Tuesday June 18, 2013
Rising Prevalence of Obesity
The prevalence of obesity has risen significantly in the United States during the past 20 years. It is reported that over 60 million adults age 20 and older, which is about one-third of US adults, are considered obese.

Weight Loss Surgery Options

Individuals who are looking into weight loss surgery will find they have many options from which to choose. Weight loss surgery is not a one size fits all solution, making it important to gather information and learn more about the various weight loss procedures before making a decision.

Weight Loss Surgery

Bariatric surgery is surging in popularity as a successful treatment for obesity and obesity-associated health conditions.

Weight loss surgery is not for casual weight loss or for those who are looking for an easy way to lose weight. It is intended as a last resort treatment for individuals who have struggled with obesity but have been unable to reach a healthy weight through non-surgical methods.

Surgery for weight loss is not an easy way out, but a tool to promote weight loss after diets, exercise, and medical weight loss programs have failed to achieve significant and lasting weight loss in severely obese individuals. It is medical surgery, not cosmetic surgery.

Before making a decision, individuals should carefully consider the alternatives and the lifelong changes that will be required after weight loss surgery. It is important to take into account both the short term and long term effects of each procedure in regards to diet, nutrition, lifestyle changes, pregnancy, initial weight loss, and long-term weight management.

The following paragraphs will cover some facts for you to consider about the various weight loss surgery options as well as the advantages and possible drawbacks of each method.

Types of Weight Loss Surgery

There are several different types of surgical procedures, but only two basic methods of promoting weight loss:

  • food restriction - restrict food intake to reduce calories consumed
  • food malabsorption - alter digestion to reduce absorption of calories through the intestine

Restrictive Methods of Weight Loss Surgery

The goal of restrictive weight loss surgery is to reduce the amount of food that an individual eats in order to promote weight loss. This is accomplished by creating a smaller stomach pouch that holds less food than a normal stomach. The restructured stomach helps an individual control meal portions and reduces hunger sensations.

The primary restrictive methods of weight loss surgery are:

  • Vertical Banded Gastroplasty
  • Laparoscopic Adjustable Gastric Banding (LAP-BAND and REALIZE Band)
  • Gastric Sleeve
  • TOGA System (currently in FDA trials)

With laparoscopic adjustable gastric banding, a band is placed around the upper portion of the individual's stomach. The band divides the stomach into one larger and one smaller portion.

The advantages of restrictive bariatric surgery include: a healthy and steady rate of weight loss, low risk of nutritional deficiencies, less hunger, and portion control.

The possible drawbacks of restrictive bariatric surgery include: lack of satisfaction with eating, the necessity of individual to make healthy eating choices, and unsatisfactory weight loss.

Malabsorptive Methods of Weight Loss Surgery

The aim of malabsorptive weight loss surgery is to promote weight loss by altering digestion. It involves cutting and rerouting the small intestine so that food bypasses a portion of the digestive system. As the normal function of the small intestine is to absorb nutrients from food, a shorter digestive tract results in less food absorption and thus less calories being retained by the body.

The primary malabsorptive methods of weight loss surgery are:

  • Biliopancreatic Diversion
  • Biliopancreatic Diversion with Duodenal Switch
  • Extended (distal) Roux-en-Y Gastric Bypass

The advantages of malabsorptive weight loss surgery include: high degree of hunger fulfillment and high rate of success with excess weight loss and long-term weight management.

The drawbacks associated with malabsorptive weight loss surgery include: lifelong need for vitamin supplements, bowel movement problems, bloating, flatulence, risk of nutritional deficiencies, intestinal irritation, gallstones, and gallbladder problems.

Combination Restrictive and Malabsorptive Procedure

The most commonly performed type of weight loss surgery involves both a restrictive and malabsorptive aspect:

  • Roux-en-Y Gastric Bypass (proximal)

With gastric bypass surgery, the size of the stomach is reduced to limit food intake and the first section of the small intestine is bypassed to reduce food absorption.

Gastric bypass surgery has been performed since the 1970's and is accepted by most bariatric surgeons and insurance companies as an effective treatment for morbid obesity. Weight loss is higher on average than seen in individuals undergoing solely restrictive surgery, but drawbacks include risk of nutritional deficiencies and dumping syndrome.

Discussing Your Weight Loss Surgery Options

If you have struggled with obesity and are looking into your bariatric surgery options, discuss the various alternatives with your bariatric surgeon before making a decision. While you may want to get input from friends, family members and other patients as well, the final decision is ultimately yours.

Take the time to consider the pros and cons of gastric bypass surgery, as well as the advantages and drawbacks of gastric bands and the gastric sleeve surgery.

The best weight loss surgery for you is not the procedure that works best for someone else, but the one that you and your doctor determine is most appropriate for your personal situation.

Consumer Guide to WLS

Weight Loss Surgery Patient

Choosing a Surgeon:

Key Factors to Consider

When choosing a doctor to perform your weight loss surgery, patients should take into account the training and experience of the doctor, the level of follow-up care offered to patients after surgery, and the presence of a support group.

These key factors will greatly influence your overall results with weight loss surgery. Qualified bariatric surgeons have better surgical outcomes; patients who participate in nutritional counseling and behavioral therapy are more likely to have successful weight loss results.

Questions to Ask

Questions to ask a prospective bariatric surgeon include:

  • Are you a board-certified surgeon with specialized training and experience in bariatric surgery?
  • Do you offer a multidisciplinary team for care after bariatric surgery?
  • Do you host a support group for weight loss surgery patients?

Obesity and WLS Options

Surgical intervention has been shown to be the most effective weight loss option for obesity. Learn more about the weight loss surgery options, patient criteria, costs, insurance, benefits, diet, lifestyle changes, and weight loss results.

  • Weight loss surgery resolves or improves many serious health conditions associated with obesity.