The medical community is increasingly coming to the consensus that, for some individuals, bariatric and other weight loss procedures may be the best solution to fight obesity, prevent or reverse pre-diabetes, and improve a host of other symptoms of the metabolic syndrome. While certainly a big decision that should be made under the guidance of a qualified health care team, including doctors and dietitians, it is often the best choice for individuals with high body mass indexes.
If you have decided to explore weight loss surgery options further, you may be wondering which procedure best fits your needs. There are two major categories of weight loss surgery. One type of procedure restricts the size of the stomach to limit the number of calories that can be comfortably consumed. Another type of procedure inhibits the absorption of calories by the body by resecting, or removing, a part of the intestines, which are responsible for absorbing nutrients.
The two major types of restrictive procedures are the gastric band, or Lap-Band, and the gastric sleeve. In the Lap-Band procedure, a band is wrapped around the stomach to section off a small pouch. This small pouch becomes the new stomach, about the size of an egg. The band can be tightened or loosened via an external port placed in the abdomen to restrict food intake further, as the recipient becomes accustomed to the band and the restriction of food intake.
A second type of restrictive weight loss procedure is a sleeve gastrectomy, or gastric sleeve. Unlike the Lap-Band, the gastric sleeve does not rely on a foreign object to section off a smaller stomach. Rather, an entire portion of the stomach is removed from the body, leaving behind a smaller, tube-like stomach that resembles a sleeve. As with the gastric band, this smaller stomach promotes earlier satiety to restrict food intake.
A Roux-en-Y gastric bypass is the most common malabsorptive weight loss procedure. As with the restrictive procedures, the gastric bypass involves creating a smaller stomach from the patient’s existing stomach. The surgeon then connects a distal portion of the small intestine to the new stomach, effectively excluding the upper small intestine from the digestive process. By reducing the absorptive surface area of the digestive tract, the gastric bypass reduces your body’s potential to process and assimilate calories.
Another type of weight loss surgery to consider is the duodenal switch, which also begins with the formation of a smaller stomach, much like the gastric sleeve. The first portion of small intestine is connected to the new stomach. The end of the small intestine is then connected to the beginning, omitting the middle portion. This greatly reduces the absorptive surface area of the small intestine and, as a result, the calories that can be absorbed.
Your doctor, surgeon and dietitian can help you choose which procedure is best for your lifestyle and your body. Regardless of your choice, bariatric surgery, coupled with healthy lifestyle changes, has the potential to increase your life expectancy and reduce your risk of chronic disease.