A Guide to Bariatric Surgery

Since it was first performed in the 1960s, bariatric surgery has evolved and changed. Now it is a mostly safe procedure that is practiced in hospitals all over the country – but is this right for you?

A Guide to Bariatric Surgery

What Is Bariatric Surgery?

Bariatric surgery describes a series of operations on the gastrointestinal system that helps obese persons lose weight. It works either by restricting the patient’s amount of food intake, by altering the body’s ability to absorb ingested food, or both.

The first gastric bypass was performed in 1969. However, this and other bariatric surgeries didn’t gain popularity until the bariatric revolution in the early 2000s, as the procedure got safer and more surgeons offered laparoscopic options that would allow for a faster recovery and leave fewer scars.

After these procedures, patients note not only a dramatic reduction in weight, but also resolution of other obesity-related conditions, including gastric reflux, obstructive sleep apnea, joint and back problems, fatty liver disease, and some forms of asthma and diabetes.

The three commonly performed procedures include:

Gastric Sleeve Procedure:Weight loss is achieved by making the stomach physically smaller, so one would require less food in order to feel satisfied. The surgeon would separate the stomach – removing at least 85% of its original volume. The remaining stomach is shaped like a thin banana, which measures 2-5 ounces. Studies have shown that patients lose 45-50% of excess weight after this procedure. The complication rate is 8% with a mortality rate of 0.19%

Adjustable Gastric Band (Lap Band): This procedure also causes weight loss by restricting the amount of food that the stomach can hold at one time. The surgeon places an inflatable band around the top of the stomach. The band sections off a small pouch toward the top of the stomach, which restricts the amount of food the person can eat in one meal. Studies have shown that patients lost 60% of excess body weight after 5 years with a very low mortality rate of 0.1%.

Roux-en-Y Gastric Bypass:Less commonly performed than the above two for weight-loss purposes, this operation causes weight loss by both restricting the size of the stomach and reducing the amount of food the body can absorb. In this procedure, the surgeon makes a small pouch at the top of the stomach. She or he then connects the pouch to a y-shaped section of the small intestine, which allows food to bypass the lower stomach and a portion of the intestines. Studies have shown that patients lose between 60% and 80% of excess body weight during the first year after surgery. Recent data shows a mortality rate of approximately 0.3%. NYU’s Weight Management Program outlines the procedure in a shortvideo.

Who Is a Good Candidate for Bariatric Surgery?

This surgery isn’t right for everyone. It’s best reserved for those who are at least 100 pounds over ideal body weight or has a BMI greater than 40 (calculateyourBMIwiththiscalculator), or if your BMI is greater than 35 and have associated health problems related to your obesity, like heart disease, type 2 diabetes, or severe sleep apnea.

In addition to being morbidly obese, most surgeons expect patients to have had tried other weight-loss treatments with little or no success, be psychologically stable, and be able to demonstrate the motivation to make a life-altering change.

Talk with you doctor about whether any of these procedures may be right for you.

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