Obesity is a big problem in modern society and many people look up to surgery for the ultimate solution. If you also count yourself in the same league since you have tried almost every method to lose weight, but your weight is stubbornly constant then going for a surgery should be a right option. But you must keep in mind that surgery will change your life permanently. Always treat surgery as the last lifeline and not a shortcut since you have to change your dietary habit and physical activity forever.
If you have:
- Body Mass Index of 40 or above
- Obese body with low BMI
- Obesity related problem like Type 2 Diabetes, High Blood Pressure, Sleep Apnea etc.
- Tried every recommended method of weight loss, but not succeeded
Then your medical consultant will most likely recommend you to go for a Bariatric surgery or simply ‘weight loss surgery’. Here, we will tell you about various contemporary weight loss surgeries, their benefits and drawbacks.
How Bariatric Surgery works
It is best to know how these surgeries affect the body which eventually helps in weight loss. So here is the secret, there are three ways which require little modification in an important organ of your digestive tract, i.e. stomach to make you eat less and lose excess weight. These fundamental procedures are:
Restrictive procedure
By restricting the holding capacity of the amount of food in the stomach, the body can be forced to eat less. The size of the stomach has been reduced by the surgeries like Lap band surgery or Adjustable gastric banding and gastric sleeve. After this surgery, you will feel full even after eating a little amount of food.
Malabsorptive procedure
By rearranging or removing a part of the digestive tract can limit the absorption capacity of your body means less intake of calories, but it also means less amount of absorbed nutrients which can raise complications. Because of high complication rates, this procedure is no longer in practice.
Combine procedure
By combining the benefits of the above two procedures, the holding capacity of the body is reduced without affecting the absorption capacity. Gastric bypass and Duodenal switch are examples of combination procedure. Gastric bypass is more Malabsorptive than restrictive, but works mainly through restriction.
Signaling procedure
This is the latest method which includes sending signal to the brain by vagus nerve that stomach it full. Signaling is performed by an electrical device like a pacemaker and it can be controlled through a remote control from outside the body.
Here we will discuss every type of surgery, their advantages and disadvantages and the risks associated with them.
Adjustable Gastric Banding
The procedure followed
Restrictive procedure has been followed in this surgery
Changes made to the digestive system
An inflatable band is used to squeeze the stomach unevenly in two portions which includes a small upper region called pouch and a larger lower region. Both sections remain connected through a small channel which slows down the emptying the content of the pouch. It makes the patient eat only half or one cup of soft and well chewed food before feeling too full.
Benefits
This is a simple and safest surgery among other contemporary counterparts like gastric bypass. You only get a scar and recover very fast and the best part of surgery is that it is reversible. The band is adjustable so that when you want your band to be tightened, it can be done easily by injecting more saline solution into the band and by removing the liquid the band can be loosened.
Drawbacks
Although weight loss is much faster than the other surgeries, but if the patient doesn’t make the changes to his/her lifestyle then he/she can regain the weight in coming years.
Risks
The most common complication of this surgery is vomiting if the patient eats more or quickly. The band can leak, loose or slip out of place. There are chances of infection like other surgeries. Life threatening complications are very rare, but it may occur in some cases.
Sleeve Gastrectomy
The procedure followed
Another restrictive procedure based surgery
Changes made to the digestive system
During this surgery 75 percent of the stomach has been removed and the purse shaped structure of the stomach is modified into a narrow tube or sleeve like. It is connected to the small intestine.
Benefits
A sleeve gastrectomy is a lower risk and a much simpler operation for highly obese patients. They can have second Bariatric surgery if required after losing sufficient weight in a year or so when their health condition has been improved enough for undergoing second surgery. Since, Intestines are intact therefore there is no effect on the absorption rate of the body which means no nutrient deficiency or complication regarding that.
Drawbacks
It is a latest technique, hence it still needs assessment of benefits and risks. It is not reversible like gastric banding surgery.
Risks
Common risk include blood clotting, infection and leakage of sleeve.
Gastric Bypass Surgery (Roux-en-Y Gastric Bypass)
The procedure followed
Combine procedure is followed by this method which includes approaches of restrictive and Malabsorptive procedure.
