Bariatric Surgery for Weight Loss

To end my blog for the month of April, I thought I would post some information on Bariatric Surgery since it is such a hot topic in weight loss methods right now. This method of losing weight is designed for the severely obesity individual that finds it difficult to treat their condition through diet and exercise alone. The operation promotes weight loss and reduces the risk of type 2 diabetes by restricting food intakes, and in some operations, interrupting the digestive process to prevent the absorption of calories and nutrients. The best results are achieved when bariatric surgery is followed with healthy eating behaviors/changes and regular physical activity, so don't think having this surgery is going to be a quick fix to your weight issues (THERE IS NO QUICK FIX)!!!

There are four types of bariatric surgery offered commonly in the United States: 1) adjustable gastric band (AGB), 2) Roux-en-Y gastric bypass (RYGB), 3) biliopancreatic diversion with a duodenal switch (BPD-DS), and 4) vertical sleeve gastrectomy (VSG). Each surgery has its own benefits and risks which you and your doctro should consider in great detail before making a decision in preceeding with gastric surgery.

Here are discriptions of each surgery with a diagram at the end (taken from my resource):

AGB - works primarily by decreasing food intake. Food intake is limited by placing a small bracelet-like band around the top of the stomach to produce a small pouch about the size of a thumb. The outlet size is controlled by a circular balloon inside the band that can be inflated or deflated with saline solution to meet the needs of the patient.

RYGB - works by restricting food intake and by decreasing the absorption of food. Food intake is limited by a small pouch that is similar in size to the adjustable gastric band. In addition, absorption of food in the digestive tract is reduced by excluding most of the stomach, duodenum, and upper intestine from contact with food by routing food directly from the pouch into the small intestine.

BPD-DS - usually referred to as a “duodenal switch,” is a complex bariatric operation that principally includes 1) removing a large portion of the stomach to promote smaller meal sizes, 2) re-routing of food away from much of the small intestine to partially prevent absorption of food, and 3) re-routing of bile and other digestive juices which impair digestion. In removing a large portion of the stomach, a more tubular “gastric sleeve” (also known as a vertical sleeve gastrectomy, or VSG) is created. The smaller stomach sleeve remains connected to a very short segment of the duodenum, which is then directly connected to a lower part of the small intestine. This operation leaves a small portion of the duodenum available for food and the absorption of some vitamins and minerals. However, food that is eaten by the patient bypasses the majority of the duodenum. The distance between the stomach and colon is made much shorter after this operation, thus promoting malabsorption. BPD-DS produces significant weight loss. However, there is greater risk of long-term complications because of decreased absorption of food, vitamins, and minerals.

VSG - historically had been performed only as the first stage of BPD-DS (see above) in patients who may be at high risk for complications from more extensive types of surgery. These patients’ high risk levels are due to body weight or medical conditions. However, more recent information indicates that some patients who undergo a VSG can actually lose significant weight with VSG alone and avoid a second procedure. It is not yet known how many patients who undergo VSG alone will need a second stage procedure. A VSG operation restricts food intake and does not lead to decreased absorption of food. However, most of the stomach is removed, which may decrease production of a hormone called ghrelin. A decreased amount of ghrelin may reduce hunger more than other purely restrictive operations, such as gastric band.

Once a patient has reached which surgery to proceed with, they need to remember that each can have major complications since these surgery's are still relatively new. Another fact is that 10 percent of all patients who undergo bariatric surgery may have unsatisfactory weight loss or regain much of the weight that they lose due to unhealthy food behaviors that don't get addressed before, during, or after surgery.

I personally don't believe in gastric surgery since I know of a couple of people who almost died from this procedure. However, if your weight issues are extreme and you are someone with severe weight complications, then this may be your best (last) option in keeping yourself alive. So, for quite a number of individuals this method is saving lives and giving them a chance to really have a life...I just hope they don't take this fact for granted and that they start eating healthy, make behavior changes with food, and be sure to stay active in order to improve the quality of their lives!

Reference:

US Dept of Health/Human Services; Weight-Control Information Network: http://win.niddk.nih.gov/publications/gastric.htm