In the last 30 years, obesity has been one of the major health problems in the United States, along with heart disease and type 2 diabetes. With more than one-third of American adults considered obese, bariatric or weight loss surgeries have become a popular option for people who have not been able to lose weight by other means.
Since weight loss surgery was first introduced to manage severe obesity, it has been embraced by patients and physicians alike for its effectiveness and safety profile. The American Society for Metabolic and Bariatric Surgery (ASMBS) reports that weight loss surgeries have helped almost 2 million Americans reduce their weight since 2011 — with over 256,000 bariatric surgical procedures conducted within 2019 alone.
At Beltline Health, we offer the best surgical weight loss options that fit your needs to help you achieve a healthy weight and resolve any medical conditions associated with obesity.
In this guide, we’ll take a look at what exactly bariatric surgery is, who should consider one, the most common types of bariatric surgery available today, and how to choose one that’s best for you.
What is bariatric surgery?
Bariatric surgery, also called weight loss surgery, is a medical metabolic procedure that helps patients with extreme obesity to lose weight. It is also a common option for people who have not been able to lose weight with other methods, especially those suffering from obesity-related health problems.
Since obesity is a risk factor for many diseases such as diabetes, heart disease, asthma, high blood pressure, and arthritis, losing weight either through surgical or non-surgical methods may help improve these conditions. In addition to these, obesity can also cause psychological distress, such as depression and anxiety.
Bariatric surgeries are commonly classified as either restrictive or malabsorptive. Restrictive procedures aim to reduce your stomach’s natural capacity to limit the amount of food you can eat at a given time. In contrast, malabsorptive methods target your digestive tract to alter how food is digested after being consumed.
However, today’s most commonly used bariatric procedures combine both concepts to offer safer and more effective ways while using minimally invasive surgical techniques. These procedures allow to induce weight loss and control obesity-related conditions with minimal complications, faster recovery, and manageable post-surgical lifestyle changes.
Who should consider bariatric surgery?
All types of bariatric surgeries can help you lose a decent amount of weight, but these procedures are certainly not for everyone. It’s best to consult a bariatric surgeon to help assess your condition and determine if you are a candidate for bariatric surgery.
But for a quick reference, here are the recommended guidelines set by the ASMBS and the National Institutes of Health:
- if you have a body mass index (BMI) of 35 to 39.9 with a history of obesity-related conditions (high blood pressure, type 2 diabetes, non-alcoholic fatty liver disease, heart disease, high cholesterol, sleep apnea, infertility, depression)
- if you have a BMI of 40 and above, regardless of any related conditions
- if you were not able to achieve or sustain a healthy weight loss over a period of time after a series of weight loss efforts like lifestyle changes and medications
There are other non-surgical procedures to achieve weight loss, like improving eating habits, increasing physical activity, and taking medications. Still, in some cases, the problem reoccurs after a year or two. Successful bariatric surgery can significantly improve these obesity-related conditions by helping get rid of the weight for good to give patients a better quality of life.
What are the common types of bariatric surgery?
There are several weight loss surgery procedures available today, and depending on different factors, one may work better than the other for you.
Gastric Sleeve Surgery
Also known as sleeve gastrectomy surgery, gastric sleeve surgery is one of the latest treatment options for medical weight loss. It is a permanent, non-reversible procedure that involves the removal of 80 to 85% of your existing stomach using minimally invasive surgical techniques.
It is classified as a restrictive weight loss surgery since the operation forms a long, narrow sleeve that limits the amount of food your stomach can hold. This will encourage the body to burn off excess fat as you consume fewer calories throughout the day. It also helps gastric sleeve patients feel less hungry throughout the day as removing part of the stomach reduces the secretion of hunger-causing hormones.
Dr. Charles Procter, one of the nation’s top bariatric surgeons and a founding member of Beltline Health, recommends sleeve gastrectomy for patients with a BMI of 35 to maybe in the high 40s, especially if they have a pretty clean medical history.
The complication rates from sleeve gastrectomy are relatively low since most operations are performed with a laparoscopic procedure. This is a surgical technique that uses several small incisions on the abdomen to access the stomach, rather than a large one with a traditional open manner. With the same outcomes, it significantly reduces surgical complications and speeds up healing times.
