The idea of having weight loss surgery might sound a bit scary. It's a big step and there are lots of options so it can be confusing. What do you need to know?
Eligibility: surgical weight loss procedures are generally available to people between the ages of 18 and 65 who have a BMI (body mass index) above 30. Exceptions are made in some cases where co-morbidities exist; such as diabetes, sleep apnea, hypertension etc.
Consultation: a consultation with a bariatric surgeon will be necessary –– to review your health history, understand your goals, consider appropriate options and help you decide which approach would be best for you. Fortunately, no-cost, no obligation consultations are available with experienced surgeons –– even by phone if required. Before arranging a consultation, however, you'll want to get a basic idea of what's out there.
Available Options: The Gastric Sleeve • The Gastric Bypass • The Mini-Gastric Bypass • Gastric Banding • The Duodenal Switch • vBloc Therapy • AspireAssist.
Here's a simple overview of the 3 most common surgical weight loss options. All have been performed for 20 years or more with proven track records as to safety and effectiveness. All begin with the basic principle of reducing the amount of space available in the stomach, which signals your brain that you are satisfied with smaller portions of food.
The Gastric Sleeve:
The most widely performed bariatric surgery in North America, the Gastric Sleeve procedure permanently removes about 75% of the stomach.
The Gastric Sleeve works two ways for sustained weight loss.
First: when you eat, the small sleeve or pouch of stomach that’s left behind fills. Filling of that part of the stomach sends signals to the brain that you feel satisfied and comfortable with smaller portions of food.
Second: the procedure removes a part of the stomach that produces a hormone called Ghrelin which is thought to be responsible for hunger signals to your brain. The less Ghrelin produced, the fewer hunger signals are sent to the brain.
The Gastric Sleeve procedure has fewer dietary restrictions than some other procedures and there is no need for periodic adjustments such as there is with Gastric Bands. Studies have shown that on average patients under-going the Gastric Sleeve will lose up to 70% of their excess weight and that most of that weight loss will come in the first year.
If reasonable diet and exercise routines are not followed after surgery, some people can re-weight gain over time because the stomach can stretch (since that is its nature and this can’t be changed) –– it can even grow back to its original size if not monitored. The Gastric Sleeve procedure is not reversible.
Gastric Bypass –– two different procedures
There are now two types of Gastric Bypass: the traditional Roux-en Y procedure which has long been the standard for weight loss. And the more modern Mini Gastric Bypass procedure which is becoming a popular alternative world-wide.
On average, patients undergoing a Gastric Bypass procedure will lose up to 75% of their excess weight with most of that weight loss coming in the first year. The weight that is lost usually stays off.
Weight-related conditions such as hypertension, sleep apnea, and type 2 diabetes can be diminished greatly or even disappear.
The Mini Gastric Bypass procedure was designed with the goal of matching the excellent results of traditional Roux-en Y gastric bypass surgery; while simplifying the procedure, shortening operating times and reducing complications.
Both Gastric Bypass procedures bypass a section of the digestive tract, therefore, patients opting for these procedures will be required to take daily supplements to compensate for the resulting reduction in nutrient absorption.
The Mini Gastric Bypass is performed laparoscopically which is a surgical technique where only small incisions are made. Laparoscopic surgery is a low-risk, minimally invasive technique with many benefits including smaller surgical scars, less pain, shorter hospital stay, faster recovery and reduced risks of infection.
The Mini Gastric Bypass is reversible. The traditional Gastric Bypass is not.
People often mistakenly refer to gastric banding generically as lap-bands. More accurately, the LAP-BAND® System from Apollo Endosurgery is the most widely used weight loss device in the world, representing over 90% of all bands used. With over 25 years of clinical research proving safety and efficacy, the LAP-BAND® is definitely the brand you want if you decide on a banding option.
The Lap-Band procedure is performed laparoscopically which is a surgical technique where only small incisions are made (note: laparoscopic surgery is sometimes referred to as keyhole surgery). It is a low-risk, minimally invasive technique with many benefits including smaller surgical scars, less pain, shorter hospital stay, faster recovery and reduced risks of infection.
Gastric banding can be significantly less expensive than other options discussed here. It is also adjustable ( (tightening or loosening of the band can be done as needed) and although designed to stay in place, it is removable by a simple procedure.
Weight loss will be a little slower than other options and there are more dietary restrictions.
Talk To A Surgeon: Everyone has a different body, a different health history, and different needs. Talking with a surgeon about your concerns and having your questions answered is the surest way to get the most up-to-date and accurate information before you make your decision.
Surgery is an option usually considered only after other options have failed to provide lasting weight loss. Once you've accepted that your weight is going to be a life-long struggle, weight loss surgery makes a lot of sense. It's not a magic solution, but it is an enormously valuable tool for sustainable weight loss.