Surgery for weight loss is the last resort for people who are extremely obese. Also known as bariatric surgery, it is usually recommended for people who have a body mass index (BMI) of 40 or above. It works out to be about 100 pounds overweight for men and 80 pounds overweight for women.
Surgery for weight loss is recommended only for people whose obesity is life threatening and when other treatments and weight loss methods have failed. It is also recommended for obese people who have a lower BMI, but have health problems linked to obesity like heart diseases, type 2 diabetes, severe sleep apnea or high cholesterol. There are certain risks involved with the surgery, and only people who fully understand the risks will be eligible for surgery.
Surgery has to be done by very well experienced surgeons in good hospitals who are also if you are doing the surgery in America, they are certified by the American board of surgery.
Types of Weight Loss Surgery
There are four types of weight loss surgery. They are adjustable gastric banding, Roux-en-Y (gastric by-pass surgery), biliopancreatic diversion with a duodenal switch, and vertical sleeve gastrectomy. Implanting an electrical device to interrupt signals between the brain and the stomach is also done.
Adjustable Gastric Banding - In this type of restrictive surgery, an inflatable band is used to divide the stomach into two portions, connected by a small channel. This slows down the emptying of the upper pouch and people feel full when they eat very little food (about ½ to 1 cup). The band can be tightened or loosened. This surgery is safe and simple to do with very little scar. Recovery is faster and the band can also be removed at a later stage if required.
The negative point of this surgery is that the weight loss is relatively less when compared to other weight loss surgeries and people are likely to regain some of the lost weight.
The main side effect of gastric banding is vomiting. It is also possible that the bands will become loose, or shift position or leak. In such cases, further surgical procedure may be required to correct this. The risks are very unlikely to be life-threatening.
Sleeve Gastrectomy – In this type of restrictive surgery for weight loss, most of the stomach (75%) is removed and only a very small portion is connected to the intestine. This is a popular form of weight loss surgery.
Sleeve gastrectomy for weight loss is less risky than other forms of weight loss surgery, Some people have a gastric by-pass surgery after sometime. Since the intestines are kept intact, food absorption is not affected and there is no deficiency of nutrients for the body.
The negative points of this type of surgery is that it is irreversible. This surgery relatively new and hence the long term side effects are unknown.
The side effects are infection, leaking of the sleeve and blood clots.
Gastric Bypass Surgery (Roux-en-Y Gastric Bypass) -This is the most common surgery for weight loss and is a combination of restrictive and malabsorptive processes. Here, the stomach is divided into two portions and both these portions are not connected. The upper portion is directly connected to the lower portion of the small intestine. By skipping most of the digestive system, less calories are absorbed leading to weight loss.
The weight loss is very fast and within six months, patients lose 50 % of the excess weight and the weight loss continues for about two years. Most of those affected with diseases see an improvement in their condition. The weight loss can be maintained for about 10 years.
There are a few negative fallouts in this kind of surgery. Since food is not digested properly, essential nutrients are not properly absorbed leading to their deficiencies. Hence life long supplements may be required. This surgery is generally irreversible. Because of food not being digested properly, some people who have undergone the gastric bypass surgery experience many side effects like nausea, bloating, diarrhea, general weakness etc.
The side effects include developing hernia and gallstones and general risks associated with all surgeries.
Maestro Rechargeable System – This sends electrical pulses between the stomach and a nerve in the brain called the vagus nerve. It tells the brain when the stomach is full. This device is attached to the stomach and has a remote control outside the body. It delivers a pulse every 5 minutes when the person is awake and switches off when he sleeps.
This is an outpatient procedure and hence is one of the simplest surgeries which takes just 1 to 1 ½ hours to implant.
The problem with this devise is that the battery has to be recharged 1 to 2 times a week. If the battery gets fully drained, it has to be reprogrammed by the doctor.
This surgery has a few side effects like vomiting, heartburn. Belching, mild nausea etc.
The side effects are relatively less and some infection or pain in the implantation site may occur.
Biliopancreatic Diversion – This is a more severe version of gastric bypass where up to 70 % of the stomach is removed and bypasses more of the small intestine. This also has a less severe version known as biliopancreatic diversion or the duodenal switch. Here less of the stomach is removed and hence more nutrients are absorbed.
- This leads to faster weight loss than the gastric weight loss. The stomach portion left out is larger and hence larger meals are possible after surgery.
- It has all the risks of gastric bypass, but in duodenal switch, the risk is lesser.
- This is the most complicated among the weight loss surgeries and side effects like hernia are also possible.
- Laproscopic surgeries have minimal invasion and hence the risk is also lower and preferred.
- Weight loss surgeries – Post surgical life