Bariatric surgery
Bariatric surgery is a type of weight loss surgery that involves reducing the size of the stomach or rerouting the digestive system to limit the amount of food a person can consume. It is often recommended for people with morbid obesity who have been unable to achieve significant weight loss through diet and exercise alone.
Types
Weight loss surgery is a surgical procedure designed to help people with obesity lose weight. There are several types of weight loss surgeries, including gastric sleeve, gastric bypass, and adjustable gastric band. A fourth type of surgery, biliopancreatic diversion with duodenal switch, is used less commonly by surgeons.
Gastric sleeve Gastric sleeve surgery, also known as vertical sleeve gastrectomy, involves removing most of the stomach and leaving only a banana-shaped portion that is stapled closed. This type of surgery reduces the capacity of the stomach, causing you to feel full faster, and may also affect hormones or bacteria in the gastrointestinal tract that impact appetite and metabolism. It is important to note that gastric sleeve surgery is not reversible as a portion of the stomach is removed permanently.
Gastric bypass Gastric bypass, also known as Roux-en-Y gastric bypass, is a three-step procedure. First, the surgeon staples the stomach to create a small pouch in the upper section, reducing the size of the stomach and causing you to feel full faster. The lower part of the small intestine is then attached directly to the small pouch, allowing food to bypass most of the stomach and the upper part of the small intestine, leading to the absorption of fewer calories.
The upper part of the small intestine is then reconnected to a new location further down on the lower part of the small intestine. This enables digestive juices to flow from the bypassed portion of the small intestine to the lower part, allowing for the complete digestion of food. Gastric bypass also changes hormones, bacteria, and other substances in the gastrointestinal tract that may impact appetite and metabolism. It is difficult to reverse, but a surgeon may perform a reversal if it is medically necessary.
Adjustable gastric band In adjustable gastric band surgery, a ring with an inner inflatable band is placed around the top of the stomach to create a small pouch. Like gastric sleeve and gastric bypass, the gastric band causes you to feel full after eating a small amount of food. The inner band has a circular balloon that is filled with saline solution, which can be adjusted by injecting or removing the solution through a small device called a port. The opening from the pouch to the rest of the stomach can be resized by adjusting the inner band.
How is it performed?
Weight-loss surgery is typically performed laparoscopically, which involves making small incisions and using thin tools and a camera-equipped scope to visualize the surgery. This method is performed under general anesthesia and has several benefits over open surgery, including lower risks, less pain, and faster recovery.
However, open surgery, which involves a single large incision in the abdomen, may be a better option for individuals with a high level of obesity, a history of previous stomach surgery, or other complex medical conditions.
Before surgery
Before the surgery, patients will typically meet with several healthcare professionals, including an internist, dietitian, psychiatrist/psychologist, and bariatric surgeon. The internist will conduct a physical examination, review the patient's medical history, and order blood tests. The dietitian will provide information on the patient's post-operative diet, while the psychiatrist/psychologist will assess the patient's readiness for the challenges of weight-loss surgery. The surgeon will provide information on the procedure and necessary follow-up.
Diet
Patients are also advised to adopt a healthy lifestyle, including regular physical activity and healthy eating, before and after the surgery. Some weight-loss surgery programs also offer support groups for patients before and after the procedure.
After surgery
After the surgery, patients will need to rest and recover. Gradual physical activity and walking can help speed up the recovery process. A liquid diet will initially be followed, and over time, patients will progress to a soft diet and eventually solid foods. Small meals and chewing well are recommended, and dietary supplements may be prescribed to ensure adequate vitamin and mineral intake.
Frequently asked questions
If you had bariatric surgery, lost and regained some or all of the weight back, can you try medical weight loss? Yes. Gastric bypass surgery is not a contra-indication for use of any of the non-surgical options to lose weight. In fact, non-surgical weight loss measures can be used irrespective of bariatric surgery status and can help either before, during and after bariatric surgery as surgical and non-surgical measures for weight loss compliment each other.
What to do if you regain weight 5 years after gastric bypass surgery? Consider a non-surgical obesity medicine physician supervised weight loss program that can help you not only lose the weight but has a maintenance plan that helps you from regaining the weight back.
Gaining weight back after gastric sleeve. What can I do? There are many non-surgical options available for losing weight. In consultation with a weight loss physician, consider all the non-surgical options such as Very Low Calorie Diets (VLCD), FDA approved prescription weight loss medications, nutritional counseling, increased physical activity, lifestyle modification etc. to name a few.
Have you gained all weight back after gastric sleeve and need help? W8MD can help. We see a significant number of post bariatric surgery patients in all of our locations either immediately after gastric bypass or sleeve to continue losing weight with our nutritional support and guidance or after they have gained some of the weight back after a few years. Remember that losing weight is only one part of the journey - the bigger part being maintaining it once you have lost.
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