After you and your doctor determine that you are a suitable candidate for bariatric surgery, the next step is to explore the most appropriate weight loss surgery for you. To make an informed decision about which bariatric procedure is right for your body, you need to learn more about each available weight loss option.
What is Weight Loss Surgery?
Weight loss surgery, or bariatric surgery, alters the stomach’s structure and, in some cases, the small intestine to reduce calorie intake and absorption. The impact of weight loss surgery extends beyond simply reducing the stomach size to decrease food consumption; it also modifies the actions of certain hormones to suppress hunger.
All bariatric surgeries are effective for weight loss, though their success rates vary. Gastric bypass results in an average loss of 71 percent of excess weight after three years. Sleeve gastrectomy leads to an average loss of 66 percent of excess weight after three years. Adjustable gastric banding achieves an average loss of 55 percent of excess weight after three years.
What are the Types of Weight Loss Surgery?
Gastric Bypass
Gastric bypass is a type of restrictive bariatric surgery in which the surgeon uses a stapling device to create a small pouch at the top section of the stomach, reducing its size to hold less food. The surgeon then attaches the lower portion of the small intestine to this small pouch.
This reconfiguration of the digestive system bypasses the lower portion of the stomach and the upper section of the small intestine, known as the duodenum. By closing off the lower section of the stomach, the procedure limits its capacity, thereby controlling the amount of food you can eat.
Pros:
- The combination of restricted calorie intake and reduced absorption can lead to faster weight loss compared to other types of bariatric surgery.
- If severe complications arise, the surgery can be reversed.
- Gastric bypass is regarded as the gold standard treatment for morbid obesity.
- It typically results in significant weight loss.
Cons:
- Due to the two-step nature of the surgery, there is an increased risk of bleeding complications.
- The recovery period may be longer compared to other weight loss procedures, and the surgery itself requires more time in the operating room.
- Patients may experience more instances of dumping syndrome, where undigested food enters the small intestine.
- There is a higher likelihood of malabsorption with gastric bypass.
- Patients cannot take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) or naproxen (Aleve).
Sleeve Gastrectomy
A sleeve gastrectomy reduces the stomach’s size without altering the small intestine, unlike gastric bypass. The surgeon reshapes the stomach into a small, sleeve-like pouch and removes the remaining portion of the stomach. Since the small intestine is not altered, food passes through the stomach and into the duodenum as usual.
By reducing the stomach’s size, you feel full faster. This surgery also has the same hormonal impact as gastric bypass, making you less hungry even with a lower calorie intake.
Pros:
- The surgery is less complex compared to gastric bypass.
- The procedure takes half the time of a gastric bypass.
- There are fewer issues with malabsorption.
- There is a lower risk of dumping syndrome.
- It is effective for weight loss.
Cons:
- The removal of the lower portion of the stomach makes the procedure non-reversible.
- Some patients may experience stomach discomfort, such as heartburn or gas, and some may develop difficulty swallowing.
Gastric Banding
Adjustable gastric banding involves using a silicone band to divide the stomach into a small and large pouch. A port attached to the abdominal wall allows saline to adjust the band, controlling the size of the food passage and how much you can eat.
Unlike gastric bypass and sleeve gastrectomy, this procedure does not surgically alter the stomach’s anatomy. Instead, the band separates the stomach into upper and lower sections, restricting the amount of food you can consume at one time.
Pros:
- Adjustable gastric banding does not involve cutting into the stomach or intestine, though it does require small surgical incisions and the creation of a stoma (a small hole in the abdominal wall).
- The procedure is completely reversible.
- It avoids complications associated with other bariatric surgeries, such as malabsorption and dumping syndrome, as it only restricts food intake.
Cons:
- It has a lower success rate compared to gastric bypass and sleeve gastrectomy.
- The band can cause complications, such as slippage or erosion.
- The stoma created for accessing the port can have complications, including irritation, infection, or blockage.
- As a foreign object, the band may not be well-tolerated by the body, potentially leading to scar tissue, nausea, and vomiting.
- It generally results in less weight loss than other bariatric surgeries.
- The band may require adjustments or saline refills over time.
How To Select A Weight Loss Surgery
When deciding on a weight loss surgery, the best approach is to consult with your doctor. This is a decision you and your doctor will make together, taking into account the pros and cons of each type of surgery. Factors such as your medical history, lifestyle, and risk tolerance will play a significant role in the decision.
There is no universally “better” or “worse” weight loss surgery—only the one that suits your body type and weight loss goals best. To aid in the decision-making process, it’s beneficial to research the available surgeries. This will enable you to have a comprehensive discussion with your weight loss surgery team about the potential impacts on your life.
Best Bariatric Surgery For Me
If you are ready to talk about your weight loss surgery options, we are here for you. Here at Maryland Bariatrics, our providers are trained on the latest techniques and safest ways to perform bariatric surgery. To learn more, please contact us today.
