Bariatric Surgery

When people are unable to lose weight after modifications to their diet and exercise plan, bariatric surgery may help to reach and maintain a normal body weight. Bariatric surgery, also known as weight loss surgery, is a general term for the surgical options available for treating obesity. Each type of bariatric surgery carries operative risks and side effects, and the pros and cons of surgical intervention for weight maintenance must be considered before electing to proceed with a bariatric surgery. For the most part, bariatric surgeries are completed successfully without incident, but any surgery presents risks. Bariatric procedures are not indicated in patients looking for a quick way to simply shed a few pounds. Weight loss surgeries should only be considered in patients with a BMI of approximately 40 or above. Men at least 100 pounds overweight and women who are at least 80 pounds overweight, with obesity-related conditions including hypertension, heart disease, glucose intolerance, diabetes, high cholesterol, hyperlipidemia, and sleep apnea, are potential candidates for bariatric surgery. Individuals that are less than 80-100 pounds overweight with obesity-related conditions are also candidates for bariatric procedures, depending on the severity of their illness and the likelihood that losing excess weight will ease their medical conditions. Bariatric surgery only applies to procedures that involve modifying the gastrointestinal tract to prevent full nutrient intake and/or absorption of food. Procedures focusing on the removal of already existing body fat or tissue like liposuction and tummy tucks are not considered bariatric procedures. There are three main classes of bariatric procedures: restrictive, malabsorptive, and combination. Depending on your health, weight loss goals, and obesity-related conditions, your doctor will develop a bariatric plan to best meet your weight loss needs. Restrictive procedures will limit the amount of food a patient can eat. The bariatric surgeon will create a small pouch off the stomach which will fill quickly during meals, helping patients to feel full eating less food, which ultimately assists in weight loss. The two major types of restrictive bariatric procedures are gastric banding and sleeve gastrectomy. Malabsorptive procedures are usually done along with a restriction technique, but rarely surgeons will perform them alone. In malabsorptive techniques, the bariatric surgeon will reroute a portion of the small intestine so that food skips this section. By rerouting the small intestine, less calories and nutrients are absorbed from the food. Biliopancreatic Diversion, Duodenal Switch, and Jejuno-Ileal Bypass are all examples of malabsoprtive bariatric surgery procedures. Combinations procedures are the most common in bariatric surgery and they involve using both restrictive and malabsorptive techniques. Roux-en-Y gastric bypass is the most frequently used bariatric sugery, and involves the creation of a small pouch in the stomach, along with the attachment of a Y-shaped section of the small intestine directly into the stomach pouch. Gastric bypass allows food to skip a large portion of the small intestine, while allowing patients to feel fuller quicker, providing the benefit of less food absorbed and less food eaten.