According to the Weight-control Information Network, or WIN, bariatric or weight reduction surgery is an option to help the severely obese to lose weight when weight loss cannot be achieved by diet and exercise. By limiting the amount of food eaten, bariatric surgery promotes weight loss, which can reduce the risk of progression or development of other conditions, such as diabetes and heart disease. Surgery comes with significant risks, and only a medical professional can decide if bariatric surgery is warranted.
Types
According to WIN, there are a few bariatric surgery options available to those in the United States. The Roux-en-Y gastric bypass, one of the first approved surgeries, reduces the size of the stomach to a small pouch and reattaches the small intestine to the pouch. The adjustable gastric band---Lap Band and Realize---uses a small band placed around the top of the stomach to reduce the amount of food eaten at one time. The biliopancreatic diversion with a duodenal switch is another option, in which the stomach is surgically reduced and the small intestine rerouted to partially prevent the absorption of food. One of the newest types of surgery to date is the vertical gastric sleeve, which involves the removal of most of the stomach.
How It Works
All types of bariatric surgery either limit food intake, decrease absorption or both, according to WIN. The lap band and gastric sleeve decrease the amount of food that is consumed. The smaller portion sizes reduce calories consumed, which results in weight loss. The roux-en-y and biliopancreatic diversion with a duodenal switch both reduce the size of the stomach and route the food directly into the small intestine, which results in restricting both food intake and absorption. By decreasing absorption, nutrients consumed pass through the gastrointestinal tract without being utilized, causing weight loss.
Risks
Bariatric surgery utilizes malabsorption to facilitate weight loss. According to the Mayo Clinic, problems associated with malabsorption include vitamin and mineral deficiency, low blood sugar, dumping syndrome, dehydration and food intolerance. Other risks include gallstones, stomach ulcers, incision site issues including hernias and bleeding, kidney stones and even death.
Costs
Bariatric surgery is expensive and may or may not be covered by medical insurance. WIN states that on average the surgery costs from $20,000 to $25,000. For some insurance companies to cover the cost it may need to be deemed medically appropriate. Some procedures may be covered by insurance; others may not.
Results
Bariatric surgery is the most effective and long-lasting treatment for the obese, according to the American Society for Metabolic and Bariatric Surgery. Each person has different results, with dramatic weight loss being the main goal. Other results include reduction in complications from type 2 diabetes, high cholesterol, high blood pressure, gastroesophageal reflux disease (GERD), non-alcoholic fatty liver disease and sleep apnea.
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