Surgical Weight Loss
While bariatric surgery can offer many benefits, all forms of weight-loss surgery are major procedures that can pose serious 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.
surgical weight loss
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 must also be willing to make permanent changes to lead a healthier lifestyle.
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.
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 progresses 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 your 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 you develop complications, see your doctor immediately. Your weight loss can be monitored and factors potentially contributing to your lack of weight loss evaluated.
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.
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.
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
Weight-loss surgery changes the shape and function of your digestive system. This surgery may help you lose weight and manage medical conditions related to obesity. These conditions include diabetes, obstructive sleep apnea, and risk factors for heart disease and stroke.
Weight-loss surgery is also known as bariatric surgery. There are various surgical procedures, but all of them help you lose weight by limiting how much food you can eat. Some procedures also limit the amount of nutrients you can absorb.
Weight-loss surgery is only one part of an overall treatment plan. Your treatment will also include nutrition guidelines, exercise and mental health care. You'll need to be willing and able to follow this long-term plan to achieve your weight-loss goals.
The general medical guidelines for weight-loss surgery are based on body mass index (BMI). BMI is a formula that uses weight and height to estimate body fat. Weight-loss surgery might be an option for an adult with a BMI of 40 or higher.
Weight loss after surgery depends on your ability to change behaviors in eating and exercise. Also, being in good mental health is important for the demands of following your treatment plan. Your team's goals are to identify psychological or behavioral risk factors, address any problems, and decide whether you're ready for surgery.
These requirements are intended to help you achieve the best possible weight-loss outcomes after surgery. Also, your ability to follow through on these plans will show your team how motivated you are to follow guidelines after surgery. Weight-loss surgery can be delayed or canceled if your health care team determines that:
Your insurance company may cover the costs of weight-loss surgery. Your team will need to show that the procedure is medically necessary. Also, you may need to provide documented evidence that you weren't able to lose enough weight with a supervised program of diet and exercise. Medicare and some Medicaid programs may cover the costs.
The process the team uses to determine if you're ready for weight-loss surgery is also there to help you make an informed decision. You will need to consider the benefits and risks, follow through with pre-surgery and post-surgery plans, and make a lifelong commitment to a new nutrition and exercise program.
Restrictive surgeries work by shrinking the size of the stomach and slowing down digestion. A normal stomach can hold about 3 pints of food. After surgery, the stomach may at first hold as little as an ounce, although later that could stretch to 2 or 3 ounces. The smaller the stomach, the less you can eat. The less you eat, the more weight you lose.
What it is: This is another form of restrictive weight loss surgery. In the operation, the surgeon removes about 75% of the stomach. What remains of the stomach is a narrow tube or sleeve, which connects to the intestines.
Pros: For people who are very obese or sick, other weight loss surgeries may be too risky. A sleeve gastrectomy is a simpler operation that gives them a lower-risk way to lose weight. If needed, once they've lost weight and their health has improved -- usually after 12 to 18 months -- they can have a second surgery, such as gastric bypass.
Pros: Weight loss tends to be swift and dramatic. About 50% of it happens in the first 6 months. It may continue for up to 2 years after the operation. Because of the rapid weight loss, conditions affected by obesity -- such as diabetes, high blood pressure, high cholesterol, arthritis, sleep apnea, and heartburn -- often get better quickly.
Cons: You won't absorb food the way you used to, and that puts you at risk for not getting enough nutrients. The loss of calcium and iron could lead to osteoporosis and anemia. You'll have to be very careful with your diet, and take supplements, for the rest of your life.
Risks: Because gastric bypass is more complicated, it's riskier. Infection and blood clots are risks, as they are with most surgeries. Gastric bypass also makes hernias more likely, which may need further surgery to fix. Also, you may get gallstones because of the rapid weight loss.
Pros: Implanting this device is the least invasive of the weight loss surgeries. The outpatient procedure may take up to an hour and a half while the patient is under general anesthesia.
Pros: Biliopancreatic diversion can result in even greater and faster weight loss than a gastric bypass. Although much of the stomach is removed, what's left is still larger than the pouches formed during gastric bypass or banding procedures. So you may be able to eat larger meals with this surgery than with others.
Risks: This is one of the most complicated and riskiest weight loss surgeries. As with gastric bypass, this surgery poses a fairly high risk of hernias, which will need more surgery to correct. But this risk is lower when the doctor uses minimally invasive procedures (called laparoscopy).
Endoscopic weight loss procedures are a promising new option for people who want help losing weight but don't want -- or may not qualify for -- bariatric surgery. These nonsurgical procedures may also be an option for people who:
Endoscopic weight loss procedures achieve better weight loss than medication but not as much as bariatric surgery. Because they are newer procedures, more data is needed on how they perform over the long term. Endoscopic procedures are not covered by insurance at this time.
These procedures require specialists with advanced training in GI endoscopy. Our surgeons and gastroenterologist have completed this advanced training and have years of experience performing these procedures with positive outcomes. We also train future weight loss surgeons to perform these procedures. 041b061a72