Weight Loss Procedure: An Overview and Competing Methods
Bariatric surgeries, particularly newer types, have proven to be generally safe and effective for those struggling with severe obesity. These procedures help individuals lose weight and improve their overall health. In this article, we will delve into four common bariatric surgeries – gastric sleeve, gastric bypass, gastric band, and stomach stapling – and compare their effectiveness, side effects, and recovery periods.
Procedures and Effectiveness
Gastric Sleeve (Stomach Stapling)
Gastric sleeve, also known as stomach stapling, removes around 80-85% of the stomach, creating a sleeve-shaped smaller stomach. This reduction in size significantly decreases a person's capacity for food and helps control hunger hormones, leading to an average weight loss of 65-75% of excess weight. The procedure is minimally invasive, with a surgery time of about 60-90 minutes, and recovery is relatively quick [1][3][5].
Gastric Bypass (Roux-en-Y Bypass - RYGBP)
Gastric bypass is a more complex procedure that creates a small stomach pouch and reroutes part of the intestines. This reduction in food intake and nutrient absorption leads to faster and often greater weight loss than gastric sleeve. Gastric bypass is also effective in diabetes remission due to reduced nutrient absorption [1][3]. However, it carries a higher risk of complications, including dumping syndrome and nutritional deficiencies requiring lifelong supplements.
Adjustable Gastric Band
Adjustable gastric banding involves placing a silicone band around the upper stomach to restrict food intake. This procedure is less invasive and reversible, but it generally results in less weight loss compared to gastric sleeve or bypass. Side effects can include band slippage or erosion, and it typically requires careful postoperative adjustments [1][2][4].
Side Effects and Risks
All bariatric surgeries have potential side effects and risks. Common side effects include mineral and vitamin deficiencies, heartburn, strictures or tightening in the stomach, hernia, bleeding, nausea and vomiting, diarrhea, anemia, difficulties swallowing, formation of gallstones, blood clots, wound infection, and osteoporosis [2].
Recovery and Other Notes
Recovery times vary depending on the procedure. Gastric sleeve and bypass require longer recoveries than the gastric band, which is quicker and often allows patients to go home the same day or the next day. Post-surgery patients typically need to follow a special diet, starting with liquids and gradually reintegrating solid foods [1][4].
In summary, gastric bypass offers the most rapid and significant weight loss but with higher risk and nutritional concerns. Gastric sleeve provides substantial, durable weight loss with fewer complications compared to bypass. Adjustable gastric banding is less invasive and reversible but produces less weight loss and may require adjustments or removal [1][3][5].
It is essential to note that bariatric surgery is expensive and may not be covered by medical insurance unless specific criteria are met, such as being unable to lose weight with exercise, diet, or other medications, having a body mass index (BMI) over 40, or having a BMI over 35 with at least one obesity-related condition.
References:
[1] American Society for Metabolic and Bariatric Surgery. (n.d.). Bariatric Surgery Procedures. Retrieved from https://asmbs.org/patients/bariatric-surgery-procedures
[2] National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Bariatric Surgery: A Guide for Patients and Families. Retrieved from https://www.niddk.nih.gov/health-information/weight-management/bariatric-surgery/index
[3] Obesity Action Coalition. (n.d.). Bariatric Surgery. Retrieved from https://www.obesityaction.org/resources/bariatric-surgery
[4] Mayo Clinic. (2020). Bariatric surgery: What to expect. Retrieved from https://www.mayoclinic.org/tests-procedures/bariatric-surgery/about/pac-20394810
[5] Cleveland Clinic. (2021). Gastric Sleeve Surgery. Retrieved from https://my.clevelandclinic.org/health/treatments/17968-gastric-sleeve-surgery
[6] University of Michigan Health. (2021). Gastric Bypass Surgery. Retrieved from https://www.uofmhealth.org/conditions-treatments/surgery-procedures/gastric-bypass-surgery
[7] University of California San Francisco. (2021). Laparoscopic Adjustable Gastric Banding. Retrieved from https://www.ucsfhealth.org/services/laparoscopic-adjustable-gastric-banding
- After gastric sleeve surgery, a person's stomach size is significantly reduced, creating a sleeve-shaped smaller stomach responsible for an average weight loss of 65-75% of excess weight.
- Gastric bypass, compared to gastric sleeve, is a more complex procedure that involves creating a small stomach pouch and rerouting part of the intestines, which leads to faster and often greater weight loss.
- The adjustable gastric banding procedure, while less invasive and reversible, results in less weight loss and may require adjustments or removal due to potential side effects such as band slippage or erosion.
- Various side effects and risks are associated with bariatric surgeries, ranging from mineral and vitamin deficiencies to heartburn, strictures, hernia, bleeding, nausea, diarrhea, anemia, difficulties swallowing, formation of gallstones, blood clots, wound infection, and osteoporosis.
- Medicare coverage for bariatric surgery is limited to individuals who meet specific criteria, such as having a high BMI or obesity-related conditions and demonstrating an inability to lose weight with other means.
