For people who are seriously overweight or obese, the struggle to lose weight can be exhausting, discouraging, even defeating. A lifetime of dieting and trying the latest fitness fads, even medications often result in a cycle of weight loss and regain. And the implications of obesity—high blood pressure, joint problems, diabetes, heart disease and even cancer, to name a few—can be devastating.
Without medical intervention, many of the nearly one-third of obese adults in the U.S. will never achieve long-term success. But there is hope. According to the American Society for Metabolic and Bariatric Surgery, weight loss surgery is proven to help reverse the progression of obesity, resulting in long-term weight loss. In fact, studies have found that more than 90 percent of bariatric patients are able to achieve and maintain weight loss of at least 50 percent of their excess body weight.
If you have been fighting the weight loss battle, and have been unable to keep the weight off with dieting and exercise alone, it is important to know first and foremost that you are not a failure. There are often genetic and physiological factors at play that can make it difficult to lose weight and keep it off. You are fighting against your body’s biological “set point” or weight that your body naturally wants to maintain. Bariatric surgery is a proven tool to help reset or re-calibrate the natural set point by altering hormones that cause weight gain
Each year, nearly 200,000 patients undergo bariatric surgery in the United States to help them lose weight and reclaim their health. If you are considering weight loss surgery, it’s important to understand the weight loss surgery options in order to choose the best type of weight loss surgery for you.
What are my weight loss surgery options?
There are three primary bariatric procedures performed today: gastric bypass surgery, gastric sleeve surgery and gastric banding surgery. Here is an overview of each procedure and the key differences between the various weight loss surgery options.
Roux-en-Y Gastric Bypass Surgery (RYGB)
During laparoscopic gastric bypass procedure, the surgeon creates a small stomach pouch that is rerouted and connected to the middle portion of the small intestine, therefore “bypassing” the remainder of the stomach, along with the first portion of the small intestine. This procedure decreases the size of the stomach from about the size of a football to the size of an egg. In doing so, the stomach capacity, or the amount of food it can hold, is reduced to about two tablespoons or one fluid ounce. By bypassing a portion of the stomach and small intestine, the procedure also limits the absorption of nutrients and calories by the intestines.
For this reason, gastric bypass is considered both a restrictive and malabsorptive operation. Due to the malabsorptive characteristics of gastric bypass, supplemental calcium, iron and vitamin B12 are necessary after surgery.
For years, gastric bypass surgery has been considered the “gold standard” of weight loss surgery options, though in recent years, surgical advancements in the gastric sleeve procedure — including the invention of the patented Mini Sleeve operation — have decreased popularity of gastric bypass surgery.
When diet and exercise alone are not enough to help you lose weight, if you have serious health problems as a result of your weight, surgery for weight loss, such as the gastric bypass procedure may be an option.
The typical candidate for gastric bypass surgery has a body mass index (BMI) of 40 or higher, or has a BMI of 35 to 39.9 as well as serious weight-related health problems, such as type 2 diabetes, high blood pressure or sleep apnea.
On average, patients who choose gastric bypass surgery lose 70 to 80 percent of their excess body weight in the first year after surgery.
Gastric Sleeve Surgery
Also known as the sleeve gastrectomy, gastric sleeve surgery is a restrictive weight loss procedure that has become the popular choice by bariatric patients in recent years, due to advancements in medical technology.
During the gastric sleeve procedure, the bariatric surgeon resects a portion of the stomach, reducing the size of the stomach to about 15 percent of its original size. The remaining large portion of the stomach is then removed. As with gastric bypass surgery, gastric sleeve surgery significantly reduces the volume of the stomach, thereby restricting the amount of food that can be consumed. In addition, the portion of the stomach, which is responsible for the production of the hunger hormone, ghrelin, is removed, decreasing hunger and cravings.
Compared to gastric bypass, gastric sleeve is considered a lower-risk surgery. First Baptist Medical Center bariatric surgeon, Dr. Todd McCarty also offers his patients the trademarked Mini Sleeve surgery, which further reduces risk and shortens recovery for the patient.
Dr. McCarty’s innovative Mini Sleeve procedure uses the natural entrances to the abdominal cavity, particularly the mouth or naval, avoiding the many painful incisions required for removal of the excess stomach with standard laparoscopic gastric sleeve surgery. The advanced Mini Sleeve technique results in fewer risks for complications, faster recovery times, few scars and no hospital stay.
As with gastric bypass surgery, the typical candidate for gastric sleeve surgery has a BMI of 40 or higher, or a BMI of 35 or higher with co-existing medical problems.
Gastric Banding
Gastric banding (lap-band) gained popularity in the 1990s as a minimally invasive weight loss surgery option. It became a popular choice because, unlike other bariatric procedures, gastric banding does not alter the anatomy of the stomach and does not involve any cutting, stapling or intestinal rerouting. It is also the only weight loss surgery option that is completely reversible.
During the gastric banding procedure, an inflatable silicon gastric band is placed around the upper portion of the stomach to create a small pouch to hold food. The adjustable band is connected with tubing to an access port placed under the surface of the skin. After surgery, the band can be adjusted in size by injecting fluid through the system when accessed through the port.
The goal of gastric banding surgery is to restrict the volume of food entering the stomach, thereby serving as a measure of portion control and reducing the capacity of the stomach. Weight loss following gastric banding surgery is typically slower and overall weight loss achieved tends to be less than that associated with other gastric procedures.
Patients who choose gastric banding can expect to lose 30 to 40 percent of their excess body weight in the first year, and 60 to 65 percent in three to five years, if they are able to maintain a healthy diet without complications. As with other bariatric procedures, you may be a candidate for gastric banding if you have a BMI of 40 or higher, or a BMI over 34.9 with other weight-related medical problems.
Surgical Revisions
In rare cases, patients who undergo bariatric surgery may not be satisfied with their results for any of a variety of reasons. In these cases, patients who have undergone a prior bariatric surgery, have the option of surgical revision to help them get back on track and lose the weight.
If you are considering weight loss surgery, call McCarty Weight Loss Center today to schedule your appointment with Dr. Todd McCarty, a leader in bariatric surgery for more than 20 years. Dr. McCarty will help you choose the right procedure to help you lose weight and keep it off for good.
If you would like to learn more about weight loss surgery options or have questions about weight loss surgery cost, contact First Baptist Medical Center today to schedule an appointment with an experienced bariatric surgeon.
