Bariatric surgery has become increasingly popular over the last decade as a weight loss solution for the severely obese. Depending on the type of procedure chosen and adherence to dietary guidelines, patients may lose up to 80 percent of their excess weight within two to three years’ time. Added benefits generally include the remission or disappearance of obesity related health issues like sleep apnea, high blood pressure and diabetes.
The four main types of weight loss surgery available are Gastric Bypass, Gastric Sleeve, Lap Band, and Biliopancreatic Diversion with Duodenal Switch (BPD/DS). Of these surgeries, the Lap Band, a procedure where a small band is placed around the top portion of the stomach to control food intake, is the least invasive and is currently the most popular choice of patients, because no changes are made to the anatomy. Surgery is done laparoscopically, with a camera and surgical instruments inserted through a tiny incision in the abdomen. Patients typically can return home the same day and can expect about a week of recovery time. One of the main advantages of the Lap Band is that it may be adjusted over time without additional surgery to meet the individual weight loss goals of the patient. Because there is no cutting of the stomach or rerouting of the intestines, there is less chance of complications and vitamin and mineral absorption remain unaffected. Gastric Sleeve is a procedure that involves the removal of about 2/3 of the stomach, creating a tube or sleeve appearance. It is also generally performed laparoscopically and does not include the removal or bypassing of the intestines. Absorption is not affected, and like Lap Band it is strictly a restrictive procedure (limiting the amount of space for food).
Gastric Bypass and BPD/DS are both more invasive procedures, typically requiring a fairly significant incision and a couple of nights stay in the hospital. Of the two, Gastric Bypass is more common and has been successful in producing dramatic weight loss results since the 1960’s. With both procedures, the amount of food the stomach can hold is restricted and the intestines are rerouted, affecting how well the body absorbs the food that is ingested. Gastric Bypass leaves patients with the ability to only eat extremely small amounts of food (1 to 2 oz.), while BPD/DS allows for patients to eat more normally. However, patients will need vitamin and mineral supplements for the remainder of their life and must make good food choices to avoid “dumping syndrome”. Dumping occurs because the intestines are no longer able to handle starchy or sugary foods very well, and ingesting them can cause severe abdominal discomfort, nausea, dizziness, etc.