Bariatric surgery is the name given to surgical procedures designed to help people lose weight through the limitation of food intake. This is accomplished by the reduction of the stomach’s capacity and size, causing malabsorption of calories — an effective approach to weight loss in cases of severe or morbid obesity. Due to improvements and advancements to the procedures, it is now possible for surgeons to perform weight loss surgery using minimally invasive techniques.
Bariatric Surgery Overview
There are four main types of bariatric surgery: gastric bypass, sleeve gastrectomy, adjustable gastric band (gastric banding), and biliopancreatic diversion with duodenal switch. Surgery is the most extreme option for medically supervised weight loss methods, which has both advantages and disadvantages. The main benefit is that the process of losing weight is quicker and easier with the surgery, however, patients still need to make changes in diet and exercise habits.
Surgery is often the last resource for patients with a Body Mass Index higher than 40, or a BMI of 35 and an associated disease, such as high blood pressure, heart disease, diabetes, metabolic disease or sleep apnea. The type of surgery that may be of the most benefit to a patient depends on a series of factors and should be discussed together by both physicians and patients, taking into consideration benefits and risks associated with surgery, which include bleeding, infection, leaks, diarrhea, and blood clots.
Bariatric Surgery Procedures
Gastric bypass or Roux-en-Y Gastric Bypass is a weight loss procedure conducted in two phases. Surgeons start by creating a small pouch in the stomach, which is followed by the creation of a connection from the pouch to the small intestine. The gastric bypass both reduces the size of the stomach and rearranges the digestive system, which causes alterations in gut hormones, improving satiety, restricting the amount of food consumed and the absorption of calories.
Sleeve gastrectomy surgery is a procedure that permanently removes up to 90% of the stomach, reshaping the remainder of it into a sleeve, similar to the size and shape of a banana. The surgery works by reducing the size and capacity of the organ, impacting gut hormones that influence hunger, satiety and blood sugar. The effectiveness of the surgery is proven, however, severe complications are possible and the process is irreversible.
Adjustable Gastric Band
Gastric band is a surgical procedure during which a plastic band is implanted around the upper part of the stomach, creating a smaller pouch. By restricting the opening and size of the organ, patients eat less and feel full faster. The stomach’s opening can be adjusted by filling the band with saline and further simple procedures may be needed to readjust, reposition or remove the band. Gastric band surgery is favored because it is simple, minimally invasive, effective, and has few serious complications.
Learn more about Gastric Band Surgery.
Biliopancreatic Diversion with Duodenal Switch (BPD/DS)
The BPD/DS procedure is based on the separation of the small intestine into two parts, in order to connect one to the stomach, rearranging the digestive system. Due to the surgery, food ingested passes directly from the newly created tubular stomach pouch into the last segment of the small intestine, bypassing about three-fourths of the small intestine, which is a part of the digestive system that carries bile and pancreatic enzymes crucial for the protein and fat absorption.