calcium, iron and vitamins. Supplements may be required in some cases.
On average, people who have gastric bypass surgery lose 60 to 70% of their excess weight. This number is significantly better than the average loss after banding procedures but not quite as good as duodenal switch surgery.
The professional name for duodenal switch surgery is the Biliopancreatic Diversion with Duodenal Switch.
Although it historically results in more weight loss than other forms of weight loss surgery, it also carries the highest risk of complications. Because of its effectiveness, it is often recommended for those with a body mass index of 50 or over.
In performing duodenal switch surgery, the surgeon removes a part of the stomach until a “sleeve”-like portion remains. This “sleeve” is attached to the final section of the small intestine. This procedure severely impacts the body’s absorption of calories and nutrients. Extra caution is required after this surgery to avoid nutritional deficiencies. Due to the higher potential for complications and added post-surgical discipline required, duodenal switch only makes up about one percent f the bariatric surgeries performed in the United States and about 5 percent of those performed in Europe.
Surgically far less complex than the duodenal switch, lap band surgery has grown to become the second most popular weight loss surgery in the United States.
By sewing a band around the top of the stomach, the surgeon divides the stomach into two sections: a small upper pouch and a larger lower pouch. Unlike the previous surgeries we’ve mentioned, the two sections are still connected with a very small channel between them. This slows down the emptying of the smaller upper pouch so that most people can only eat less than one cup of soft or well-chewed food before feeling too full or even sick.
Lap band surgery has the advantage of being minimally invasive. It is also easily reversible as it just takes removing the band. In general, people who get lap band surgery experience less weight loss than those who have more invasive surgeries and are more likely to regain some of their lost weight over the years.
One of the newer forms of bariatric surgery rapidly gaining acceptance in the United States is Gastric Sleeve Surgery.
The procedure is usually performed by vertically dividing the stomach to create a long pouch. This pouch is then stapled and the rest of the stomach is removed. Like a complete stomach, the pouch connects the esophagus to the small intestine and does not bypass any of the nutrient absorbing areas of the digestive system. Because of this, people who undergo gastric sleeve surgery usually don’t encounter the same potential for vitamin and mineral deficiencies faced by those who have gastric bypass surgery or the duodenal switch.
Since this form of weight loss surgery is relatively new, it is still not covered by some insurance companies who cover other forms of bariatric surgery.
Other interesting forms of bariatric surgery have been developed or are still in the early stages of being tested. Some of these include mini gastric bypass surgery, transoral gastric volume reduction, EndoBarrier Endoluminal Lining, and the Implantable Maestro System. Although insurance coverage for these procedures is extremely limited at the present time, they bear watching in the future.
We have entered a “brave new world” where weight loss surgery is not only becoming more acceptable but the medical community is working to discover ways to make it even safer and more effective. If you are considering bariatric surgery, we encourage you to research this topic further so you can ask your personal doctor and surgeon the right questions to discover the surgery that is right for you.