Severe obesity is a chronic condition that is hard to treat with diet and exercise alone. Bariatric surgeries
are operations on the stomach and/or intestines that help patients with extreme obesity to lose weight.
Some promote weight loss by restricting food intake, others interrupt how food is digested, preventing some calories and nutrients, such as vitamins, from being absorbed. Recent studies suggest that bariatric surgery may even lower death rates for patients with severe obesity.
There are two basic types of weight loss surgery:
- Restrictive surgeries
- Malabsorptive/Restrictive surgeries
They help with weight loss in different ways:
- Restrictive surgeries work by physically restricting the size of the stomach and slowing down digestion.
- Malabsorptive/restrictive surgeries are more invasive surgeries that consist in addition to restricting the size of the stomach, removing or bypassing parts of the digestive tract, making it harder for the body to absorb calories. Purely malabsorptive surgeries are no longer done because of their side effects.
Weight loss surgeries are not for everyone. Doctors only recommend it for people who:
- Have a body mass index (BMI) of 40 or more.
- Have a lower BMI (of 35 to 40) but also have a serious health problem related to obesity, such as heart disease, type 2 diabetes, severe sleep apnea, or high cholesterol.
- Have tried and failed to lose weight by other means.
- Fully understand the risks.
The ideal weight loss surgery depends on the current health and body type. It is very important to talk with the surgeon and decide which procedure to choose.
- Restrictive weight loss surgery.
- 75% of the stomach is removed.
- Sometimes, a sleeve is a first step in a sequence of weight loss surgeries. It can be followed up by gastric bypass or other surgeries, if more weight loss is needed.
- Is a simple operation that allows a lower-risk way to lose weight especially for people who are very obese or sick.
- In people with high BMIs and results in an average weight loss of greater than 50% of excess weight.
- Doesn't affect the absorption of food so nutritional deficiencies are not a problem.
- Is irreversible.
Gastric Bypass Surgery (Roux-en- Y Gastric Bypass)
- In the operation, the surgeon divides the stomach into two parts, sealing off the upper section from the lower. He then connects the upper stomach directly to the lower section of the small intestine. It is creating a shortcut for the food, bypassing a section of the stomach and the small intestine. Skipping these parts of the digestive tract means that fewer calories get absorbed into the body.
- Combines both restrictive and malabsorptive approaches.
- Swift and dramatic weight loss. ( 50% of it happens in the first six months) and may continue for up to two years after the operation.
- Because of the rapid weight loss, health conditions affected by obesity often improve quickly.
- Has a good long-term result (studies have found that many people keep most of the weight off for 10 years or longer.)
- Risk of serious nutritional deficiencies.
- Risk of dumping syndrome (food is "dumped" from the stomach into the intestines too quickly, before it's been properly digested) Causing nausea, bloating, pain, sweating, weakness, and diarrhea.
- Is generally considered irreversible.
Facts about Weight Loss Surgeries:
- For severely obese people for whom diet and exercise have failed, weight loss surgery can be lifesaving.
- Depending on the type of weight loss surgery, patients often lose 30% to 50% of their extra weight six months after surgery.
- Some statistics show that 10% of the patients undergoing these surgeries do have minor complications. Less than 5% experience serious ones. (infection of the wounds, constipation, bleeding in stools, pulmonary emboli, gallstones..)
- Two years after their bariatric surgery, women reported improvements in their overall sexual satisfaction, according to a study published in the Journal of the American Medical Association (JAMA Surgery).
- Studies also show that people undergoing surgery for weight loss live longer than people of similar weight who don't have surgery, and 95% of people report an improved quality of life.
- Other studies found an 83% improvement in type 2 diabetes after weight loss surgery.
Many people who have the surgery lose weight quickly, but regain some weight later on. While generally safe, weight loss surgery has risks and requires a lifelong commitment in eating patterns and lifestyle.