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Consider Your Options for Bariatric Surgery Success

Bariatric surgery has been found to be the most reliable approach to achieving weight loss for those with severe obesity (BMI>35) associated with medical problems and morbid obesity (BMI > 40).  That doesn’t mean it’s a shortcut or a simple way to achieve weight loss; it requires a lifelong commitment to lifestyle changes.

How Bariatric Surgery Works

For that reason, it’s important to give the different types of bariatric surgery careful consideration. Each is simply a tool you can use to achieve your weight loss goals.

Bariatric surgery helps patients achieve weight loss in two different ways.

  1. Restriction: Decreases the size of the stomach, which limits the amount of food you can consume before feeling full.
  2. Malabsorption: Shortens or bypasses part of the small intestine, which reduces the amount of calories and nutrients absorbed by the body.

Some procedures apply both restriction and malabsorption, and some only restrict calories. Each type of bariatric surgery has pros and cons, which are summarized below.

Roux-en-Y Gastric Bypass Surgery

This minimally invasive surgery decreases the size of the stomach to about the size of a small egg. This decreases the amount of food the stomach can hold, which will trigger fullness. The smaller stomach is connected directly to the middle portion of the small intestine; it bypasses the rest of the stomach and upper portion of the small intestine. This reduces the amount of calories being absorbed. The stomach continues to function, sending enzymes and digestive juices into the small bowel.

Points to Know:

  • Usually leads to fast, dramatic weight loss of an average of 70-80% of excess weight
  • Weight-related afflictions, such as diabetes and high blood pressure, often resolve or greatly improve
  • Vitamin deficiencies are possible
  • Requires major surgery, but can be accomplished laparoscopically in more than 99% of cases

Sleeve Gastrectomy Bariatric Surgery

With this laparoscopic surgery, a small, sleeve-shaped stomach, about the size of a banana, is created by cutting, stapling and removing a large portion of excess stomach. The size (15% of normal stomach) restricts the amount of food and calories that can be consumed.  The procedure also eliminates a part of the stomach that produces the hormone that stimulates hunger (Ghrelin). The remaining stomach and intestines function normally otherwise, preventing malabsorption of nutrients.

Points to Know:

  • Most foods can be consumed, but just in smaller amounts
  • Weight loss is more gradual, but still averages 60-70% of excess weight
  • This has become the most popular weight loss surgery
  • A common complication includes acid reflux
  • Surgery is not reversible

Adjustable Gastric Band Surgery

This laparoscopic procedure involves placing a band around the upper most part of the stomach, partitioning the stomach into one small and one large portion.  The smaller-sized portion limits food consumed as patients feel full faster, but does not interfere with food absorption.  A port is placed under the skin of the abdomen which allows the band to be adjusted to make it larger or smaller as needed.

Points to Know:

  • This is the least invasive weight loss surgery, but weight loss results are variable and less dramatic
  • Band is adjustable and surgery is reversible
  • Leads to loss of about 40% of excess weight, in a more gradual time frame
  • Vitamin deficiencies are rare
  • Band can slip, leak, or (rarely) erode into the stomach
  • Not a popular since the sleeve gastrectomy became an approved weight loss procedure

Duodenal Switch for Weight Loss Surgery

This procedure, one of the most complicated of the bariatric surgeries, combines a sleeve gastrectomy with a bypass of two-thirds of the small intestine. The result is a calorie restriction and malabsorption for enhanced weight loss.  The duodenal switch was once universally denied by insurance companies but is increasingly being covered.

Points to Know:

  • Generally produces reliable, long-lasting weight loss which averages 80% of excess weight
  • Vitamin deficiencies and chronic diarrhea are common complications
  • Sleeve gastrectomy portion of this surgery is not reversible
  • One of the least popular options among patients nationwide

Find out if your weight puts you at risk for health issues today.

Consult with our bariatrics team about if insurance covers bariatric surgeries, or about MD Save options through CHI Health.

Michael Hovey, MD, FACS
Michael Hovey, MD, FACS

Dr. Michael Hovey is a bariatric and general surgeon for CHI Health. He also serves at the Medical Director for the Weight Management Department.

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