Bariatric surgery has gained quite a huge popularity among people who wish to lose weight but are unable to lose it through other means. Weight loss demands exercising, diet management, and changes in lifestyle. However, there is nothing that an individual can do if all these methods of weight management fail to work.
Bariatric surgery, also known as weight loss surgery, is only recommended to a handful of patients every year. There is a criterion to the selection of patients for a bariatric surgery and not everyone can undergo it for the sake of weight loss.
Typically, weight loss surgery is recommended for individuals who are:
- Overly obese
- Unable to lose weight through conventional methods
- Living with poor quality of life
- Affected by comorbidities associated with obesity such as poor heart and lung function, hypertension, and diabetes
How does bariatric surgery work?
There are different types of bariatric surgeries and all of them have a specific mode of action. Their mode of action can be divided into two main ways:
Malabsorption: In this case, the surgery results in weight loss by reducing or limiting the number of calories that the body can absorb. Because the body now absorbs fewer nutrients and calories than required, the extra weight is lost over a period of time.
Restriction: In this case, the surgery results in weight loss by restricting the amount of food that your stomach can hold at a time. You get a feeling of fullness early while having food and thus, you end up taking fewer calories than before.
What are the different types of weight loss surgeries?
There are four different types of weight loss surgeries – gastric bypass (Roux-en-Y), laparoscopic gastric banding, laparoscopic sleeve gastrectomy, and biliopancreatic diversion with duodenal switch. Each surgery has its own mechanism of promoting weight loss as listed in Table 1.
Table 1: Types of weight loss surgeries and their mechanism of action
| Weight loss surgeries | |
| Type | Mode of action |
| Gastric bypass | Both restriction and malabsorption |
| Gastric banding | Restriction |
| Sleeve gastrectomy | Restriction |
| Biliopancreatic diversion with duodenal switch | Both restriction and malabsorption |
Gastric bypass: In this surgery, bariatric surgeons create a pathway for food to bypass a large portion of the stomach and the intestine. As a result, the amount of food that the patient can consume at a time is restricted and so is the absorption capacity of the intestine. The remaining part of the stomach, however, continues to make digestive juices and send them to the small intestine.
Gastric banding: In this surgery, the bariatric surgeons tie an adjustable and inflatable balloon around the upper part of the stomach. This limits the amount of food that a person can consume at a time and triggers an early feeling of fullness. The tightness of the balloon around the stomach can be adjusted later according to the weight loss needs of the patient.
Sleeve gastrectomy: In this surgery, the bariatric surgeons cut a portion of the stomach to create a banana-like sleeve or a pouch that can hold a limited amount of food. It works by suppressing the production of the hunger hormone, ghrelin, which is not produced by the removes part of the stomach any longer.
Biliopancreatic diversion with duodenal switch: A large part of the stomach is removed along with the middle part of the intestine. The valve that regulated the transfer of food from the stomach to the intestine is left along with the duodenum. The middle section of the intestine is closed off and the upper part is connected to the end. This is known as the duodenal switch. The bile and pancreatic digestive juices continue to flow to the middle intestine, which is left as is in the body. This is known as biliopancreatic diversion.
Which is the best weight loss surgery for me?
Choosing a specific type of weight loss surgery is a difficult decision to take. You need to have your goals and expectations in place before you choose a specific type of surgery. Additionally, you need to speak to your surgeon about it before you make up your mind.
It is important to set your expectations on weight loss goals first. Gastric bypass patients lose around 70 percent of their weight, while sleeve gastrectomy patients lose up to 60 percent of their weight. Gastric banding patients lose around half of their weight in the first few months after the surgery.
Additionally, you need to consider the reliability of weight loss and whether you need a quick or gradual weight loss solution. You also need to consider the reversibility of the procedure before making the decision.
