Table of ContentsView AllTable of ContentsPurposeTypes of SurgeryGastric BypassAdjustable Gastric BandingSleeve GastrectomyBiliopancreatic DiversionSADI-SWeight Loss DevicesGastric BalloonVagal BlockadeHow to ChooseQualifyingOutlook
Table of ContentsView All
View All
Table of Contents
Purpose
Types of Surgery
Gastric Bypass
Adjustable Gastric Banding
Sleeve Gastrectomy
Biliopancreatic Diversion
SADI-S
Weight Loss Devices
Gastric Balloon
Vagal Blockade
How to Choose
Qualifying
Outlook
Many types of weight loss surgery are available for treating obesity and overweight. It’s estimated that 41.9% of people in the United States live with obesity.
Without treatment, obesity could lead to serious complications. Diabetes, high blood pressure, and high cholesterol are some of the chronic disorders that are related to obesity. Surgical weight loss options vary in their advantages, potential drawbacks, and risks.
Halfpoint / Getty Images
Who Are Weight Loss Surgeries For?
Weight loss surgery(bariatric surgery) is a commitment. It involves making changes to diet and lifestyle to get the most benefits for weight loss and improved health.
Bariatric surgery is for people who are living withobesity. It’s not always the first choice for weight loss, however. People with obesity usually try many strategies, but nothing works. Weight loss surgery is used to reduce the health risks that are associated with obesity, such as heart problems.
Weight losssurgeryis for people with a particularbody mass index (BMI)and/or obesity-related health conditions. Obesity is defined as a BMI of 30 or greater, and severe obesity is a BMI of 40 or greater.
Body Mass IndexBody mass indexis a dated, biased measure that doesn’t account for several factors, such as body composition, ethnicity, race, gender, and age. Despite being a flawed measure, BMI is widely used today in the medical community because it is an inexpensive and quick method for analyzing potential health status and outcomes.
Body Mass Index
Body mass indexis a dated, biased measure that doesn’t account for several factors, such as body composition, ethnicity, race, gender, and age. Despite being a flawed measure, BMI is widely used today in the medical community because it is an inexpensive and quick method for analyzing potential health status and outcomes.
Understanding the Types of Weight Loss Surgery
Bariatric surgery might be categorized into types, including restrictive surgery, malabsorptive surgery, combination/mixed, and reduction ofhungerhormones.
Restrictive surgeryis effective for weight loss because it reduces the size of the stomach. After this surgery, people take in fewercaloriesbecause they get full after eating less food.
Some types of surgery alsoreduce the amount of hunger hormonesproduced in the stomach. Removing the section of the stomach that secretes these hormones produces less hunger.
Gastric Bypass Surgery (Roux-en-Y)
Procedure
Pros
Another study showed the type 2 diabetes remission rate was high even if the person regained weight.
Cons
Risks
This surgery may also be calledlap band surgery or laparoscopic gastric banding surgery. It is a common form of weight loss surgery that reduces the amount of food the stomach can hold.
In adjustable gastric banding surgery, a band is placed around the top part of the stomach. It results in a smaller stomach, which leads to being full sooner during a meal.
For people who live withdiabetes, gastric banding surgery brings the disease into remission in 57% of cases. People might lose about 45% of what is considered their excess body weight.The band can be adjusted as needed or it can be removed, meaning this surgery is reversible.
Adjustable gastric banding may be less effective for weight loss than the surgeries that also involve shortening the small intestine.
This surgery tends to have lower rates of certain risks (including death) than some types of bariatric surgery. However, the rates of needing a second procedure in order to get the desired results are higher than they are in other forms.
Sleeve gastrectomy, also calledgastric sleeve surgery, is one of the more common weight loss surgeries in the United States.
In gastric sleeve surgery, most (about 80%) of the stomach is removed and closed up with staples. The part that’s left is narrower, in the shape of a banana. People have less area in the stomach, so they feel full quickly when eating.
Removing part of the stomach might result in the stomach making fewer hormones that control appetite, causing less hungry. This surgery may lead to more weight loss than with the adjustable gastric band, with people losing about 60% of their excess body weight.Only the stomach is affected, and the small intestine is not altered.
The reflux may be related to developing ahiatal hernia, which is when the stomach pushes up into the chest through a hole in the diaphragm.
A biliopancreatic diversion is done in two parts, affecting both the stomach and the small intestine. First, most of the stomach is removed, leaving only a small section.
Food travels through the small stomach and the two sections of the intestine. As a result, people feel full quicker when eating, and fewer calories are absorbed in the small intestine.
This surgery, which affects both the stomach and the small intestine, is effective for weight loss. One research review showed that 59% of people had effective weight loss at 34 months after surgery.
In addition to consuming and absorbing fewer calories, the hormones that control hunger (which are produced in the stomach) are also reduced.This procedure is effective for achieving remission from type 2 diabetes in up to 84% of people.
Because this surgery results in such high levels of calorie restriction, it could prevent the absorption of enough vitamins, minerals, and protein from food.
Due to severemalabsorption, 0.5% to 4.9% of people will need more surgery on the small intestine. Insufficient weight loss might occur in 0.5% to 2.78% of cases.
Single Anastomosis Duodeno-Ileal Bypass With Sleeve Gastrectomy (SADI-S)
SADI-S is helpful in achieving remission of type 2 diabetes, with one study showing as many as 93% of people achieving that goal. The remaining 7% had partial remission or tookmedicationto manage the disease. It is effective for weight loss, with 77% of people losing a medically significant amount of weight after the first year.
