Consider the options for weight-loss surgery
Obesity is a complex medical issue related to a variety of genetic, hormonal, metabolic and behavioral factors that has been increasing sharply throughout the world. In less than 40 years, the prevalence of obesity in America has increased by more than 50%. That means two out of every three American adults are now considered overweight or obese.
Unfortunately, the obesity epidemic is also rapidly spread- ing among children. About one-quarter of 2- to 5-year-olds and one-third of school-age children, including adolescents, are over- weight or obese in America.
There are several co-morbidities—two or more co-existing medical conditions—related to obesity, such as diabetes, hypertension, heart disease, certain types of cancers, arthritis, depression, kidney stones, and fatty liver disease. It accounts for about one of every 10 American deaths.
Research shows the best way to combat obesity is to prevent it before it develops. However, for those who need to seek treat- ment for obesity, there are numerous options available, including behavioral changes (healthy diet and regular exercise), medical solutions (sympathomimetic drugs or lipase inhibitors), and surgical interventions.
Obesity surgery is the most beneficial option for people with co-morbidities, as most experience rapid weight loss for 12 to 18 months following surgery. Patients may experience weight loss of up to 50% of their excess weight in the first six months and 77% of their excess weight within one year. Patients typically maintain 50% to 60% of their weight loss 10 to 14 years after surgery.
There are numerous weight-loss surgery options, but the ones most commonly performed are laparoscopic gastric banding, laparoscopic vertical sleeve gastrectomy, and laparoscopic gastric bypass.
Weight-loss surgery is overall a very safe option, with the 30-day mortality rate dropping to less than 0.17% over the years. However, as with any surgery, it carries potential risks and complications, which should be discussed with a surgeon.
Surgery is only a tool, and to achieve long-term weight loss success, patients must also be willing to alter their diet and physical lifestyles, and be compliant with their surgeon’s recommendations. Most weight-loss centers provide regular group meetings to further support patients’ goals.
Patients interested in weight-loss surgery are advised to research their options and their surgeon thoroughly.
Gastric Bypass
Performed by creating a small reservoir (pouch) for food at the upper end of the stomach, which is connected to the upper small intestine by a new small anastomosis (outlet). The ingested food bypasses the majority of the stomach and portion of the small intestines, which remains alive and undisturbed but still functional. It’s often associated with a permanent decrease in appetite, and although it has a small component of malabsorption, it mainly limits the amount of food intake. Weight loss is fairly rapid initially, which stabilizes over time to a healthy weight for the body.
Gastric Sleeve
Performed by removing the outer 85% of stomach, converting it into a narrow “sleeve” or tube that holds much less food, resulting in lower production of hunger hormones (Ghrelin), which reduces appetite and hunger sensation. Digestion is normal, and there is no re-routing of the intestines. Weight loss is rapid for most patients, comparable to patients who have gastric bypass.
Gastric Banding
An adjustable restrictive procedure that reduces the amount of food eaten. Patients generally have fewer dietary restrictions, and may not require long-term nutritional supplements. It does not alter any part of the stomach or the small intestine. Patients with a lower BMI may benefit from it, and although it is the safest surgical weight-loss procedure, it still comes with risks and complications. Generally, weight loss is slower than gastric bypass or gastric sleeve procedures, and if the band is removed, the majority of patients regain most or all the weight they lost.