Changes made to the digestive system
The stomach is partitioned into two sections and both sections are sealed in between. The upper section of the stomach is then directly connected to lower region of the small intestine. This rearrangement of the digestive tract skips three regions of the digestive system and hence less absorption of calories take place which helps in losing weight much faster.
Benefits
A swift and dramatic weight loss takes place after the surgery and 50% of the expected weight loss can be achieved in the first six months and continue up to 2 years. Improvement has been noted in the obesity related health problems like diabetes, high cholesterol, high blood pressure, sleep apnea, arthritis and heartburn with the rapid weight loss. It gives a long term result and it was found that the patient has maintained the reduced weight for a decade or longer.
Drawbacks
Since three main parts of the digestive system have been put on the switch off mode, therefore the absorption of nutrients goes down and you have to take supplements regularly. You can also have ‘Dumping Syndrome’ which involves the dumping of food which is not digested properly from stomach to small intestine very quickly. This can cause some complications like nausea, bloating, sweating, pain, diarrhea and weakness. 85 percent of the gastric bypass patients experience dumping syndrome after surgery and it can be triggered by taking high carbs food or sugar. Although, it is considered irreversible, but in some rare cases it has been reversed with difficulties.
Risks
It is more risky since it is a complicated procedure. The most common complications associated with this surgery are abdominal hernia which requires further minor surgeries to rectify it, infection and blood clotting. Gallstones may develop due to the rapid weight loss.
Maestro Rechargeable System
The procedure followed
Signaling procedure has been followed in this type of surgery
Changes made to the digestive system
No physical changes have been made to the digestive system, but an electrical device has been implanted in the abdomen which will give a signal to your brain through vagus nerve which tell the brain about stomach full status. The device is programmed in advance in order to deliver a pulse of 5 minutes on and 5 minutes off during your waking hours. It remains inactive in your sleeping hours.
Benefits
It is the least invasive technology in the field of weight loss surgery. It is performed under general anesthesia and takes up to one and half hour duration. It can be adjusted and controlled from outside the body through a remote control.
Drawbacks
The device needs to be charged once or twice a week because if the battery goes off your doctor has to reprogram it. The complication has been noted in this surgery is heartburn, nausea, vomiting, belching and chest pain.
Risks
Infection chances and pain at the site of implantation.
If you are still confused about which surgery you should go for then take the advice of some medical expert which has enough experience in the field of weight loss.
You should consult your doctor, who can assess the main cause for not losing weight and when your doctor recommend you for the weight loss surgery or Bariatric surgery then you should seriously consider it. The surgery results may be more effective when:
- It is operated by an experienced surgeon
- You spend your post surgery days in a health care center which offers you a care program which takes care of your diet, exercise and behavioral changes.
- You are fully aware of the risk and benefits and willing to cooperate with the surgery and follow the post surgery precautions.
Why you have been suggested weight loss surgery?
If you are assessed with a body mass index (BMI) of 40 or above it or if you are having any weight related health problem such as Type 2 Diabetes, High Blood Pressure, Severe Arthritis, Obstructive Sleep Apnea, etc. along with BMI ranges between 35 to 40 then your doctor would more likely suggest you weight loss surgery.
Benefits of surgery
Weight loss surgery as its name suggest will help you in shedding those extra pounds and improves your overall health. It is found that most of the obesity related problems get rectified post surgery and it also increases the life span of the patient.
Risks of surgery
Weight loss surgery promises benefits, but it has risks as well and approx. 10% cases have developed complications post surgery. Some general problems arise which may cause pain and discomfort and thus requires minor surgeries. These common inconveniences are:
- Abdominal Hernia
- Infection in wound
- Digestion related issues like nausea, vomiting, diarrhea, bloating, excessive sweating, dizziness
Although life threatening complications are rare, but they have happened in 3% cases. These complications are
- Leakage in new gut connection
- Pulmonary embolism
- Heart attacks
- Ulcers
Senior citizens who are aged over 60 are more prone to these kind of risks, but if the surgery has been done under the supervision of an experienced surgeon then chances of having complications are very less. Some general complications may happen post surgery such as
- Vitamin deficiencies since absorption of nutrients by body get reduced after surgery
- Gallstones may occur when you lose pounds of weight in a very short time
- Sagging skin, which can be corrected by body contouring surgery.
