The Centers for Disease Control and Prevention (CDC) reports approximately 40 percent of adults in the United States struggle with obesity, and the American Society for Metabolic and Bariatric Surgery (ASMBS) estimates about a third of obese adults fall under the umbrella of severe, or morbid obesity. In cases of severe obesity where individuals haven't had success with diet, exercise, or medications for weight loss, bariatric surgery is the next step. Bariatric surgery is a safe and effective approach for treating individuals who struggle with severe obesity.
Bariatric surgery provides several benefits for those who undergo a procedure. The ASMBS reports most patients maintain their weight loss after surgery with success defined as the loss of 50 percent or more of excess body weight. Other benefits include a 60 percent reduction in cancer mortality, a 90 percent reduction in death related to diabetes, and more than a 50 percent reduction in death related to heart disease. Weight loss surgery patients also can experience increased mobility and the elimination of medication regimens for diabetes, high blood pressure, and other weight-related conditions.
Not everyone is a candidate for bariatric surgery, and not all procedures will work for those who are. Options for bariatric surgeries vary by risk, by how invasive they are, and the specific way they impact a person's food impact and the way their body processes food. Current approved and accepted bariatric surgeries and procedures are listed below.
Gastric Bypass Surgery or Roux-en-Y Gastric Bypass
Gastric bypass surgery, formally referred to as Roux-en-Y gastric bypass, has been performed for more than 50 years on those who struggle with severe obesity. Two different mechanisms lead to significant weight loss as a result of gastric bypass surgery. First, surgeons create a small stomach pouch by dividing the stomach, which reduces food intake. In fact, one year after surgery, a patient can eat the same size meal as a seven or eight year-old child. Second, a portion of the small intestine in bypassed and connected to the small pouch, releasing special hormones, which makes patients feel less hungry. Many gastric bypass surgeries are done laparoscopically, but in some cases, surgeons must perform an open procedure.
Lap-Band® Surgery or Gastric Banding
Gastric banding is a laparoscopic weight loss procedure where a surgeon places an adjustable silicone band around the stomach. The band separates the stomach into two pouches: a small upper pouch and a larger pouch consisting of the lower part of the stomach. The band is connected to a port that sits near a patient's belly button. The inside of the band has a balloon which is used to adjust the size of the band through different levels of inflation. When the band is filled, it slows the movement of food from the small pouch to the large pouch and helps patients feel full faster, resulting in weight loss. Those who have the Lap-Band® surgery can go for follow-up visits to adjust the level of inflation in the band to meet their weight loss goals.
Gastric Sleeve Surgery or Sleeve Gastrectomy
When a patient undergoes a sleeve gastrectomy, a surgeon vertically staples the stomach, removing approximately 85 percent of the large outer part of the stomach and leaving a sleeve or banana-shaped pouch. This drastically restricts food consumption and absorption. Gastric sleeve surgeries have become popular in recent years, comprising about 60 percent of all bariatric surgeries. The surgery is typically performed laparoscopically and doesn't include any bypasses, nor do surgeons remove any of the small intestine. Additionally, patients can benefit from powerful metabolic changes and don't have to deal with the nutrient malabsorption which can accompany other procedures.
Loop Duodenal Switch (DS)
The loop duodenal switch (DS) procedure is an updated form of the duodenal switch surgery. This is a two-part surgery comprising of one procedure similar to the gastric sleeve, followed by a bypass of the small intestine. The difference between the loop DS procedure and a traditional duodenal switch lies in the bypass; traditional DS surgery includes bypassing the small intestine in two spots and the loop DS only includes one point of bypass, making the updated version safer for those who are morbidly obese.
Stomach Intestinal Pylorus-Sparing Surgery (SIPS)
SIPS surgery is a relatively new procedure, similar to the traditional DS surgery with modifications preventing the loss of the pyloric valve. These modifications eliminates spikes in blood sugar which can occur with other surgeries. Like a DS procedure, SIPS begins with a sleeve gastrectomy which is slightly larger than the normal sleeve. The surgeon then places an attachment below the pyloric valve to preserve it. SIPS also avoids dividing the small intestine or bypassing too much of it, so patients don't have to deal with short bowel issues.
Endoscopic Intragastric Balloon (EIB)
An EIB is the newest bariatric technology and does not require surgery. This minimally invasive non-surgical procedure involves placing a silicone balloon in a patient's stomach and controlling food intake through different levels of inflation. A doctor places the balloon
through the mouth with an endoscopic procedure. Once the balloon is placed, the doctor inflates the balloon with saline. The balloon typically takes up about half the space in a patient's stomach, helping them feel full and reducing food intake. EIBs can only remain in the body for up to six months, so this is a temporary option for those who are not eligible for bariatric surgery.
Achieve Long Lasting Weight Loss
The research about bariatric surgery shows those who commit to a lifestyle change including a healthy diet and regular exercise achieve long lasting weight loss after surgery. In addition to the physical changes, successful weight loss also positively impacts a person's mental health and overall quality of life. If you struggle with obesity and have been unsuccessful with diet and exercise, bariatric surgery might be the answer for you.
Contact an experienced team of weight loss specialists for a consultation or attend an online bariatric surgery information session to learn about which bariatric procedure might be the best option for you.