Weight-loss surgeries, also known as bariatric surgeries, are designed to help obese individuals and those at risk of obesity-related medical problems begin to lose and manage weight. Several bariatric surgery options are available in the United States for those who qualify. Each works differently, comes with varied risks and requires long-term follow-up care. Talk to your doctor to determine whether weight-loss surgery is appropriate for you.
Function
Weight-loss surgeries aim to promote weight loss in obese individuals who can't lose weight through conventional means, such as diet and exercise, and those at risk for obesity-related medical conditions. Bariatric surgery is not considered a final solution to obesity, but a valuable starting point and means of jump-starting weight loss. The goal is to improve weight management while reducing a person's risk for serious conditions and disease.
Types
Four types of weight-loss surgeries are common in the United States: adjustable gastric band (AGB), Roux-en-Y gastric bypass (RYGB), biliopancreatic diversion with a duodenal switch (BPD-DS) and vertical sleeve gastrectomy (VSG). AGB limits food intake. A small band is placed at the top of the stomach to create a pouch that can be expanded or deflated. The body can only retain food that fits within this small pouch. RYGB also uses the small band to reduce food intake. In addition, RYGB reduces food absorption by rerouting ingested food past certain areas of the digestive system.
BPD-DS, also known as a "duodenal switch," is a complex procedure that involves removing a large portion of the stomach, rerouting some food to inhibit absorption and rerouting digestive juices to reduce digestion. VSG was once considered a first-stage surgery for people in need of BPD-DS, but who needed less intensive surgery as preparation. VSG has since been proved helpful for some as a solitary procedure. It works by removing most of the stomach to restrict food intake and reduces production of a hunger-producing hormone called ghrelin.
Effectiveness
Though individuals' results vary, weight-loss surgeries are producing promising results. According to the National Association for Weight Loss Surgery, 62 percent of patients studied by the American Obesity Society who underwent AGB surgery lost at least 25 percent of their excess body weight, 52 percent lost at least 33 percent and 10 percent lost at least 75 percent. Following weight-loss surgery, most people lose 28 to 65 percent of their body weight after two years, and 54 percent lose this amount after five years. People most successful at losing weight and keeping it off participate in additional treatments, such as dietary programming, behavioral therapy and physical fitness training.
Requirements
Candidates for weight-loss surgery must have either a body mass index (BMI) that exceeds 39 (the equivalent of roughly 100 excess pounds for men or 80 excess pounds for women) or a BMI that falls between 35 and 39.9 coupled with a serious obesity-related health condition, such as heart disease, type 2 diabetes or advanced sleep apnea.
Candidates must also demonstrate reasonable operative risks (meaning their body can likely tolerate the surgery safely) and the ability and willingness to partake in follow-up treatments, such as food restriction and exercise, on a long-term basis. Prior to surgery, candidates should understand the surgical procedure, the potential risks and lifestyle changes that will be required.
Complications
Since people remain overweight immediately following surgery and excess body weight adds stress to the chest cavity, pneumonia may develop. According to the Mayo Clinic, roughly 5 percent of people develop infections in the incision made during weight-loss surgery. Blood clots in the leg, called venous thrombosis, may also occur, unless leg exercises, such as walking or leg lifts, are done during recovery. Leaks may develop near the stitching or staple lines in the stomach.
More serious complications may include hernias, ulcers or a narrowing of the opening between the stomach and intestine. Narrowing of the opening, or stoma, though rare, may require additional surgery.
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