The rate of complications in the early days after having this surgery is about 5% (however, this is less than in other combination bariatric surgery types). SADI-S surgery is associated with a risk of developing reflux, with a rate of 2% per year and 8% of people having this complication after 15 years.
The yearly risk ofbowel obstructionis 0.3%, with about 1% of people experiencing this complication sometime in the 15 years after the surgery. Also, within 15 years, 4% of people have a revision to improve the desired results of the surgery or to manage a complication.
Aside from surgery, a few different types of devices are used to promote weight loss. They are less invasive than bariatric surgery, but they may result in less weight loss.
Two types of balloons might be used for weight loss. They are placed inside the stomach using special tools inserted through the mouth and down through theesophagus(food tube).
A gastric balloon is placed while the person is under anesthesia during the endoscopic procedure. The balloon is inserted into the stomach and filled with saline. With less space for food in the stomach, the person feels fuller quicker.
A gastric balloon is temporary, which may make it attractive to some. It is a procedure rather than a surgery, so it’s not associated withsurgical risksor a hospital stay.It can be used for people who are not able to or who do not want to have surgery.
In one study of 159 people, BMI was reduced from a mean (average) of 34 to a mean of 30.
The long-term effects of gastric balloon procedures are not yet known because they have not been in use long enough. However, they are only used temporarily, for six to 12 months. This means that another procedure is needed to remove the balloon within a year of having it placed.
This is not a passive weight loss option. It involves altering diet and lifestyle.The weight loss is often not as much as with surgical procedures.
After the balloon is placed, some people experiencenausea,vomiting,abdominal painand/or discomfort, andsymptoms of reflux. About 5% of people might need to have the balloon removed because these symptoms do not resolve.
Other risks include injuries during placement, such as ahole in the stomach or the esophagusor the balloon moving out of place and causing an obstruction. Infection from bacterial overgrowth is another possible complication.
Vagal Blockade (vBloc)
Invagal blockade(vBloc) a medical device is used to affect thevagus nerve(which regulates digestion and other body functions). It alters the way this nerve works, which can lead to a change in how hungry or full people feel.
A vagal stimulation device is placed usinglaparoscopic surgery.The person is under general anesthesia. The procedure takes under two hours to finish. The implanted device gives off an electrical charge at regular intervals to block the hunger signal.
Studies show excess weight loss of about 24% with vagal blockade. The procedure is reversible, so people can have the device removed.
The device does need to be charged twice a week. Not many studies have yet reported on the use of this device, so the long-term effects and results are not yet known.
Adverse effects may includeheartburn,dyspepsia(indigestion), abdominal pain, belching, anddysphagia(difficulty swallowing). However, most of these symptoms are felt for only a short time and improve on their own. After 18 months, 7% of people needed surgery again to make an adjustment.
How to Choose the Right Weight Loss Surgery for You
A number of factors will help determine if weight loss surgery is right for you, as well as whichprocedureis the best one. People should use shared decision-making with their healthcare providers to understand all the pros, cons, and risks as applied to them as individuals.
Some things to consider include:
How Do You Qualify for Weight Loss Surgery?
Not everyone will qualify for weight loss surgery. Certain metrics must be met in order to be a good candidate. Some of the qualifications will be different based on where the procedure is being performed. Not every type of procedure is performed at every institution, and surgeons may have their own criteria for candidates.
Weight Loss Surgery Screening Process
The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has published the following guidelines for bariatric surgery:
Aside from these objective factors, other conditions may need to be met. This can include first trying other noninvasive methods for weight loss, such as diet and exercise or certain medications.
Amental health screeningmay also be done to ensure that the person is ready for the impacts that the surgery may have on their life and emotional wellness. In addition, a person may need to be able to commit to making diet and lifestyle changes to ensure that the surgery is a success.
Weight Loss Surgery for Teens
Guidelines determine the eligibility of teens for bariatric surgery. The American Society for Metabolic and Bariatric Surgery (ASMBS) advises that surgery be considered for teens who meet one of these criteria:
Bariatric Surgery for TeensThe ASMBS states that bariatric surgery is the standard of care for severe obesity in adolescents. The organization recommends that children with severe obesity be referred early to a metabolic and bariatric surgery center.
Bariatric Surgery for Teens
The ASMBS states that bariatric surgery is the standard of care for severe obesity in adolescents. The organization recommends that children with severe obesity be referred early to a metabolic and bariatric surgery center.
What Is the Outlook for Someone After Weight Loss Surgery?
Weight loss surgery has become more common and techniques have improved in recent years. Overall, the risks of complications are low, and most people do well.
One problem that people will need to watch for is regaining weight. Working with the support team to make the most appropriate and beneficial lifestyle changes will be important in achieving long-lasting success.
After having weight loss surgery, people can expect to make some changes to their diet and lifestyle. Vitamin and mineral supplements will be needed for life. Most people will be encouraged to exercise in order to maintain weight loss. Quitting smoking and drinking less alcohol will also be recommended.
Frequent follow-up appointments are required in the first year or two after surgery, and then regular checkups thereafter with a healthcare provider to monitor for complications.
Summary
Several options are available for weight loss surgery and devices. People must meet certain criteria to be considered candidates for these procedures. Each type of procedure has its own benefits, drawbacks, and risks, which should be carefully considered with the help of healthcare providers.
The surgery and procedures required are not the final step toward weight loss. Also required are changes to diet, lifestyle, and medications or supplements for the rest of the person’s life.
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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