Types of Weight Loss Surgery
Weight loss surgery involves modifications to your stomach or small intestine and sometimes it includes changes in both organs. According to the modification involved, there are five types of surgeries:
Gastric Bypass
This surgery has made changes to the stomach, which results in a small stomach often called pouch. Because of this small stomach you will feel full after having a small meal so it makes you eat less. The food goes directly to the small intestine from the pouch. The surgery is performed with a laparoscope, which is a small camera and helps in performing the surgery with more precision.
Adjustable Gastric Band
This surgery also involves modification on your stomach, which includes putting a band on the topmost part of your stomach. The small balloon inside the band controls the tightening and loosening of the band. Thus, this band controls the inlet of food to your stomach. This surgery also involves laparoscope.
Gastric Sleeve
This surgery has also performed on the stomach and includes the removal of a major part of the stomach and leaves a narrow section of the topmost part of the stomach which is known as gastric sleeve. This surgery helps in reducing the levels of hunger inducing hormone Ghrelin which makes you eat less.
Duodenal Switch
This surgery makes a bypass from gastric sleeve to your small intestine, thus limiting your intake of food. This reduces the absorption of nutrients such as vitamins and minerals in your body and thus sometimes it may cause complications.
Electric Implant
An electrical device which functions like a pacemaker has been implanted in your abdomen by surgery. This device sends signals to your brain through vagus nerve when your stomach is full. This device can be controlled from outside the body through a remote control.
How to choose a weight loss surgery type?
Amount of weight removed
In general, patients undergone a bypass surgery will lose 70 percent of the extra weight, gastrectomy patients lose approx. 60 percent and gastric band patients will lose around 50 percent. The results depend on the scheduled follow ups attended by the patient and lifestyle changes made after the surgery.
Reliability factor
Patients underwent gastric bypass or sleeve surgery, most likely achieve the expected amount of weight loss as mentioned above. If these patients don’t follow the recommended lifestyle, then they may gain weight in due course of time. In case of gastric banding surgery patients can lose 70 – 90 percent of excess weight which is higher than the expected weight loss of 50 percent and in some cases there is no weight loss. No weight loss happens in the case where the patient doesn’t follow up or making changes in the lifestyle.
Time Factor
Patients of Gastric bypass and sleeve generally tend to lose 5 – 7 pounds per week and achieve the expected weight loss amount in a year. Therefore, these surgeries give results in less time while gastric banding patients have a slow and steady weight loss. They tend to lose 1-2 pounds per week and achieve the expected weight loss in two years of time.
Reversibility factor
Some patients prefer gastric banding over the bypass surgery in a hope that when some cure of obesity will come up, they will get rid of the band and live like before. Although, gastric bypass is also reversible, but it is more challenging than removing a band. A sleeve gastrectomy cannot be reversed like the other two methods. But it should be noted that when banding or bypass is reversed the patient tends to gain weight since the device for controlling hunger and food intake has been removed. The only way is to maintain the lost weight after reversal surgery is to lead a healthy lifestyle.
Fear factor
Many patients fear that more invasive surgery means more danger. Although, this is right that gastric bypass or sleeve surgery are major operations, but when we look at the complication occurrence rate, we found out that both surgeries carry the same probability rate of 10 – 15 percent complication rate but surgeries in recent times are much safer.
There is no book, device or person which can tell you precisely that which surgery will be best for you, but consultation with an experienced medical professional will give you clearer view. So, have faith in your doctor and go for the suggested surgery if it is the last option left for you.
Weight loss surgery is not like cosmetic surgery, which includes removal of fatty acid, but it is much more complicated. Normally people look at weight loss surgery like a cosmetic counterpart and make wrong perceptions about it.
Here we will talk about the general weight loss surgery perceptions and how close they are to the reality.
Perception:
Weight loss surgery is just like cosmetic surgery so it is not a big deal.
Reality:
Weight loss surgery or Bariatric surgery alters the structure of the digestive system unlike cosmetic surgery which involves removal of fat tissues. Therefore, this surgery has real risks like any other surgery such as infection, weakness, low immunity, leakage, blood clotting and many more. Sometimes these risks are life threatening.
