Surgery to achieve weight loss is a serious undertaking. Anyone thinking about weight loss surgery should understand what the surgery involves.
The following are some of the most frequently asked questions (FAQ) about bariatric surgery:
How does bariatric surgery promote weight loss?
Surgeons use techniques that produce weight loss primarily by limiting how much the stomach can hold. Two types of surgical procedures used to promote weight loss are:
Through food intake restriction, malabsorption, or a combination of both, you can lose weight since less food either goes into your stomach or stays in your small intestine long enough to be digested and absorbed.
- Restrictive surgery: During these procedures the stomach is made smaller. A section of your stomach is removed or closed which limits the amount of food it can hold and therefore causes you to feel full.
- Malabsorptive surgery: Most of digestion and absorption takes place in the small intestine. Surgery to this area shortens the length of the small intestine and/or changes where it connects to the stomach, limiting the amount of food that is completely digested or absorbed (causing malabsorption). These surgeries are now performed along with restrictive surgery.
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What are the benefits to weight loss surgery?
Bariatric surgery is known to be the most effective and long lasting treatment for morbid obesity and many related conditions, but now mounting evidence suggests it may be among the most effective treatments for metabolic diseases and conditions including type 2 diabetes, hypertension, high cholesterol, non-alcoholic fatty liver disease and obstructive sleep apnea.
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What are the risks of bariatric surgery?
Weight loss surgery carries real risks. As many as 10% of people have complications afterwards. Usually problems are only unpleasant or inconvenient, may cause some pain and discomfort, or require additional surgeries, side effects include:
Serious complications that may occur after weight loss surgery, although rare -- happening about 3% of the time -- can sometimes be life-threatening:
- Nausea, vomiting, and diarrhea
- Wound infections
- Abdominal hernias
About 1 in 400 people die from weight loss surgery complications at thirty days. The risk is higher for people over age 60. Having bariatric surgery at a center with experienced surgeons reduces this risk.
- Blood clot to the lungs (pulmonary embolism)
- Leaks in the new gut connections
- Bleeding ulcers
- Heart attacks
Even after successful weight loss surgery, other problems are common:
Women of child bearing ages should avoid pregnancy until their weight becomes stable since rapid weight loss and nutritional deficiencies can harm a developing fetus.
- Gallstones, often requiring gallbladder removal
- Vitamin deficiencies or malnutrition, from poor absorption
- Excess skin, requiring surgical removal (body contouring)
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What are the weight loss surgical options?
There are two main types of weight loss surgery: restrictive and malabsorptive operations. While similar, each approach offers varied benefits and risks.
Restrictive surgery - restrictive operations such as the Adjustable Gastric Banding and Sleeve Gastrectomy drastically limit food intake without otherwise interfering with the normal digestive process. The patient loses the ability to eat anything but very small amounts of food at one time.
Although restrictive operations lead to weight loss in almost all patients, they are less successful than malabsorptive operations in achieving substantial, long-term weight loss. Successful results depend on the patient’s willingness to adopt a long-term plan of healthy eating and regular physical activity.
A common risk of restrictive operations is vomiting, which is caused when the small stomach is overly stretched by food particles that have not been chewed well. Band slippage and saline leakage have been reported after Adjustable Gastric Banding. In a small number of cases, stomach juices leak into the abdomen after Sleeve Gastrectomy, requiring an emergency operation. In less than one percent of all cases, infection or death from complication may occur.
Malabsorptive surgery - Malabsorptive operations such as the Gastric Bypass restrict both food intake and the amount of calories and nutrients the body absorbs. Roux-en-Y gastric bypass (RGB) is the most common and successful technique.
Malabsorptive operations can produce greater weight loss than restrictive operation, and are considered more effective in reversing the serious health problems associated with severe obesity. Patients who have malabsorptive operations generally lose two-thirds of their excess weight within two years.
In addition to the risks of restive surgeries, since malabsorptive operations carry greater risk for nutritional deficiencies, food bypasses the duodenum and jejunum, where most iron and calcium are absorbed. Menstruating woman may develop anemia because not enough vitamin B12 and iron are absorbed. Decreased absorption of calcium may also bring on osteoporosis and metabolic bone disease. Patients are required to take nutritional supplements that usually prevent these deficiencies.
Patients require close monitoring and lifelong adherence to special diets, supplements and medications.
Holy Name Medical Center offers 3 types of Bariatric surgical procedures.
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- Adjustable Gastric Banding
- Sleeve Gastrectomy
- Gastric Bypass (Roux-en-Y)