Deciding to get weight loss surgery isn't easy. And after making the decision to do it, there are still many different procedures to choose from. The best one for you depends on a lot of things: Your goals, your surgeon's preference, your current health.There are two basic types of weight loss surgery --restrictive surgeries and restrictive/malabsorptive surgeries. They help with weight loss in different ways.
Restrictive surgeries work by physically restricting the size of the stomach and slowing down digestion. A normal stomach can hold about three pints of food. After surgery, the stomach may at first hold as little as an ounce, although later that could stretch to 2 or 3 ounces. The smaller the stomach, the less you can eat. The less you eat, the more weight you lose.
Malabsorptive/restrictive surgeries are more invasive surgeries that work by changing how you take in food. In addition to restricting the size of the stomach, these surgeries physically remove parts of your digestive tract, which makes it harder for your body to absorb calories. The good news is, according to CNNhealth.com, while it’s a known fact that weight-loss surgery can help reverse type 2 diabetes and ease other obesity-related conditions, new research suggests that obese women who undergo bariatric surgery experience a 42 percent drop in their cancer risk.
Gastric Sleeve Gastrectomy:
This is a relatively new form of restrictive weight loss surgery. In the operation, which is usually done with a laparoscope, about 75% of the stomach is removed. What remains of the stomach is a narrow tube or sleeve, which connects to the intestines.
The Pros: For people who are very obese or sick, standard gastric bypass or biliopancreatic diversion may be too risky. A sleeve gastrectomy is a simpler operation that allows them a lower-risk way to start losing weight. Afterwards, once they've lost weight and their health has improved --usually after 12-18 months --they can go on to have a second surgery, such as gastric bypass.
The Cons: Since a sleeve gastrectomy is often just the first step in weight loss surgery, you will probably face further operations later on. Unlike gastric banding procedures, a sleeve gastrectomy is irreversible. Also, it’s a purely gastric restrictive surgery and sustained weight loss depends upon maintenance of the size of gastric sleeve.Over time, it is highly probable that there will be some stretching of the gastric sleeve.Most importantly, since it's relatively new, the long-term benefits and risks aren't yet known.
Vertical Banded Gastroplasty:
Gastric banding is among the least invasive weight loss treatments. This surgery uses an inflatable band to squeeze the stomach into two sections: a smaller upper pouch and a larger lower section. The two sections are still connected; it's just the channel between them is very small, which slows down the emptying of the upper pouch. Gastric banding physically restricts the amount of food you can take in at a meal.
Pros: The advantage to gastric banding is that it's simpler to do and safer than gastric bypass and other operations. It's routinely done as minimally invasive surgery, using small incisions, special instruments, and a tiny camera called a laparoscope. Recovery is usually faster. You can also have it reversed by surgically removing the band.
Cons: People who get gastric banding often have less dramatic weight loss than those who get more invasive surgeries. They may also be more likely to regain some of the weight over the years.
Gastric Bypass Surgery (Roux-en-Y Gastric Bypass):
The most common type of weight loss surgery, making up about 80% of all weight loss surgeries in the U.S., combines both restrictive and malabsorptive approaches. It can be done as either a minimally invasive or open surgery. The surgeon divides the stomach into two parts, sealing off the upper section from the lower, then connects the upper stomach directly to the lower section of the small intestine. Essentially, the surgeon is creating a shortcut for the food, bypassing a section of the stomach and the small intestine.
The Pros: Weight loss tends to be swift and dramatic. Most of it happens in the first six months. It may continue for up to two years after the operation. Because of the rapid weight loss, health conditions affected by obesity --like diabetes, high blood pressure, high cholesterol, arthritis, sleep apnea, heartburn, and other conditions --often improve quickly. You'll probably also feel a dramatic improvement in your quality of life. Gastric bypass also has good long-term results; studies have found that many people keep most of the weight off for 10 years or longer.
The Cons: By design, surgeries like this impair the body's ability to absorb food. While that can cause rapid weight loss, it also puts you at risk of serious nutritional deficiencies. The loss of calcium and iron could lead to osteoporosis and anemia. You'll have to be very careful with your diet --and take supplements --for the rest of your life.