Why Is Bariatric Surgery Better Than Standard Diets?

Obesity is responsible for major health care costs, as obese people are at high risk for developing diabetes, heart disease and other health problems. Also known as weight-loss surgery, bariatric surgery is designed to help obese people lose weight and reverse associated health conditions. Bariatric surgery is currently known as the most effective treatment for obesity.

Types of Bariatric Surgery

The two most common types of bariatric surgery are gastric bypass and gastric banding. Gastric bypass surgery involves making the stomach into a small, walnut-sized pouch and re-routing the digestive system so that food does not pass through some of the small intestine. With gastric banding, a band is tied around the stomach to decrease its volume so that you feel fuller faster.

Features

With a standard diet, your stomach capacity remains the same and every calorie you eat stays in your body. Bariatric surgery offers two important features that a standard diet cannot replicate; restriction and malabsorption. With gastric bypass, the size of the stomach restricts the amount of food that can be eaten, and bypassing part of the intestine prevents some nutrients from being absorbed into the bloodstream. Gastric banding is also restrictive as it decreases the size of the stomach.

Physiological Changes

Following a standard diet requires you to resist what your body naturally wants. If you typically eat 3,000 calories per day, going on a 1,500 calorie per day diet will cause your brain to send out hunger signals as your body searches for the missing calories. Having the discipline to continuously ignore these signals can be stressful and psychologically draining. Bariatric surgery changes the inner workings of your body so that your brain receives signals that you're full with much less food than it did before. This way, losing weight is more intuitive and less reliant on willpower.

Long-term Benefits

According to Schernthaner, a 2006 study by Anderson and colleagues showed that standard diets are rarely successful in the long-term management of severe obesity. For most dieters, weight loss is only temporary and eventual weight gain often exceeds what was lost. Bariatric surgery patients lose between 47.5 and 61 percent of their excess body weight, and according to Shah, a 2004 study following 641 patients showed that most of the weight was kept off after 10 years. Bariatric surgery can also resolve type II diabetes, high blood pressure, high blood lipids and sleep apnea. It is less common for these health problems to resolve with standard diets.

Hormonal Changes

Diabetes resolves in 80 percent of people with type II diabetes who undergo gastric bypass surgery. Weight loss alone can improve and resolve diabetes, but in a 2008 study by Laferrère it was shown that, in gastric bypass patients, diabetes resolves even before the patient loses a significant amount of weight. This is because the surgery has a direct effect on hormones that are responsible for blood sugar and insulin control. These hormones are usually imbalanced in patients with type II diabetes, but with surgery the levels return to normal within one month. In Laferrère's study, this response was not seen in people with diabetes who went on a low-calorie diet and lost the same amount of weight. This shows that the effect is related to the surgery rather than the weight loss.