Obesity has reached epic proportions in the United States with statistics showing that over 75% of adult Americans are considered overweight or obese. Studies have shown that an individual with a very high body mass index (BMI) has a very low probability of being able to lose enough weight, without medical assistance, to bring their BMI down to a healthy level. Bariatric Surgery may be a good solution for these patients.

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Who Would Benefit From Bariatric Surgery?

There is a standard criterion that qualifies people for bariatric surgery. Individuals who have a BMI of 40+ or have a body mass index of at least 35 and suffer from one or more obesity-related conditions that may include:

• Type 2 diabetes;
• High blood pressure;
• Sleep apnea;
• Joint problems that inhibit mobility.

Typically, these patients must also have a documented history of weight loss efforts through other means, they must be free from conditions that would exclude them from a surgical procedure, and they must be willing to make the lifestyle changes that are required.

Bariatric Surgery Methods

Bariatric surgeries work through one of two methods or a combination of both. These methods are classified as restrictive and malabsorptive.

Restrictive Type of Bariatric Surgery

Restrictive bariatric surgery prevents or limits the amount of food the patient can eat in one sitting. This restriction is accomplished by making the stomach smaller through a surgical procedure. The stomach is reduced to approximately 70-80% of its original size. When the stomach size is reduced, it also reduces the amount of ghrelin (the hormone that makes you feel hungry) that the stomach can produce. The patient feels “full” longer, the stomach takes longer to empty, and “hunger pangs” are greatly reduced which all promote weight loss. All bariatric surgeries use restrictive methods.

Malabsorptive Type Of Bariatric Surgery

Many bariatric surgeries also contain malabsorptive elements that help promote weight loss. This is done by surgically altering the digestive system so that the food the patient ingests does not stay in the body for a long enough time to extract all the calories and nutrients from that food. The food skips part of the routine digestive process and is eliminated from the body quicker than normal. Patients usually are required to take nutritional supplements for the rest of their lives after undergoing bariatric surgery.

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5 Types Of Bariatric Surgery

Gastric Sleeve Surgery (VSG, LSG)

Gastric sleeve surgery, vertical sleeve gastrectomy (VSG), and laparoscopic sleeve gastrectomy (LSG) are all terms used to describe the same surgical procedure. This procedure drastically reduces the size of the patient’s stomach to about 25% of its original size.

The surgery is performed laparoscopically through small incisions that are strategically placed on the patient's abdomen. Guided by a tiny camera, the surgeon cuts out and removes a large portion of the stomach stapling the remaining edges together to form a banana-like tube. Vertical sleeve gastrectomy only uses the restrictive type of bariatric surgery and is also used as the first step in other weight loss surgery procedures.

Gastric Bypass Surgery

Gastric bypass (Roux-en-Y) is a two-step bariatric surgery. During the first step, the surgeon performs gastric sleeve surgery which alters the patient's stomach size. Next, the surgeon reroutes a section of the small intestine so the food the patient ingests will bypass a large portion of the digestive system and travel directly into the small intestine.

Gastric bypass surgery uses a combination of restrictive and malabsorptive bariatric surgery types which prevent the patient from eating too much at one time and also prevents the body from absorbing all the calories and nutrients from the food.

Mini Gastric Bypass

The mini-gastric bypass is very similar to the gastric bypass but was developed to reduce surgical time, risks, and complications. The surgeon first makes the stomach smaller (gastric sleeve surgery) Next, a larger portion of the small intestine is bypassed but this is done with less intestinal rerouting. The mini gastric bypass uses both restrictive and malabsorptive techniques.

Duodenal Switch Surgery

Biliopancreatic diversion with duodenal switch (BPD-DS) is commonly known as The duodenal switch and uses both restrictive and malabsorptive techniques resulting in significant weight loss.

This surgery is like a combination of gastric sleeve and gastric bypass surgery but with greater malabsorptive ability. In addition to the reduction in stomach size, the digestive system is significantly altered to reduce the number of nutrients and calories that can be absorbed by the body.

Duodenal switch surgery is normally reserved for super obese individuals as it offers the greatest weight loss potential but also has a higher risk and complication rate.

Gastric Band

Gastric band surgery, like gastric sleeve surgery, is a restrictive type of bariatric surgery. The surgeon installs an adjustable device that resembles a belt on the upper portion of the stomach which limits the patient's ability to consume very much food.

This belt reduces the size of the stomach without dividing it permanently like other weight loss surgeries. The band can be adjusted to manage the size of the opening between the smaller upper portion of the stomach and the lower portion.

When the patient eats, the upper portion of the stomach fills up fast and the patient is not able to continue eating. The food passes very slowly into the lower portion of the stomach (keeping the patient feeling full longer) and travels through the digestive system as normal. Gastric bands are meant to be life-long devices but can be removed if necessary.

Alternatives To Bariatric Surgery

Bariatric surgeries effectively promote weight loss but all come with risks and potential long-term complications. With the exception of gastric band surgery, all bariatric surgeries are permanent alterations and not easily or safely reversed.

Non-surgical weight-loss procedures such as Suture Sculpt endoscopic sleeve gastroplasty (ESG) and Orbera gastric balloon offer significant weight loss potential with limited risk and reversibility.

To learn more about losing weight without surgery, contact Batash Endoscopic Weight Loss Center. We would be happy to explain how these procedures work and help you determine how you can safely and successfully reach your weight loss goal.

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