Top three weight loss procedures

Lana Bandoim's picture

If you have a serious weight problem which has not been helped by exercise, diet or medication, and you also have a serious accompanying condition such as diabetes or high blood pressure, then it may be time to consider surgical procedures. However, how can you tell which one is best for you?

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Surgeons use a variety of bariatric or weight loss procedures either to restrict the size of the patient’s stomach, reduce the intestine’s ability to absorb nutrients or some combination of the two. All of these procedures have their advantages and disadvantages and have been proven to produce long-term weight loss in many patients.

Gastric bypass

One of the most frequent procedures is the Roux-en-Y gastric bypass, which combines stomach restriction with malabsorption. Staples are used to make a small pocket at the top of the stomach, which is then connected to a section of the small intestine. The surgeon reattaches the upper part of the small intestine to the rest of the stomach making a “Y” shape.

Some of the food you eat will go straight down the intestine without being digested. This combination has been shown to produce rapid, significant and sustained weight loss in thousands of patients. However, the dumping of partially digested food has proven to be a problem for a few people. In some cases, the surgery has to be reversed.

Adjustable gastric banding

The adjustable gastric band is a ring which is used to divide the stomach into two parts and results in a figure-of-eight or hour-glass configuration. The narrowing dramatically slows down digestion, so you can only eat a small quantity of food before feeling full.

On the positive side, this procedure is considered safer than other operations such as gastric bypass and the tightness of the band can be adjusted later. The physician simply has to increase or decrease the volume of liquid pressurizing the band.

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On the negative side, the weight loss seen is typically less dramatic than with the bypass operation and may decline over time. Food has to be soft or well chewed to pass through the narrowing, and it is possible for the band to slip out of place.

Sleeve gastrectomy

Sleeve gastrectomy is an operation which radically reduces the volume of the stomach by 85 percent. Keyhole surgery is used to remove the lower bulge of the stomach, which is then stitched or stapled back together as a banana-shaped tube. It is sometimes combined with other procedures but has shown good results on its own by enabling patients to lose half their excess weight in under a year and is now considered to be the fastest growing weight loss procedure in North America.

Since there is no interference with the intestines, many side effects are avoided, and there is no loss of nutrients through malabsorption. The stomach continues to function normally, so patients are able to eat most foods in moderation, and there is a low risk of dumping syndrome. The operation is irreversible. There is a slight risk of leaking from the seam or blood clot formation, and, as with all surgery, infection can occur.

Other considerations

There is a new approach which uses a small device similar to a pacemaker to send electrical signals to the patient’s stomach nerves and gives the message that it is full. However, it is too early to see how effective this procedure will be in the long term.

Your doctor will want to be sure you have honestly tried a rigorous program of diet, exercise and possibly prescribed medication before turning to surgery. Guidelines state that surgery is appropriate for people with a BMI (Body Mass Index) of over 40 or less if they have a serious accompanying condition. As a rough guide, this means about 80 pounds overweight for women or 100 pounds for men.

Psychological factors are also important. Are you likely to stick to an appropriate diet after you have the procedure? Research shows a heightened incidence of depression following sudden weight loss. If you understand the risks and decide to go ahead with a bariatric procedure, make sure to choose a clinic which has a proven track record in performing your particular operation.

Image from Pixabay.com and used with permission.

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