Weight Loss Surgery

The type of weight-loss surgery, also called metabolic and bariatric surgery, that may be best to help a person lose weight depends on a number of factors. You should discuss with your doctor what kind of surgery might be best for you.

In gastric sleeve surgery, also called vertical sleeve gastrectomy, a surgeon removes most of your stomach, leaving only a banana-shaped section that is closed with staples. The surgery reduces the amount of food that can fit in your stomach, making you feel full sooner. Taking out part of your stomach may also affect hormones or bacteria in the gastrointestinal system that affect appetite and metabolism. This type of surgery cannot be reversed because some of the stomach is permanently removed.

Weight Loss Surgery

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Gastric bypass surgery, also called Roux-en-Y gastric bypass, is done in three steps. First, the surgeon staples your stomach, creating a small pouch in the upper section. The staples make your stomach much smaller, so you eat less because you feel full sooner.

In this type of surgery, the surgeon places a ring with an inner inflatable band around the top of your stomach to create a small pouch. Like gastric sleeve and gastric bypass surgery, the gastric band makes you feel full after eating a small amount of food. The inner band has a circular balloon inside that is filled with saline solution. The surgeon can adjust the inner band to resize the opening from the pouch to the rest of your stomach by injecting or removing the saline solution through a small device, called a port, that is placed under your skin.

Today, adjustable gastric band surgery is less commonly performed in the United States, compared with the gastric sleeve or gastric bypass, because it is associated with more complications, predominantly the need for band removal due to intolerance.5 Gastric band surgery also typically results in significantly less weight loss and is associated with more complications, predominately the need for band removal due to intolerance.5

This type of surgery allows you to lose more weight compared with the other three operations described above. However, it is also the most likely to cause surgery-related problems and a shortage of vitamins, minerals, and proteins in your body. For these reasons, surgeons do not perform this particular procedure often. However, some surgeons may recommend it for patients who have severe obesity and certain health conditions.

Weight-loss surgery is mostly done laparoscopically, which requires only small cuts, under general anesthesia. Through these incisions, the surgeon can insert thin tools and a small scope attached to a camera that projects images onto a video monitor. Laparoscopic surgery has fewer risks than open surgery and may cause less pain and scarring. Recovery may also be faster with laparoscopic surgery.

Open surgery, which involves a single, large cut in the abdomen, may be a better option than laparoscopic surgery for certain people. You may need open surgery if you have a high level of obesity, had stomach surgery before, or have other complex medical problems.

After surgery, you will probably be started on a liquid diet. Over several weeks, you will move to a soft diet that includes such foods as cottage cheese, yogurt, or soup. Eventually you will begin consuming solid foods again. Your health care professional will tell you which foods and beverages you may have and which ones you should avoid. You will need to eat small meals and chew your food well. You will need to take dietary supplements that your health care professional prescribes to make sure you are getting enough vitamins and minerals.

The number of pounds people lose after weight-loss surgery depends on the individual and on the type of surgery. One study found that after 1 year, people undergoing adjustable gastric banding, gastric sleeve, and gastric bypass lost between 38 and 87 pounds. Of the three most common procedures, gastric bypass produced greater weight loss, on average, but had more complications in the month after surgery. Most people regained some weight over time, but that amount was usually small compared with their initial weight loss.6

Bariatric surgery is done when diet and exercise haven't worked or when you have serious health problems because of your weight. Some weight-loss procedures limit how much you can eat. Others work by reducing the body's ability to absorb fat and calories. Some procedures do both.

While bariatric surgery can offer many benefits, all forms of weight-loss surgery are major procedures that can pose risks and side effects. Also, you must make permanent healthy changes to your diet and get regular exercise to help ensure the long-term success of bariatric surgery.

Bariatric surgery isn't for everyone who is severely overweight. You may need to meet certain medical guidelines to qualify for weight-loss surgery. You likely will have an extensive screening process to see if you qualify. You also must be willing to make permanent changes to lead a healthier lifestyle.

