Losing weight can be a very hard task for some people. Our country spends countless amounts of money to shed the extra pounds we have gained in our modern lifestyles. The problem is that it doesn’t seem to be working.
It is estimated that 1 out of 3 adults in the US is obese. It’s not hard to figure out that people are trying to lose weight, just look at all the money that we have spent. It’s nearly $65 billion per year! But what do they do when everything seems to have failed and there is no way out? Most turn to surgery.
We aren’t talking about liposuction, which is used to remove excess fat deposits under certain parts of the body to make it look nicer and firmer, we are talking about major weight loss surgery, also known as bariatric surgery.
What types of bariatric surgery are there?
There are actually 5 different types of bariatric surgeries, and each is different from another in specific ways. Out of these five types of surgeries, three are very common and the two others aren’t as common.
The three most common surgeries are Adjustable Gastric Banding, Sleeve Gastrectomy, and Gastric Bypass Surgery. The two least common surgeries are the use of a Maestro Rechargeable System and Biliopancreatic Diversion. Let’s take a look at each one of these surgeries a bit closer.
Adjustable Gastric Banding
Adjustable Gastric Banding is a restrictive type of weight loss surgery. The idea behind this surgery is very clever. A band is used to separate your stomach into two parts, an upper section which is smaller in size and a lower section much larger in size.
Both of these sections are still connected through a small opening. This small opening between the pouches reduces how fast the upper pouch empties. The result is that the patient is able to eat much less before getting full, which in turn reduces the amount of calories being consumed by the body.
This surgery is usually much easier to do than other weight loss surgeries like gastric bypass. The scar is generally much smaller as well.
Recovery from the surgery is also shorter, so time spent at the hospital isn’t as long as after other surgeries. Finally, the surgery can be easily reversed if necessary. If need be, the size of the band can also be changed at your doctor’s office by either increasing the amount of liquid inside the band or decreasing it.
The amount of weight lost after this type of a surgery is often slower and less drastic when compared to other surgeries. Also, the likelihood of gaining the excess weight back after the initial weight loss is greater than other surgeries.
The most complained about issue that patients face after this surgery is frequent vomiting. They aren’t used to the now much smaller amount of room for their food to go into and end up overeating quickly after surgery which results in vomiting. Other complications can also occur with the band itself.
The band can slip or become lose or even leak and fixing these problems will require more surgery. Infection is a possibility as well, although this is always a risk with any surgery. Life-threatening problems are very unlikely but are possible.
Sleeve Gastrectomy is another restrictive type of surgery. During this surgery, about 70% of your stomach is removed and all that’s left is a banana shaped passage which connects directly to your intestine.
Most people who undergo this type of surgery are successful with their weight loss, but sometimes it is used as the first step in a series of required weight loss surgeries.
This type of surgery is used with people who are very sick or severely obese and other surgeries pose too much risk. It is a much simpler operation, which creates a risk-free way to lose excess weight.
If the results aren’t sufficient then additional surgery, such as gastric bypass, can be done to further the weight loss.
This procedure cannot be reversed. This surgery is also relatively new which means that risk and long-term benefits aren’t set in stone yet.
The most typical complications involved with this type of surgery are infections, blood clots, and leaking of the sleeve.
Gastric Bypass Surgery
Gastric Bypass Surgery (Rouxen-Y) is both a restrictive and malabsorptive type of surgery. This weight loss surgery is the most commonly used of the 5.
Similarly to the gastric banding surgery, the stomach is divided into two parts; however, the upper part is completely sealed off from the lower part of the stomach. Then the surgeon attaches the upper part of the stomach directly to the lower section of the small intestine.
The result is a type of shortcut where food skips part of the lower intestine and the stomach, which reduces the amount of calories that your body is able to intake.
The weight loss is drastic and rather immediate. Nearly 50% of the weight loss occurs during the first 6 months after surgery. Furthermore, the weight may continue to drop up to 2 years after the surgery.
Because of its quick effects, people who are suffering from life-threatening obesity-related complications can benefit the most from this type of surgery.
There has also been a lot of positive feedback from patients who have had this surgery done in the past and in most cases, they were able to keep the weight off for 10 years and even longer.
Technically, this type of surgery is irreversible. However, in some extreme cases, there have been reversal procedures completed. Malnutrition is also a possibility due to the reduced nutrient absorption capabilities since a big part of your digestive system is being bypassed.
This means you will have to take vitamin supplements for the rest of your life. Dumping syndrome is another possibility, which can occur when food passes from the stomach to your intestine way too quickly.
This is more likely after a gastric bypass than normally. Dumping syndrome can cause diarrhea, pain, bloating, sweating, nausea, and weakness.
Gastric bypass is a more complicated surgery. This means that your surgery-related risks are increased, such as infection and blood clots. Gallstone and hernias are also an increased risk.
Maestro Rechargeable System
This is an implant type surgery and is less commonly used. Whenever your stomach becomes full, a special set of nerves sends a signal to your brain to let it know that it’s time to stop eating.
This surgery involves a pacemaker type device which delivers electrical pulses to these nerves to make you think that you are full. It is implanted in your abdomen and controlled through a remote from the outside.
When you are awake, the implant is supposed to send pulses for 5 minutes then turn off for another 5 minutes then cycle again. At night, the system is supposed to stay offline.
Out of all the weight loss surgeries out there, this is the least intrusive one. Under general anesthesia, the surgery may take only about an hour and a half.
You have to keep the device charged at all times. Usually, this means that you will have to charge it about twice per week and if you let the device discharge completely then you will have to visit your doctor to get it reprogrammed. Some side effects may be nausea, vomiting, heartburn, chest pain, and belching.
The risks are usually only limited to surgery-related complications and pain at the site of the implant.
