Weight Loss Surgery
Who Need Weight Loss Surgery or Bariatric Surgery
Weight loss surgery is not for everyone. There are different factors which determine if one is a right candidate for this procedure.
One of the most important factors is body mass index (BMI). BMI is used to assess excess weight by adjusting actual weight against person’s height. If the body mass index (BMI) is 32.5 or more — you may be suitable candidate for weight loss surgery. Generally speaking, if you are more than 20-25 kgs overweight, then you may fall in this category.
If you have tried various conventional measures and failed to maintain the weight loss, then bariatric surgery is one available option for significant, sustained weight loss.
Weight loss surgery may be an appropriate treatment option for those with serious obesity-related health issues such as high blood pressure. For such people, the risk of complications of the disease and even sudden death is high if they do not lose weight. Surgery not only helps lose weight but also reduces the risks from these complications.
Types of Weight Loss Surgery
The three most common types of weight loss surgery are the Roux-en-Y Gastric Bypass, the Adjustable Gastric Band, and the Vertical Sleeve Gastrectomy.
1. Gastric Bypass Surgery
Gastric bypass surgery, the most common of which is the Roux-en-Y gastric bypass procedure, results in a portion of the stomach being stapled to reduce appetite and food intake. A small stomach pouch is formed, but no portion of the stomach is removed surgically. The top section of the stomach (called the pouch – about the size of an egg or a walnut) is where food is digested. It holds only about one ounce of food.
The pouch is then connected to the small intestine. Fewer nutrients and calories are absorbed. Hunger and food intake are reduced, and 55 to 65 percent of excess weight can be lost, usually within one year. Because absorption of food nutrients is decreased, vitamin deficiencies may occur if supplements are not taken.
Gastric bypass surgery will require one to two days stay in the hospital. General anesthesia is utilized during surgery. Gastric bypass may be performed by either a traditional incision that will leave a permanent scar, or more commonly with a laparoscopic procedure that may leave less scarring and allow a quicker recovery. Full recovery may take two to five weeks before a patient can return to normal activities.
2. Adjustable Gastric Band Surgery
Adjustable Gastric Band Surgery, often referred to as lap band or band surgery is usually performed as an outpatient procedure. In the surgery, an adjustable silicone band is placed around the upper portion of the stomach. Small incisions are made in the skin to allow the band to be placed (laparoscopic procedure). The band creates a small stomach pouch at the top of the stomach – the stomach is not surgically reduced in size. The smaller pouch that is created with the band results in smaller amount of food intake, and a feeling of fullness after eating smaller portions of food. Surgery typically takes 45 minutes to an hour during which general anesthesia is used. Patients will go home the same day. Recovery is roughly two weeks.
After surgery, the tightness of the band can be adjusted by injecting saline into a small port. The port is implanted in the skin during the surgery and is attached to the gastric band. Injection of the saline can be done in the doctor’s office. The band can be loosened or tightened to meet weight loss goals. Adjustable gastric band surgery is a reversible procedure, and is considered the least invasive of all of the weight loss surgeries. Patients who are compliant with instructions on diet can usually lose between 30 and 40 percent of excess weight with the gastric band procedure. Weight loss is slower with gastric band surgery and it may take up to five years for complete weight loss.
3. Vertical Sleeve Gastrectomy
In vertical sleeve gastrectomy, at least 85 percent of the stomach is removed during surgery. The remaining narrow portion of the stomach is attached to the intestines. The volume of the stomach is reduced, but rerouting around the intestine does not occur, thus preserving nutrient absorption. Surgery typically lasts 60 minutes and general anesthesia will be used. The vertical sleeve gastrectomy procedure is not reversible. Sleeve gastrectomies may be appropriate as an alternative to gastric banding in certain patients.
The in-hospital recovery period is about two days, with a two to three week period for full recovery. Patients will lose 40 to 55 percent of their excess weight which is generally seen one to two years after surgery.