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Bariatric Surgery
Candidates
Weight loss surgery, also called gastric or bariatric surgery, is designed to treat patients suffering from class 3 (morbid) obesity with comorbidities who are unable to lose weight using conventional dietary and exercise methods.
Types of Bariatric Surgical Procedures
In brief, there are two classes of surgery: stomach/gastric banding and stomach/gastric bypass. The former is a type of "restriction" surgery, the latter a type of "malabsorption" surgery. Examples of stomach band operations include: vertical banded gastroplasty and adjustable gastric banding (lap band). Examples of gastric bypass include: Roux-en-Y bypass, Fobi Pouch, Biliopancreatic Diversion bypass with/without Duodenal Switch. As well as traditional 'open' surgery methods, gastric surgeons now use minimally invasive laparoscopic techniques that utilize instruments connected to video monitors, to help reduce post-operative complications.
Gastric Banding
Stomach or gastric banding is a "restrictive" type of operation designed to "restrict" food intake by reducing the size of the stomach. Bariatric surgeons typically create a small stomach pouch using gastric-staples, or a silicone or silastic stomach band. This shrinks the stomach from melon to egg size and reduces the amount of food patients can eat at one meal. Although gastric band surgery is usually reversible and does not fundamentally alter the anatomy of the digestive system, it is easier for patients to "cheat". Therefore stomach banding is not as effective for weight reduction as stomach bypass operations.
Gastric Bypass
Stomach bypass surgery is a "malabsorptive" type of operation designed to restrict food intake AND reduce calorie absorption. In a two stage process, the weight loss surgeon typically shrinks the stomach using gastric-staples and then bypasses the first part of the small intestine (duodenum and jejunum). This bypass causes food to pass much more quickly through the digestive tract and greatly reduces the amount of calories (and nutrients like vitamins and minerals) that the patient absorbs from the eaten food. Gastric bypass surgeries are considered to offer significant weight loss, although they are no guarantee of long term weight reduction.
Post-Operative Weight Loss and Dietary Guidelines
Both stomach banding and bypass surgery depend upon patients following their post-operative eating and exercise guidelines. If patients do NOT observe these food and nutritional rules they will not lose much weight and any weight loss may be regained within 2-5 years. They also run the risk of serious malnutrition.
Weight Loss Surgery For Teenagers
Due to the increasing levels of obesity among adolescents and teens, several gastric surgery pilot schemes are in operation to treat obese children. Being reversible, adjustable gastric lap band is the main bariatric option.
Popularity of Weight Loss Surgery As a Weight Control Option
Gastric bypass and stomach banding is becoming a mainstream weight control method for the treatment of severe clinical obesity. In 2004, 144,00 weight loss surgeries are predicted to be performed. The average bariatric surgery patient is a woman in her late 30s who weighs approximately 300 pounds. The average cost of the surgery is $30,000.
Note: Weight loss surgery, whether bypass or stomach banding, to reduce severe clinical obesity is a serious undertaking requiring detailed consultation with your doctor and bariatric surgeon.
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