Bariatric surgery is a popular treatment option for morbidly obese people who have not been able to experience sufficient weight loss. Morbid obesity can lead to diabetes, heart disease, high blood pressure, cancer and many other serious conditions. Over 800,000 people have undergone this procedure, also commonly referred to as weight loss surgery.

Morbid obesity is classified as a Body Mass Index (BMI) of 40 or more, which equals being 100 pounds or more over ideal body weight. This condition leads to difficulty performing everyday tasks and may cause serious complications and a shorter life expectancy. The quality of life is also low in morbidly obese people. The causes of morbid obesity can vary but often include a combination of genetic, environmental and social factors.

There are several different types of bariatric surgery, but most focus on reducing the size of the stomach. This causes patients to feel full faster and therefore eat less food. After surgery, a proper balanced diet is required to help lose weight in a healthy way and keep it off. While these restrictive procedures are most common, others use a malabsorptive technique that does not allow the small intestine to absorb all the calories that a person takes in, and some combine restrictive and malabsorptive techniques.

Some of the most common bariatric procedures include:

• Gastric Bypass - This is a combination procedure and is the most popular weight loss surgery. Gastric bypass creates a pouch from the top of the stomach and connect it to a section of the small intestine, causing food to bypass the large intestine and limiting the body from absorbing fat. Read more >>
  


• Gastric Banding - This is a restrictive procedure that implants a silicone band around part of the stomach and molds it into two different areas. An injection port is also attached to the abdominal wall and connected to the band and used to adjust the band. Read more >>
  


• Biliopancreatic Diversion (BPD) - In this procedure, a small sleeve is created in the stomach and then attached to the end of the small intestine to bypass the rest and only absorb some of the calories.
  

Bariatric surgery may be performed through a laparoscopic procedure or a traditional open procedure depending on the type of surgery and your general health conditions. Most procedures today are able to be performed laparoscopically which allows for smaller incisions, less tissue damage and shorter recovery times. You and your doctor can decide together which procedure is best for you.

There are risks associated with bariatric surgery, but the benefits are usually greater. The risks of bariatric surgery include bleeding, pain, infection, pneumonia, hernia, gallstones and stoma obstruction. Despite these risks, the mortality rate for these procedures is very low, and the benefits far outweigh the risks for most people.

Bariatric surgery provides an overall improved quality of life through rapid weight loss that lasts 18 to 24 months. It also drastically decreases the risks of co-morbid conditions, such as diabetes, heart disease, high blood pressure and cancer, which often occur alongside morbid obesity.

Although these procedures can improve self-confidence and appearance, they are not considered cosmetic surgery. Bariatric surgery is used for medical purposes and requires a lifelong commitment of diet and exercise in order to be successful. While it may seem like a quick-fix for weight loss, bariatric surgery should be considered as a medical treatment first. Patients must consider all aspects of the procedure and the after care when considering bariatric surgery. Call your doctor for a consultation.

Roux-en-Y gastric bypass surgery is performed to help severely obese patients lose significant amounts of weight. The surgeon uses suture-like staples to separate a portion of the top of the stomach and create a pouch, which is then connected directly to a section of the small intestine called a Roux limb. (This and the Y-shaped junction between the large and small intestines give the procedure its name.) Bypassing the majority of the stomach and the small intestine, or duodenum, limits the body's ability to absorb fat from food. Creation of the smaller stomach pouch restricts the amount of food that can be digested at any time. This combination of malabsorptive and restrictive techniques makes the Roux-en-Y procedure one of the most successful gastric bypass surgeries.