Biliopancreatic Diversion is both a restrictive and malabsorptive type of surgery and is less commonly used. The more extreme version of the gastric bypass surgery, biliopancreatic diversion is done by removing nearly 70% of your stomach and bypassing a higher amount of the small intestine than during regular gastric bypass.
There is a less extreme version of biliopancreatic diversion which involves an addition of a duodenal switch to the surgery which bypasses less of your small intestine and removes less of your stomach than regular biliopancreatic diversion surgery.
The addition of a duodenal switch reduces the risk of dumping syndrome, malnutrition, and ulcers.
Even faster and more drastic weight loss than gastric bypass. Even though a large portion of the stomach is removed, the post-surgery stomach capacity is greater than after gastric bypass surgery, meaning you can have larger meals.
The reason why this is the less commonly used surgery for weight loss is because it contains the same risks as those involved with gastric bypass but the risk of not getting enough nutrients is much higher. A duodenal switch might reduce these risks.
This carries the same risks as those of gastric bypass surgery, but they are increased due to the complication of the surgery and even greater nutrient intake reduction.
Who should consider bariatric surgery?
It should be pretty obvious that bariatric surgery is a very important and long term impacting procedure. Determining who might need the surgery varies from one patient to another and there are many factors which play a major role in whether you should consider any of the bariatric surgeries.
One example is if you have already had any type of abdominal surgery previously, it might not even be possible to undergo any of the bariatric surgeries.
You have to understand that these types of surgeries won’t only affect your physical state. There can be a huge emotional effect which will come along with a bariatric surgery.
Simply deciding that you want to do the surgery isn’t enough to qualify for these procedures. You have to have tried diets and exercise, including a medically supervised program, without any success. You also have to fall into one of the following categories:
- Your BMI index is 40 or above, which usually means you are about 100lbs overweight for males and 80lbs overweight for females.
- Your BMI range is 35-40 but you have an additional health issue which is directly related to your obesity.
- You are at least 100lbs heavier than your ideal body weight.
If you meet these basic prerequisites, then your doctor will certainly consider bariatric surgery as a possibility. However, there are plenty of other factors which will be taken into account to determine if this is the best option for you.
Your age, medical conditions, and mental health will also play a huge role in your doctor’s decision. The older you are, the higher the risks are for developing surgery-related complications, and if you are under the age of 18 then it might not even be a possibility. Your overall physical health will be a huge determining factor.
Whether you smoke, drink, or have any chronic conditions and the types of medications you are on will all play a major role in decision making. Are you a binge eater, prone to substance abuse, or susceptible to anxiety?
These will also determine whether the problem is psychological and if help from a psychiatrist is required before determining if bariatric surgery is the right choice for you.
You also have to keep in mind that bariatric surgery isn’t a miracle procedure. You will have to put work into keeping the weight off, as well. You can’t simply get the surgery and then continue eating as you were before.
You will need to keep an eye on your diet and the quantity of food you consume, as well as keep an active lifestyle. Bariatric surgery is designed to get excess weight off, help you start moving, and keep the weight off. But it won’t work if you don’t put work into it.
Does bariatric surgery work?
It would be fantastic if we could say “Yes!” without a second thought, but the reality is that even though the numbers for successful weight loss post surgery are very convincing, there are few who end up gaining the weight back.
In 2013 there were 179,000 weight loss surgeries. Out of all of them, 34% were Gastric Bypasses, 14% were Adjustable Gastric Bandings, 43% were Sleeve Gastrectomy of which 1% included a duodenal switch, 6% were revisional surgery, and 3% were classified as other.
Some people speculate that most weight loss surgery patients gain the weight back, but this isn’t exactly true. While about 50% of all weight loss surgery patients do gain some weight back after 2 years, the weight gained is only equal to about 5% of the weight lost.
Most patients are able to keep the weight off long term and are considered to have successful weight loss, meaning they maintain weight loss equal to or greater than 50% of their total excess body weight.
After looking at the facts and reviewing the statistics, we are able to say that in nearly all cases, post bariatric surgery long term weight loss was a success. However, there is a slight chance that you might not be able to keep the weight off. Take note, relapse weight gain is greatly dependent on the decisions of the patient.
What are the alternatives?
As we mentioned earlier, bariatric surgery if for people who have tried everything they can possibly do and there was no effect or the weight came back quickly. This surgery is life altering and very important. You have to legitimately give other weight loss methods dedication and really try to lose the weight naturally.
Talk to your doctor! They will be able to help decide which diet is the best, what exercises to do, and where to start. Simply walking can do amazing things when it comes to weight loss, but you should talk to your medical professional to determine if your joints are healthy enough to maintain such high levels of stress from all the excess weight.
Your heart is also a huge factor and testing will need to be done to ensure you are healthy enough and to determine the levels of stress that you can take before slowing down.
Pay attention to your brain and not your gut. If you are obese, chances are your stomach has most likely stretched to a bigger size then someone who is at the ideal body weight. This means you will feel hungry and want food more often.
Don’t let your stomach control you. Use your brain to trick yourself or to just simply conquer what your stomach is forcing you into thinking. Logic and common sense are your friends. Knowledge is vital as well, and there is plenty of information out there on a variety of diets. Read about them and try those that you think you can handle. Most importantly, don’t give up!
Bariatric surgery should be your last resort. For some people, it might be the only answer. But you have to understand, it is not going to work if you don’t maintain your new lifestyle changes after the surgery.
You control everything and you are the only one who can reduce how much you eat or change what you eat.
You are the only one who can wake up in the morning and go for a walk or a run. You are the only one who can choose to go out on a hiking trip during the weekend rather than hit up your favorite restaurant. Bariatric surgery can get a lot of weight off quickly, but it’s up to you to keep it off.