If you qualify for bariatric surgery, your health care team gives you instructions on how to prepare for your specific type of surgery. You may need to have lab tests and exams before surgery. You may have limits on eating and drinking and which medicines you can take. You may be required to start a physical activity program and to stop any tobacco use.

The specifics of your surgery depend on your individual situation, the type of weight-loss surgery you have, and the hospital's or doctor's practices. Some weight-loss surgeries are done with traditional large incisions in your abdomen. This is known as open surgery.

Today, most types of bariatric surgery are performed laparoscopically. A laparoscope is a small, tube-shaped instrument with a camera attached. The laparoscope is inserted through small cuts in the belly. The tiny camera on the tip of the laparoscope allows the surgeon to see and operate inside the abdomen without making the traditional large cuts. Laparoscopic surgery can make recovery faster and shorter, but it's not the best option for everyone.

Surgery usually takes several hours. After surgery, you awaken in a recovery room, where medical staff watches you for any complications. Depending on your procedure, you may need to stay a few days in the hospital.

Roux-en-Y (roo-en-wy) gastric bypass. This procedure is the most common method of gastric bypass. This surgery is typically not reversible. It works by decreasing the amount of food you can eat at one sitting and reducing absorption of fat and calories.

Which type of weight-loss surgery is best for you depends on your specific situation. Your surgeon will take many factors into account, including body mass index, eating habits, other health issues, previous surgeries and the risks involved with each procedure.

After weight-loss surgery, you generally won't be allowed to eat for 1 to 2 days so that your stomach and digestive system can heal. Then, you'll follow a specific diet for a few weeks. The diet begins with liquids only, then to pureed and very soft foods, and eventually, to regular foods. You may have many restrictions or limits on how much and what you can eat and drink.

Gastric bypass and other bariatric surgeries can provide long-term weight loss. The amount of weight you lose depends on the type of surgery and your change in lifestyle habits. It may be possible to lose half, or even more, of your excess weight within two years.

Gastric bypass and other weight-loss surgeries don't always work as well as you might have hoped. If a weight-loss procedure doesn't work well or stops working, you may not lose weight and you may develop serious health problems.

Keep all of your scheduled follow-up appointments after weight-loss surgery. If you notice that you are not losing weight or have complications, see your doctor immediately. Your health care team can track your weight loss and investigate possible causes for your stalled weight loss.

It's also possible to not lose enough weight or to regain weight after any type of weight-loss surgery, even if the procedure itself works correctly. This weight gain can happen if you do not follow the recommended lifestyle changes, such as getting regular physical activity and eating healthy foods.

There are different types of weight loss surgery. They often limit the amount of food you can take in. Some types of surgery also affect how you digest food and absorb nutrients. All types have risks and complications, such as infections, hernias, and blood clots.

Many people who have the surgery lose weight quickly, but regain some weight later on. If you follow diet and exercise recommendations, you can keep most of the weight off. You will also need medical follow-up for the rest of your life.

Obesity is a medical term for a chronic disease that threatens your health and requires long-term management. There are several medications, devices, and surgeries to help you achieve weight loss. Weight loss surgery, also called bariatric surgery or metabolic surgery, refers to operations that help you lose weight by altering your digestive system and/or appetite.

Restrictive surgeries work by shrinking the size of your stomach and slowing digestion. A normal stomach can hold about 3 pints of food. After surgery, your stomach may at first hold as little as an ounce, although later that could stretch to 2 or 3 ounces. The smaller your stomach, the less you can eat. The less you eat, the more weight you lose.

Pros: This operation is simpler to do and safer than gastric bypass and other operations. You get a smaller scar, recovery is usually faster, and you can have surgery to remove the band.

You can also get the band adjusted in a doctor's office. To tighten the band and further restrict your stomach size, the doctor injects a more saline solution into the band. To loosen it, the doctor uses a needle to remove liquid from the band.

Cons: People who get gastric banding often have less dramatic and slower weight loss than those who get other surgeries. They may also be more likely to regain some of the weight over the years. 2351a5e196