Bypass surgery may take several hours to complete, and hospital recovery time usually lasts 4-5 days. Patients who qualify for minimally invasive (laparoscopic) surgery have smaller scars, lower risk of hernias, less post-operative discomfort and shorter recovery time. A liquid diet supplemented with pureed foods must be followed for several weeks after the procedure. Potential complications include:

• Bleeding
• Infections
• Gallstones
• Gastritis (inflammation of the stomach lining)
• Vomiting
• Iron, calcium, or vitamin B-12 deficiency
• "Dumping syndrome" - A condition where food empties too quickly into the small intestine, resulting in nausea, cramping, vomiting, diarrhea, bloated feeling, dizziness, sweating.
• Further surgeries to correct complications or tighten loose skin

After surgery, the patient's stomach can hold about a tablespoon of food. This will expand over time but will not exceed one cup. A normal stomach holds one quart. Because stomach size is substantially and permanently reduced, patients are limited in the amount of food they can eat in a single meal and do not suffer from constant hunger. Smaller meals eaten throughout the day are recommended rather than less frequent, larger meals.

Although the Y-connection allows pancreatic fluid and bile to aid in absorption of nutrients, bypass of the small intestine from the digestive process may result in insufficient absorption of vitamins and minerals, in addition to the desired reduction in fat absorption. Regular meetings with the surgeon and a dietician will be scheduled before and after surgery to establish a diet and exercise plan to determine whether nutritional supplements are necessary. These appointments will take place regularly in the first year following surgery and less frequently afterward.

Bypass surgery is not a quick fix. Patients who undergo the procedure must be willing to make life changes to achieve and maintain weight loss and to prevent complications from the surgery. But with determination, good nutrition and regular exercise, the results can be dramatic: Most patients lose about 1-2 pounds per week and reach a stable weight 18 to 24 months after surgery. Weight loss occurs most rapidly immediately after surgery. Patients often also enjoy relief from weight-related illnesses such as sleep apnea, type 2 diabetes, high blood pressure, heartburn and incontinence.

Body Mass Index (BMI) is a calculation based on height and weight that measures body fat and determines classes of weight. A normal BMI is 18-25. Candidates for bariatric surgery typically have a Body Mass Index or BMI of 40 or more, or a BMI of 35 with a serious illness that can be improved with weight loss. Other factors taken into consideration include the patient's physical and mental health and ability to follow a strict diet and exercise program. Patients interested in this procedure should schedule a consultation with their physician.

Gastric banding is just one of many restrictive operations to help aid major weight loss. A restrictive operation makes the stomach smaller in order to restrict food intake and therefore promote weight loss. Gastric banding is one of the most common restrictive procedures and has been approved by the FDA since 2001. These procedures are intended for morbidly obese people whose overall health is an issue because of their weight.

Gastric banding restricts the size of the stomach by placing a small silicone band around the top of the stomach to create a pouch, similar to a stomach stapling procedure. The food that you eat then travels into only the small pouch and makes you feel fuller much faster. A small opening in the pouch then allows the food to travel into the rest of the stomach and intestines. The size of the pouch can also be adjusted by inflating or deflating the band, which can help reduce side effects and improve weight loss.

Many gastric banding procedures can be performed laparoscopically, using tiny instruments through tiny incisions. It is considered the least invasive and safest weight loss surgery, with very few possible complications. Some people may experience nausea and vomiting or minor surgical complications after gastric banding, but these problems are usually mild and temporary. Gastric banding can also be reversed if necessary and the stomach tends to return to normal size.

Gastric banding can help many obese people lose about half of their excess body weight after one year. It is typically recommended for people with a body mass index (BMI) of 40 or higher. Those with a BMI of 35 or higher and an obesity-related health problem, such as high blood pressures, diabetes or arthritis, may also be candidates for gastric banding.

Although gastric banding provides faster and easier weight loss than traditional diet and exercise, a healthy diet and life and still necessary in order for the procedure to be effective. While the pouch will physically restrict the amount of food you feel comfortable eating, it is important to eat a healthy and balanced diet in order to receive the proper nutrients and not counteract the purpose of the band. High-calorie liquids such as soda or milkshakes may cause you to regain weight. Overeating can cause the pouch to stretch. Gastric banding requires a long-term commitment to healthy eating and dedication to losing weight.

Call your doctor for a consultation to discuss your weight loss options and decide if gastric banding is right for you.