Weight loss surgery (or bariatric surgery) refers to a series of minimally invasive procedures that an obese individual can have in order to reduce their food intake, therefore causing them to lose weight. Immediately following these procedures, most people lose a significant amount of weight and continue to do so for 18 to 36 months.
When combined with a comprehensive treatment plan, weight loss surgery often leads one to experience long-term health benefits and a greater quality of life. These surgeries have been shown to improve and even resolve health conditions related to obesity, such as: type 2 diabetes, hypertension, heart disease and more.
So, how do you know if weight loss surgery is right for you? First of all, consult a doctor who specializes in bariatric procedures. There are some basic qualifications one must meet in order to be considered for these procedures:
- You need to have a BMI (Body Mass Index) of 40 or more—or you need to be more than 100 lbs over weight.
- You need to have a BMI of 35 or more and at least two obesity related co-morbidities (type 2 diabtetes, hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease).
- You’re unable to achieve and sustain a healthy weight loss with prior weight loss efforts.
If you can relate to one or more of the above points, you should look into the different options for weight loss surgery.
In this article, we will introduce the most common bariatric surgeries, which are: gastric bypass, sleeve gastrectomy, and duodenal switch. More detail and a video description of these surgeries and other weight loss options can be found in the weight loss options section of this website.
Gastric bypass has historically been the most popular weight loss surgery. Gastric bypass aids in weight loss by changing how your stomach and small intestine handles the food you eat. Your surgeon will use a “staple” to divide your stomach to a smaller upper section and a larger bottom section. The top part of your stomach (called the “pouch”) is where the food you eat will go. And it will only hold a very small amount of food—which notably aids in the weight loss that will likely follow. Your surgeon will also connect a small portion of your small intestine to a small hole in your “pouch”. The food you eat will now be able to travel from the pouch and into this new opening and then into the small intestine. Because of this rerouting, your body will absorb fewer calories from the food you’re eating. Which will, again, encourage significant weight loss.
You will likely have a 2-3 day hospital stay after this procedure, and you will have 4 to 6 small incisions on your abdomen. You will be on a strict recovery plan for several months post-surgery and should be in close contact with your surgeon and health care team. A few advantages and disadvantages, according to the American Society for Metabolic and Bariatric Surgery (ASMBS)
Produces long-term weight loss of 60-80 percent, may lead to conditions that increase calorie burning, produces favorable changes in hormones that reduce appetite and enhance satiety, and is said to have one of the least painful recoveries.
Technically a more complex operation than some of the other weight loss surgeries. Could lead to a greater complication rate, can lead to long-term vitamin/mineral deficiencies (particularly vitamin B12, iron, calcium, and folate), and requires adherence to dietary recommendations, life-long vitamin/mineral supplementation, and follow-up compliance.
More information about Gastric Bypass Surgery can be found here.
The sleeve gastrectomy (also known as gastric sleeve) is a relatively new weight loss surgery that has gained popularity because of its low complication rate and good weight loss results. In fact, it has become one of the most popular weight loss procedures. The gastric sleeve involves removing about 75-80% of the stomach, leaving a narrow gastric tube or “sleeve”—resembling a banana. No intestines are removed or bypassed during this procedure, which is a major advantage of this procedure because it brings a much lower chance of developing nutrient deficiencies.
The gastric sleeve aids in weight loss for a number of reasons: with the new narrow stomach pouch, it limits the amount of food that can be eaten at one time, and after eating a small amount of food, you will feel full very quickly and continue to feel full for several hours. The gastric sleeve may also cause a decrease in appetite. In addition to reducing the size of the stomach, it may also reduce the amount of gut hormones produced, which impact a number of factors including hunger, satiety, and blood sugar control.
You will likely have 24-48 hour hospital stay post-surgery and you will have 5-6 small incisions on your abdomen. You will be on a strict recovery plan for several months post-surgery and should be in close contact with your surgeon and health care team. A few advantages and disadvantages, according to the American Society for Metabolic and Bariatric Surgery (ASMBS)
Induces rapid and significant weight loss of more than 50 percent, requires no foreign objects be places in your body and no bypassing or re-routing of the food stream, and causes favorable changes in hormones that suppress hunger, reduce appetite and improve satiety.
Nonreversible procedure, has the potential for long-term vitamin deficiencies, and has a higher early complication rate than some of the other procedures.
More information about sleeve gastrectomy surgery can be found here.
Biliopancreatic Diversion with Duodenal Switch (Duodenal Switch or DS)
The duodenal switch (BPD/DS) is a well-established weight loss surgery that provides excellent weight loss and long-term resolution of health conditions associated with obesity. This operation is usually, but not always, reserved for those with a BMI of greater than 50 because this surgery tends to produce greater amounts of weight loss compared to other weight loss procedures. Patients could lose from 60-85% of excess body weight.
First, your surgeon will reduce the size of your stomach. Basically, a sleeve gastrectomy is preformed where a portion of your stomach will be removed, leaving a narrow tube (or sleeve) from the top to near the bottom of your stomach. This will reduce the amount of food you can eat at one time, as we have learned before, resulting in weight loss.
Next, your surgeon will reroute the natural path of digestion. Food is directed away from the upper part of the small intestine (the duodenum). The duodenum is divided just past the outlet of the stomach, and then the last portion of the small intestine (the distal) is then brought up and connected to the new outlet created in the new “sleeve” stomach. So now, when you eat, food will travel through the new narrow stomach and dump directly into the last portion of the small intestine—bypassing roughly three-fourths of the small intestine. This cuts back on how many calories and nutrients you absorb significantly, which also aids in weight loss.
And lastly, the bypassed part of the small intestine (which carries bile and pancreatic enzymes which are essential for protein and fat breakdown and absorption) is reconnected to the last portion of the small intestine—because you need those enzymes and bile. This way the bile and enzymes can eventually mix back into the food stream. However, with the rerouting the normal way these enzymes and bile break down food in changed and the amount produced is changed. Therefore, even more weight loss will result. So, you will find weight loss because your stomach is smaller, your small intestine is rerouted, and because your digestive juices are altered.
Although it is a larger and more complex weight loss surgery, your hospital stay should still only be 2-3 days post-surgery and like other procedures you will have a few small incisions on your abdomen. Like the other procedures, you will be on a strict recovery plan for several months post-surgery and should be in close contact with your surgeon and health care team. A few advantages and disadvantages, according to the American Society for Metabolic and Bariatric Surgery (ASMBS)
Results in greater weight loss than other surgeries (as discussed above), allows patients to eventually eat near “normal” meals, reduces the absorption of fat by 70 percent or more, causes changes in hormones that reduces appetite and improve satiety, and is shown to be the most effective against diabetes compared to others surgeries.
Higher complication rate than other surgeries, has a greater potential to cause protein deficiencies and long-term vitamin/mineral deficiencies (iron, calcium, zinc, and fat-soluble vitamins), and requires compliance with follow-up visits.
More information about duodenal switch surgery can be found here.
Schedule an consultation with Dr. Ayoola to discuss which procedure could be the best option for you. Weight loss surgery can be an intimidating thought, but it could also be just what you need to achieve the weight loss you desire.
#4 Weight Loss Surgery