Perception:
If you don’t get the desired result after surgery, then you can revert it back
Reality:
Some weight loss surgeries are irreversible and if it is reversible, then it has its own challenges. Reversing of procedure can also cause side effects. Before surgery your doctor tells you about the benefits and risks of the surgery along with the lifestyle changes you have to make post surgery. If you will not follow your medical consultant’s instructions, then you will not get the benefits and even reversal of surgery would not help in your case. It will worsen your situation because of the arrangement and rearrangement of the digestive tract which disturbs the body homeostasis.
Perception:
Weight loss surgery will reduce your weight in months and then you can eat anything you like.
Reality:
Weight loss surgery does help in weight loss, but in less amounts like 3-4 pounds in a month. You have to make modifications in your daily diet to recover from the surgery at first, then to maintain the body weight later on. The surgical procedure will limit the ability of your body to hold large amounts of food and if you even continue to do so you will feel uncomfortable and you can have small complications like nausea, vomiting, belching, gas, diarrhea etc.
Perception:
You can choose the surgical procedure you want to go through.
Reality:
Well, maybe it is possible in your dreams. Weight loss surgery is not like having your favorite candy, it is pretty risky. Your doctor will discuss all types of surgery, but will perform only that surgery, which will suit you the best. Every human body is different and therefore responds differently that is why, according to your body health index and statistics your doctor will recommend you the most appropriate procedure for you.
Perception:
Weight loss surgery is painless and a quick fix
Reality:
It is just like any other surgery and requires recovery time and precautions after surgery on the basis of procedure used during your surgery. If it is an open procedure as in the case of gastrectomy sleeve, then you may feel abdominal pain and requires 4-6 weeks of time to heal when you are following the medical instructions regularly. In case of laparoscopic procedure, you can go to your work in a week’s time since it is less invasive, but you will feel some digestion related problems and you have to take precautions as well. So, it is easy, but definitely not quick or painless.
Perception:
Weight loss surgery gives you a slim and trim figure
Reality:
It is a real surgery and it is not to make you beautiful for heaven’s sake. It is for your health and to rectify obesity related complications. After surgery, you will lose weight at a slow and steady pace which helps in improving the health complications like Sleep Apnea, Type 2 Diabetes, Arthritis, High Blood Pressure etc. It can take 1 -2 years to make your weight moderate and in some cases another set of surgeries are also required. You will have saggy skin because of drastic weight loss which can be rectified with body contouring surgery.
Perception:
There is no need of exercise or physical activity after surgery
Reality:
In an open procedure case, the patient is advised not to do heavy lifting or strenuous exercise to prevent any damage to the stomach incisions. But, in case of laparoscopic surgery or other procedures you can take up light exercises a week after and heavy workout after a few months under the guidance of your medical team. If you will keep yourself physically active then it will help you in losing more weight quickly and in maintaining ace of weight later on. Those people who do not take up exercises and eat unhealthy, even after surgery tends to regain weight.
Perception:
It is very costly
Reality:
The cost of weight loss surgery in the USA is between 10000 – 30000 dollars for the common procedures like gastric sleeve, gastric bypass and gastric banding. So, it is indeed a costly procedure, but health insurance covers most of the expenses that is why many people goes for it.
Perception:
After surgery, you will be healthier overall
Reality:
Weight loss surgery can only reduce your weight and your health is in your hands. The rearranged digestive systems has its own limitations like low absorption rate of nutrients which can cause nutrient deficiency in the body and unless you take vitamin and mineral supplements regularly you will become weak and prone to diseases due to low immunity. Your digestive system will not able to hold food for a long time and hence dump it into the small intestine without proper digestion which will cause ‘Dumping Syndrome’ and you can have diarrhea and other digestion related problems. You can develop gallstones due to low absorption of nutrients and you have to take bile salt supplements after surgery to prevent such conditions. All these things indicate that your health will be compromised in some way or another.
So, these are common myths or perceptions which must be cleared after reading the realties. It will help you in understanding the concept of weight loss surgery and you will feel more confident while recommending it to anybody.
There is no book, device or person which can tell you precisely that which surgery will be best for you, but consultation with an experienced medical professional will give you clearer view. So, have faith in your doctor and go for the suggested surgery if it is the best option for you.
