Bariatric Surgery Explained

The obesity epidemic has become a serious problem in the United States. The obesity prevalence rate recorded for 2017-2018 was just over 42%.
Weight loss is challenging, especially when there are barriers, including mental health and environmental barriers. Many people look for the quick and easy way to weight loss, but that option is not adequate in maintaining long-term weight loss. Lifestyle changes including healthy, balanced diet and exercise must be incorporated for long-term success. 
Healthy weight loss is not about a special restrictive diet or weight loss program. These options can lead to a roller coaster ride for weight management. Individuals who gradually and steadily lose weight are more likely to be successful in keeping the weight off. 

When traditional weight loss methods fail and obesity-related health conditions are decreasing quality of life, bariatric surgery may become an option. This decision is a serious step and should be thoroughly discussed with your practitioner. In this blog, we walk through bariatric surgery, including pros, cons, and types of surgery.

 

What Is Bariatric Surgery? 

Weight loss surgery, also known as bariatric and metabolic surgery, is a collective term for procedures used to treat obesity and obesity-related conditions in order to impact quality of life. Changes are made to your digestive system in order to facilitate weight-loss.

Depending on the type of surgery you pursue, there may be caloric restriction, malabsorption of nutrients, or a combination of both.

Today, surgeons perform minimally invasive surgical techniques, such as robotic and laparoscopic surgery, to make tiny incisions. These techniques ensure the least amount of pain, faster recovery, and shorter hospital stays.

With that in mind, it is essential to be prepared for your hospital stay. Ensure you pack all of the items on your bariatric surgery hospital checklist

Bariatric surgery is only a tool for weight loss. After the procedure, you will need to maintain a healthy diet and exercise regularly in order to see long-lasting health benefits.

 

Can I Have Bariatric Surgery? 

Bariatric surgery isn't accessible to everyone. You must meet the qualifications and have already tried traditional weight loss methods.

bariatric surgery requirements

You may qualify if you are battling with obesity or extreme obesity. When we say extreme obesity, this includes those with a Body Mass Index (BMI) of 40 and over. Those eligible for a bariatric surgery due to obesity, would qualify with a BMI between 35 and 39.9 suffering from a weight-related health issue. This would include high blood pressure, type 2 diabetes, or severe sleep apnea.

Furthermore, individuals with a BMI of 30 to 34 may be eligible for bariatric surgery if facing significant obesity-related conditions or the inability to achieve weight loss for a sustained period of time even while attempting weight loss methods. 

 

What Are the Risks of Bariatric Surgery? 

Bariatric surgery is a major step that comes with possible short-term and long-term risks. 

Short-Term Health Risks Risks of Bariatric Surgery

Some risks that you may experience shortly after bariatric surgery are:

  • Infections
  • Constipation
  • Internal Bleeding
  • Blood clots in the lungs (Pulmonary embolism)
  • Anesthetic reactions
  • Gastrointestinal leakage
  • Death (highly uncommon)

Long-Term Health Risks 

Bariatric surgery can have some long-term adverse impacts. Some long term risks include:

  • Gallstones
  • Malnutrition
  • Hernias
  • Low blood sugar
  • Ulcers
  • Acid reflux
  • Dumping syndrome (diarrhea, nausea, lightheaded, and vomiting)
  • Death (highly uncommon)*

Before choosing bariatric surgery, you should explore non-surgical bariatric weight loss options.

*Tip: There is less than a 1% chance of death within the first 30 days following bariatric surgery. The fatality rate 5 years after weight loss surgery is less than 6%. 

 

What Are the Benefits of Bariatric Surgery? 

Benefits of Bariatric Surgery

Bariatric surgery benefits go far beyond weight loss. This operation also facilitates daily activities for you, thus improving quality of life. Not to mention, it decreases your risk of developing health problems associated with excess weight, which include:

  • High blood pressure
  • Cardiovascular disease
  • Obstructive sleep apnea
  • Type 2 diabetes
  • Osteoarthritis (joint pain)
  • Nonalcoholic steatohepatitis (NASH) and nonalcoholic fatty liver disease (NAFLD)

 

What Are the Types of Bariatric Surgery?

You can discuss options with your doctor to decide on the suitable weight-loss surgery for you, as there are various bariatric surgery procedures types. Below are the most common procedures:

1. Sleeve Gastrectomy  Sleeve Gastrectomy

A sleeve gastrectomy restricts the amount of food that can be eaten, resulting in weight loss.

In this non-reversible surgery, surgeons use surgical staples to remove 75% of the stomach, leaving a "sleeve" resembling the size and shape of a banana. Your new stomach will hold less food and beverage and surgical changes to the GI tract can change hormones to regulate hunger and fullness.

2. Roux-en-Y Gastric Bypass (RYGB)  Roux-en-Y Gastric Bypass

Commonly known as gastric bypass, Roux-en-Y is the gold standard for bariatric surgery.

Using a laparoscope approach, your stomach will be separated to create a small stomach pouch. The stomach pouch will be reattached to a lower portion of the small intestine.

The new stomach pouch can hold up to an ounce of food. The idea is to cause caloric restriction by decreasing the size of the stomach, followed by, nutrient malabsorption due to part of the stomach and first section of the small intestine being bypassed for the outcome of weight loss. 

3. Adjustable Gastric Band (AGB)  Adjustable Gastric Band

Commonly referred to as “the band” or “lap band” procedure. This procedure is suitable for someone that is highly motivated regarding diet and lifestyle change postoperative to ensure positive weight loss results. It is reversible and has fewer complications.

This surgery relies on restriction of food. The procedure is performed by securing a silicone adjustable gastric band around the stomach's upper section, creating a small pouch. The band can be adjusted and is used to control the amount of food that can be consumed, promoting a feeling of fullness when eating only a small amount.

4. Biliopancreatic Diversion With Duodenal Switch (BPD/DS) 

This procedure is less common than the other surgeries listed above and can be seen abbreviated to BPD/DS. This operation reaps some of the best weight loss results. However, it's considered complex and more likely to cause health complications, malnutrition, and vitamin deficiencies.Biliopancreatic Diversion With Duodenal Switch

The procedure consists of two steps. First, a sleeve gastrectomy is done where 70-80% of the stomach is removed resulting in a stomach the size and shape of a banana. Next, the intestine is divided further down than in gastric bypass surgery, resulting in a larger amount of the small intestine being bypassed. 

Due to a larger portion of the small intestine being bypassed and a smaller window for digestive enzymes to mix with food, there is a higher risk of becoming deficient in nutrients that may not be a problem in other surgeries.

 

Final Thoughts

In conclusion, there are several questions that you need to address with your practitioner when considering bariatric surgery. First, you need to establish whether you're eligible, considering your BMI and weight-related conditions.

Secondly, you'll settle on the best type of bariatric surgery for you. This choice depends on how much weight you're looking to lose, health risks, and obesity-related conditions.

Weight-loss surgery can be a game-changer, preventing weight-associated illnesses, improving overall health, and facilitating everyday tasks.

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**This blog is for information and education purposes only. This information is not intended to substitute professional medical advice, diagnosis, or treatment. Please consult with your physician or another qualified health provider with any questions in regards to a medical condition.