Understanding the Three Types of Bariatric Surgery

For many obese patients, the number on the scale isn’t just about physical appearance. Obesity can be a killer. It has been linked to more than a dozen serious medical problems. The solution to losing weight for some individuals is bariatric surgery. Understanding the types available can make the decision on whether to have surgery less stressful.

Obesity and Weight Loss Surgery

Surgery to lose weight works by limiting the amount of food a person is able to eat or reducing food and calorie absorption. Many surgeries incorporate a combination of both.

The Mayo Clinic says surgery is an alternative when other options have failed and the following factors are present:

  • The individual has a body mass index (BMI) of 40 or higher.
  • The BMI is between 35 and 39.9 but is accompanied by a serious health issue like diabetes.
  • The patient has a commitment to making the lifestyle alterations required for the surgery to be successful.

The National Institute of Diabetes and Digestive and Kidney Diseases adds that patients visiting a weight loss clinic to explore surgery should realize that some individuals achieve losses short of their objectives. Others regain some weight over time.

There are two approaches to surgery. One involves cutting open the stomach in a traditional manner. In the second, a laparoscopic doctor inserts a small camera through cuts about half an inch long to visualize the surgery. Today, most surgery to lose weight is laparoscopic.

Weight Loss Treatment Options

According to the Wexner Medical Center at The Ohio State University, doctors perform three types of surgery:

  • Gastric banding is reversible and adjustable, so it can be customized for each patient. It is minimally invasive, with small incisions and rapid recovery. A band pulled tight forms a channel between two created stomach pouches. Banding could be an outpatient procedure or require a stay overnight. Risks include band slippage, band wear, and the possibility of infection at the port where adjustments are made.
  • Gastric bypass involves creating a small pouch at the top of the stomach. The surgeon connects the small intestine to the created pouch, bypassing most of the stomach. This yields a 65 to 80 percent loss of excess weight and is well suited to patients with disorders like diabetes. Risks include leakage through sutures or staples, ulcers in the small intestine or stomach, internal hernias, a blockage of the stomach opening, and a possible spleen injury. Some patients experience iron and vitamin deficiencies.
  • Sleeve gastrectomy is a procedure to remove a portion of the stomach and create a smaller food storage area. Patients experience no malabsorption issues and can lose up to 70 percent of excess weight within 18 months. Risks include bleeding, sleeve stricture, leakage from the suture line, nausea and heartburn, and a vitamin B12 deficiency.