If you have changed your diet, exercise, and social habits, but are still unable to lose weight, you may decide to consider weight loss surgery. There are two main types of surgery shown to help severely obese people lose stubborn fat: the roux-en-Y gastric bypass and the laparoscopic adjustable gastric band. Both of these options have advantages and disadvantages, and, like with any surgery, both carry risks.
Roux-en-Y Gastric Bypass Surgery
Perhaps the better known of the two primary weight loss surgery options today, the roux en-Y, also known simply as gastric bypass surgery, is also the more invasive of the procedures. Recovery from this surgery can take longer, but the results are more dramatic, with a weight loss of 6-7 pounds per week in the initial weeks.
In this form of weight loss surgery, the surgeon fashions a small pocket out of a portion of the stomach and attaches a part of the intestine called the jejunum directly to this pocket. The rest of the stomach and the first portion of the intestines, the duodenum, are thus bypassed.
This facilitates weight loss in two ways. First, this form of weight loss surgery allows only a small amount of food to occupy the stomach-pouch at a time, causing the patient to feel full sooner and limiting the amount of food that can be eaten. Second, by bypassing most of the stomach and all of the duodenum, the amount of nutrients from food which are absorbed is significantly reduced.
Because roux-en-Y weight loss surgery reduces the body’s ability to properly digest food, diet and nutrient supplements must be carefully monitored after surgery to prevent diseases caused by vitamin or mineral deficiencies. In addition, because meals must be small, patients must be able to eat frequent snacks and meals as part of their diets in order to take in enough food once they have reached a healthy weight.
Laparoscopic Adjustable Gastric Band Surgery
Lesser known than gastric bypass, this form of weight loss surgery is less dramatic, but is often easier to live with once weight has been lost. In addition, this surgery is less invasive than gastric bypass surgery, using cameras and probes inserted through small incisions.
Like gastric bypass surgery, laparoscopic adjustable gastric band surgery involves the formation of a small pouch near the top of the stomach. Unlike gastric bypass, however, this form of weight loss surgery does not bypass the rest of the stomach or any of the intestine. Instead, an inflatable band is used to pinch off a portion of the stomach.
Like in gastric bypass surgery, the patient feels full more quickly, because the food collects quickly in the gastric pouch. However, in adjustable gastric band surgery the passage of food through the digestive tract is slowed, so full nutrient absorption still takes place.
Weight is lost at a rate of 1-2 pounds a week for 2-3 years. A port left just under the skin allows the band to be adjusted in the doctor’s office as the patient recovers and over time. The band may be loosened in time to the point at which the weight loss surgery is essentially reversed.
Which Weight Loss Surgery is Right for Me
Laparoscopic adjustable gastric band surgery is usually preferred, particularly for those who are able to maintain their weight through diet, exercise, and social changes, but who are unable to lose a previously established, sizable fat deposit. After reaching a healthy weight, there are few lifelong side effects of this weight loss surgery.
For those who are significantly obese and have trouble exercising or whose social situation encourages overeating, gastric bypass may be the more appropriate weight loss surgery option. That said, the patient must be able to maintain a healthy diet with the appetite control provided by the smaller gastric pouch and must be willing and able to comply with doctor’s instructions regarding dietary choices and supplements.