Weight loss or bariatric surgery classifies a specific group of surgical interventions to help obese people lose weight. For the most part, healthcare providers recommend weight loss surgery for patients with class III obesity. When all other weight loss approaches have failed, keeping the excess weight on will pose a greater medical risk than the surgery itself.
Whether you’re looking for options regarding bariatric surgery in Miami or in other cities, the different types of bariatric surgeries serve the same purpose. These interventions usually modify the digestive system (most often the stomach and the small intestine) to help regulate the calorie consumption and absorption of the patient. These surgeries may also reduce the hunger signals between the brain and the digestive system.
In this article, our expert bariatric surgeon, Dr. Whittwell, and his experienced team discuss the basics of weight loss surgery, the different types of weight loss surgery, why it’s performed, and how it helps patients.
About Bariatric Surgery
Weight loss surgeries are the most effective long-term treatment for class III obesity. They can also prevent several metabolic issues related to being obese, such as fatty liver diseases and diabetes.
Some might see the different types of bariatric surgery as quick fixes for an ongoing problem. Still, in reality, patients need to prepare for the intervention and commit to serious long-term lifestyle changes to ensure the success of the surgery.
As said before, the intervention is typically recommended for people with class III obesity, where patients are usually unable to sustain weight loss through traditional exercise and diet alone because the body has “registered” the excess weight as normal. Whenever the person’s body mass index (BMI) drops, the body will want to return to that weight.
In that sense, weight loss surgery aims to change how the body manages the calories the patient consumes. It allows for healthy lifestyle and diet changes to reach their full effectiveness in promoting long-term weight loss and maintenance.
Weight Loss Surgery and Other Conditions
Obesity is generally associated with several chronic medical issues, many potentially life-threatening. After bariatric surgery, the risk factors associated with these diseases are greatly reduced. For the most part, patients with class III obesity, who are also great candidates for the surgery, are at high risk (or already have) one or more of the following diseases:
- Hypertension is when the blood flows through the blood vessels with too high force, wearing down the blood vessel walls.
- High cholesterol is when the blood has too much fat in it, causing blockages in the blood vessels that may lead to heart attacks or stroke.
- Heart disease. Apart from plaque buildup, obesity can impair cardiac function and may cause congestive heart failure.
- High blood sugar, which is a precursor to diabetes.
- Type 2 diabetes, since storing excess fat can lead to insulin resistance.
- Obstructive sleep apnea leads to upper respiratory tract blockages, reducing oxygen flow to essential organs during sleep.
- Kidney disease
- NAFLD or non-alcoholic fatty liver disease. The body begins to deposit the excess fat in the liver leading to chronic inflammation and long-term organ damage.
- Osteoarthritis. The extra weight puts unnecessary pressure on the joints, increasing the chances of developing degenerative joint disease.
- Cancer: Obesity is connected to a higher risk of malignancy development in over a dozen cancer types.
Who Is a Good Candidate?
As mentioned above, people with class III obesity are the best candidates. They are either:
- Morbidly obese – have a body mass index of 40 or higher.
- Have a body mass index of 35 and one of the health issues listed above.
Preparation for Weight Loss Surgery
Before the intervention, the bariatric surgeon will want to ensure you are mentally and physically fit. Your bariatric surgeon will introduce you to a team of experts who will evaluate your mental and physical health while discussing the benefits and the risks.
Patients may undergo different medical screenings to ensure that the surgery is safe in their case. Smokers and those who drink must quit both before qualifying for the intervention.
Also, bariatric surgeons will recommend following a specific preparation diet sometime before the intervention’s appointment. This diet aims to reduce the amount of excess fat inside the abdomen, making the surgery safer and reducing the chances of complications.
Performing Bariatric Surgery
For the most part, weight loss surgery is performed with minimally invasive techniques, like laparoscopic surgery, meaning only a few small incisions will be made to ensure less scarring and faster healing.
In rare cases, bariatric surgeons may recommend open surgery because of other peculiar conditions.
Types of Bariatric Surgery
Weight loss surgery can be performed in the following ways:
Gastric sleeve
Sleeve gastrectomy is the most popular type of bariatric surgery in the United States. It’s a simple procedure with few associated complications and risks. This procedure removes a significant portion of the stomach (around 80%), leaving only a tiny tubular part, reducing the amount of food the patient can consume and making them feel fuller much faster. Also, reducing hunger hormone production in the stomach helps stabilize metabolism, regulate blood sugar, and decrease appetite.
Gastric bypass
Also called the “Roux-en-Y,” gastric bypass means that the small intestine will end up in the form of the letter Y. The bariatric surgeon starts by creating a tiny pouch at the stomach’s top, separating it from the lower portion with staples. After that, the surgeon divides the small intestine and connects the new segment to the stomach pouch. This way, the food will only flow to the smaller, new stomach while the rest is bypassed, restricting the small intestines’ capacity to absorb food.
DPD-DS
DPD-DS or biliopancreatic diversion with duodenal switch combines intestinal bypass and sleeve gastrectomy. Like gastric bypass, this surgery creates a larger bypass, significantly reducing hunger hormone production and nutrient absorption.
While this is the most effective weight loss surgery, it can also make it challenging for the body to get enough nutrients.
SIPS
Stomach intestinal pylorus sparing surgery (SIPS) is an advanced version of the duodenal switch, aiming to reduce the associated complications. Like the first version, it starts with sleeve gastrectomy and then divides the intestine at the duodenum. The small intestine gets reattached as a loop with only one anastomosis instead of two. This enables improved nutrient absorption, as less of the small intestine is blocked.
After Surgery
Following the first year after the procedure, the doctor will regularly monitor the patient by taking metabolic blood tests to establish whether there are any nutritional deficiencies and how their health is improving.
After the first year, patients may be recommended different body contouring procedures to help eliminate the excess loose skin after the weight loss.
How Much Will Patients Lose After Bariatric Surgery?
In most cases, patients can lose about half of the excess weight after surgery and keep it from returning. Still, it’s essential to know that different types will yield different results, with duodenal switch procedures enabling patients to lose 80% of the excess fat. In contrast, with a gastric bypass, patients may lose up to 70% of the extra weight. The results from sleeve gastrectomy range between 30% to 80%.
Assessing the Risks and Benefits
While modern medical interventions are considered safe, there’s always a chance of complications, and there are always some risks to consider when opting for any kind of surgery.
With weight loss surgery, there are certain surgical risks involved, such as:
- Bleeding
- Hernias
- Infection
- Anastomotic leaks
- Blood clots
- Small bowel obstruction
On the other hand, surgeries that alter the digestive system may lead to other digestive complications, such as:
- Dumping syndrome
- Malnutrition and malabsorption
- Gallstones
- Bile reflux
When assessing the benefits, experts usually point out the following:
- Sustained and significant weight loss
- Reduced production of hunger hormones
- Better blood sugar and cholesterol management
- Overall improved metabolism
- Lowered chances of developing diseases closely linked to obesity
- Healthier and longer life
Learn About the Available Options
Weight loss surgery is a more complex intervention that can save the patient’s life in the long run from many diseases linked to being morbidly obese. Still, there are a couple of myths and misconceptions surrounding the surgery; if you want to learn more about the procedure from a team of caring and compassionate experts, schedule an appointment with us today.
We are ready to answer all of your questions.