Types of Bariatric Surgery
In gastric bypass surgery, the bariatric surgeon staples a person's stomach to create a small pouch in the upper section, divides the small intestine into two parts and attaches the lower part directly to the small stomach pouch. The surgeon then reconnects the upper part of the small intestine to a new location farther down on the lower part of the small intestine. This procedure is difficult to reverse but can be done if medically necessary. Gastric bypass surgery allows a person to feel full sooner, absorb fewer calories and digest food fully.
Gastric sleeve or VSG surgery is an irreversible bariatric surgery that permanently removes most of the stomach, leaving only a banana-shaped section closed with staples. This procedure reduces a person's food intake, giving a person the feeling of a full stomach sooner, even with a small amount of food.
This type of surgery involves placing a ring with an inner inflatable band and a circular balloon that is filled with saline solution. The ring is then wrapped around the top of a person's stomach to create a small pouch. The surgeon can inject or remove the saline solution through a port under your skin. An adjustable gastric band requires several follow-up visits to adjust the size of the band opening. The surgeon may remove the band if it causes problems or does not help you lose enough weight. Like gastric sleeve and gastric bypass surgery, an adjustable gastric band makes a person feel fuller after eating a small amount of food.
This type of surgery starts with a procedure like gastric sleeve surgery and then proceeds to a second surgical procedure that divides the small intestine into two tracts. It reduces the number of calories and amount of nutrients absorbed and allows a person to lose more weight compared with the other three operations described above. It is also most likely to cause surgery-related problems and a shortage of vitamins, minerals and proteins in the body.
Weight Loss Surgery Frequently Asked Questions
Bariatric surgery is not for everyone. According to the American Society for Metabolic and Bariatric Surgery, you may qualify for bariatric surgery if you have:
- BMI ≥ 40, or more than 100 pounds overweight
- BMI ≥ 35 and at least one or more obesity-related comorbidities such as Type 2 diabetes (T2DM), hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders or heart disease
- Inability to achieve a healthy weight loss sustained for a while with prior weight loss efforts
Most patients return to work in one or two weeks after surgery. Since obesity is a long-term disease, life after bariatric surgery requires yearly visits with a bariatric specialist for life. These visits are essential to help keep the weight off after surgery. Additional treatment, such as weight loss medications, may be recommended for some patients. Patients also need to be on vitamin and mineral supplements for life.
Patients may lose as much as 60% of excess weight six months after surgery and 77% as early as 12 months after surgery. On average, patients who have had bariatric surgery maintain 50% of their excess weight loss five years after surgery.
Bariatric surgery is the most effective and long-lasting treatment for severe obesity. Studies show that bariatric surgery may reduce a patient's risk of premature death by 30-50%. However, like any major surgical operation, it carries a risk of complications which may include:
- Blood clots
- Wound infection
- The gastric band slipping out of place, which needs further surgery to put it back in place or remove it
- Leak in the gut
- Blocked gut as a result of scarring and reduced blood flow to the area
- Malnutrition due to poor vitamin and mineral absorption from food
- Gallstones, which can form in the first year or two after bariatric surgery
- Excess skin, particularly around the breasts, stomach, hips and limbs
- Risk of death, although very rare
