As a disease, obesity has rapidly reached epidemic levels, silently affecting the most developed countries in the world. In the United States alone, 35.1% of the adult population and 20.5% of adolescents between 12 and 19 years old are obese, according to the Centers for Disease Control and Prevention (CDC). In severe and chronic cases, less invasive methods for losing weight, such as diet changes and exercise may no longer be an option.
Morbid obesity is diagnosed according to patients’ Body Mass Index (BMI) and it affects critical physical capacities such as breathing or walking. In addition, obesity can cause a series of other medical conditions, often referred to as “comorbidities,” including diabetes, high blood pressure, sleep apnea, gastroesophageal reflux disease (GERD), gallstones, osteoarthritis, heart disease, and cancer.
In these cases, weight loss surgery is often the best and sometimes even the only option for treatment, and is a decision made between a patient and physician as part of a medically supervised weight loss program. There are currently three major types of weight loss surgery — gastric bypass, sleeve gastrectomy, and gastric banding — and are conducted according to each patient’s individual needs and characteristics.
Weight Loss Gastric Bypass Surgery
Gastric bypass is a surgical procedure that reduces the size of the stomach and alters the function of both the stomach and the small intestine in order to increase satiety and enhance weight loss. This type of weight loss surgery is performed in two steps during a two to four-hour procedure and is particularly indicated for patients with BMI higher than 40 or higher than 35 and one comorbidity.
The patient is administered general anesthesia and the surgeons start by creating a small pouch in the upper section of the stomach using staples, which reduces the capacity of food intake. Then a bypass is created, connecting part of the small intestine to the new stomach pouch. The bypass prevents food from going into part of the stomach and small intestine, reducing the absorption of calories. The procedure can be conducted either through open surgery or with a laparoscopy, using a tiny camera placed into a small incision in the abdomen.
Weight Loss Sleeve Gastrectomy Surgery
During a sleeve gastrectomy, surgeons remove up to 90% of the patient’s stomach, reducing its size and food intake capacity. After removing a large portion of the stomach, the remaining part is joined with surgical staples and the new stomach will have the approximate size and shape of a banana. Patients will feel full more quickly, despite the fact that it does not affect the sphincter muscles that allow food to enter or leave the stomach.
This procedure, which is conducted under general anesthesia and through a laparoscopy, is the most invasive one and the removal is permanent. Therefore, it is particularly indicated for patients with the same characteristics eligible for other weight loss surgeries, but that are too heavy to safely undergo other types of procedures. Additionally, further surgeries may be needed to help in the treatment.
Weight Loss Gastric Banding Surgery
Gastric banding is the least invasive and risky surgery to treat obesity. It is performed through small incisions in the abdomen in a procedure that takes 30 to 60 minutes. The surgeons place the surgical tools through the incision and create a small pouch in the upper part of the stomach by placing a rubber band around the organ. In this way, the space available for food intake is much smaller, increasing the feeling of satiety and enhancing weight loss.
Additional surgeries may be needed to adjust, replace, reposition or remove the band and the procedure can be reversed, particularly when it is not effective. The success of any kind of weight loss surgery is closely associated with lifestyle alterations simultaneously conducted by the patients, including having a healthier diet and exercise.