Following a sleeve gastrectomy, you will need to follow a special post-surgical diet that starts with a clear liquid phase, followed by full liquids and pureed foods. You will be able to consume regular foods again once your new stomach is fully healed. But since a portion of your stomach is removed, you will need to reduce food intake or portion sizes compared to what you are eating before the surgery.
Gastric Bypass Surgery
Considered the “gold standard” among the medical weight loss procedures, gastric bypass surgery is the second most common type of bariatric surgery in the United States. It is also known as Roux-en-Y gastric bypass surgery, where the bariatric surgeon uses laparoscopic procedures to create a small pouch out of the stomach.
As food is digested, it completely bypasses a large section of the stomach and the duodenum to reroute the food to the small pouch that fills up quickly when you eat. With this, you will feel full with just a fraction of the food that you typically consume, which results in the absorption of fewer calories and nutrients.
“When we start to get into more complicated diabetes or hypertension, as well as patients with a BMI of up to 55, I prefer performing gastric bypass procedure. It that takes maybe an hour, done either laparoscopic or robotically in the hospital,” says Dr. Procter.
In addition to weight loss, gastric bypass also targets to improve chronic conditions like type 2 diabetes, hypertension, sleep apnea, and high cholesterol. Based on our gastric bypass patients’ experiences, they typically lose about 60% of their excess body weight within 18 months of the procedure.
Like sleeve gastrectomy, gastric bypass surgery has low complication rates and minimal post-surgical pain. While the resulting metabolic changes can reduce cravings, patients are required to follow a specific diet and level of physical activity to ensure success along the way. Patients also need monitoring for nutrient deficiencies since fewer nutrients are absorbed by the stomach.
Duodenal Switch
Duodenal switch surgery is one of the most innovative weight loss procedures to treat morbidly obese patients or those with a body mass index (BMI) of 50 or greater. Likewise, patients at high risk of developing one or more obesity-related conditions usually undergo this type of surgery.
This weight loss surgery is a combination of two separate procedures mentioned above. The first would be gastric sleeve surgery which would dramatically reduce the capacity of the stomach to decrease caloric intake and the secretion of hunger-stimulating hormones. It would be followed by gastric bypass surgery, where half of the small intestines is bypassed to further reduce calorie and fat absorption during digestion.
However, even if you are ‘super obese’, patients with pre-existing digestive issues such as gastric reflux (GERD) and irritable bowel syndrome are often advised against having duodenal switch surgery as it aggravates their symptoms. Likewise, patients with pre-existing vitamin or mineral deficiencies are not good candidates for this weight loss procedure.
As patients lose weight after the surgery, they are required to follow a highly restrictive lifelong diet that involves eating vegetables and lean proteins while avoiding simple sugars and complex carbohydrates. Since nutrient absorption is significantly reduced, patients are advised to take multivitamins to prevent nutrient deficiencies.
Which type of bariatric surgery is the best for you?
You now have an idea of how each weight loss surgery works to help you achieve a healthy weight. All of these types are safe, effective, and less invasive since they are usually done using laparoscopic and robotic surgical techniques.
Simply put, the best weight loss surgery for you will depend on your current medical conditions, level of obesity, eating habits, and previous surgeries, which will be determined with the medical advice of a certified bariatric surgeon. You will be closely monitored before, during, and after the surgery to ensure that you are qualified to undergo surgery and observe for possible serious complications.
If your first weight loss surgery doesn’t help you achieve a healthy or expected weight, a second surgery may be done to perform the necessary revision. The same is true with gastric banding procedures where the band can move over time. The bariatric surgeon will most likely remove the lap band and perform either a gastric sleeve or bypass surgery through bariatric revision surgery.
When considering bariatric surgery, it’s crucial to find the right option for your needs through the guidance of a team of bariatric surgeons, dietitians, medical assistants, nurses, and counselors who have extensive experience in weight loss surgery.
At Beltline Health, we will walk you through the steps necessary to qualify for weight loss surgery and provide the lifelong support needed to maintain a permanent healthy weight and lifestyle. These include resources for nutritional counseling, exercise physiologists, psychological evaluation, and support groups to ensure that each patient has a successful and positive weight loss experience.
Sign up for our free weight loss online seminar to help you get started on your weight loss journey. Visit our website to message us or call us at (470) 419-4380 for more information.
