Obesity, a major cause of death in the United States, leads to more than 280,000 deaths each year, says the University of Maryland Medical Center. More than 200,000 bariatric surgeries--surgery to alter the stomach or intestines in a way that causes weight loss--are performed each year in the United States, according to the Merck Manual. Different types of bariatric surgery work for different types of people. All bariatric surgery carries some risk, some serious.
Qualifications
People who qualify for bariatric surgery must be obese. This means they have a BMI, body mass index, of 40 or greater or have a BMI of 35 and additional medical problems related to obesity--such as diabetes, heart disease or sleep apnea that could improve with weight loss of five to 10 percent, according to Merck.
Categories
Most bariatric surgery is performed laparoscopically, through very small incisions, although not all people can have laparoscopic surgery, Aurora Health Care says. About 8 percent of people, most often those weighting over 365 lbs., require laparatomy, or open abdominal surgery, Merck says. Bariatric procedures fall into two categories: restrictive, malabsorptive or both. Restrictive procedures decrease the amount of food eaten at one time by decreasing stomach volume, while malabsorptive procedures allow food to bypass the stomach and intestine so that less food absorbs.
Specific Types
Several types of bariatric surgeries are commonly performed, the two most common being the Roux-en-Y procedure and laparoscopic adjustable gastric banding. The Roux-en-Y gastric bypass, which makes up 80 percent of all bariatric surgery, according to Merck, remains the most common procedure performed by the Mayo Clinic, MayoClinic.com reports, because this procedure has the highest long term success rate. The Roux-en-Y procedure, often referred to as simply gastric bypass, reduces the size of the stomach and bypasses part of the intestines.
Laparoscopic adjustable gastric banding, often referred to as lap band surgery, restricts the size of the stomach. An adjustable band placed around part of the stomach allows gradual tightening of the band.
Results
Average weight loss for Roux-en-Y surgery tends to be higher than weight loss from lap band surgery. About 60 percent to 80 percent of excess weight is lost after gastric bypass, with 40 percent to 70 percent of excess weight lost, on average, after lap band surgery, Aurora Health Care says. Weight loss occurs most rapidly in the first two years, then stabilizes. Patients may regain some weight after the first two years but generally gain back only 10 percent to13 percent of weight lost over a 10-year to 14-year period, according to the University of Maryland Medical Center.
Complications
Serious complications can occur after bariatric surgery. Although wound infection occurs most frequently, in about 3 percent of patients, between .02 percent and 1 percent die within a 30 day post-operative period--mostly from blood clots in the lungs or problems with the surgical connection between the cut pieces of intestine, Merck says. Nausea, vomiting, malnutrition and vitamin deficiencies may develop.
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