For many individuals, losing weight is a medical necessity that diet and exercise alone cannot resolve. Left untreated, obesity can lead to serious health complications, including heart disease, type 2 diabetes, and joint issues. That’s where weight loss surgery becomes a critical option. While the specific techniques differ, all types of weight loss surgery share the same goal of improving one’s health through weight loss.
According to The American Society for Metabolic and Bariatric Surgery (ASMBS), weight loss surgery, also known as bariatric surgery, may reduce a patient’s risk of premature death by 30-50%, and is the most effective and long-lasting treatment for severe obesity. Bariatric surgeries result in significant weight loss and the improvement, prevention or resolution of many obesity-related diseases such as type 2 diabetes, heart disease, sleep apnea, hypertension, and some cancers.
Understanding the Different Types of Weight Loss Surgery
Bariatric surgery encompasses several surgical procedures that are designed to help individuals lose weight by altering the digestive system in various ways. Some limit the amount of food you can eat, while others affect how your digestive system works and absorbs nutrients. Each type of weight loss surgery differs in complexity, effectiveness, and suitability for specific health conditions, and all types come with risks and complications, including hernias, infections, and blood clotting. Types of weight loss surgeries include:
- Gastric Bypass: This procedure, also called Roux-en-Y gastric bypass, uses a stapling device to create a small pouch in the top section of the stomach, reducing the size so it holds less food. The surgeon then reroutes part of the small intestine, reducing food intake and absorption.
- Sleeve Gastrectomy: A sleeve gastrectomy alters the size of the stomach but leaves the small intestine unaltered. About 80% of the stomach is removed, leaving a smaller, sleeve-shaped stomach. Changing the size of the stomach allows the individual to get full faster, reducing the amount of food intake.
- Adjustable Gastric Band: A silicon band is placed around the stomach to separate the stomach into a smaller pouch and a larger pouch. The size of the pouch may be adjusted over time, the procedure does not surgically alter the anatomy, and it is reversible.
- Biliopancreatic Diversion with Duodenal Switch (BPD/DS): This complex surgery combines a sleeve gastrectomy with a rerouting of the intestines to bypass a large portion of the small intestine. It is a very invasive procedure utilized when significant weight loss is necessary.
The type of weight loss surgery that may be best for you depends on several factors, and patients should discuss these options with their healthcare provider.
How to Determine If You’re a Candidate for Weight Loss Surgery
Weight loss surgery is typically recommended for individuals who have tried and failed to achieve significant weight loss through diet and exercise, and fall into one of the following categories:
- Have a body mass index (BMI) of 40 or higher;
- Have a BMI of 35 or higher and suffer from a serious obesity-related health problem, such as type 2 diabetes, heart disease, or sleep apnea; or
- Have a BMI of 30 or more with type 2 diabetes that is difficult to control with medical treatments and lifestyle changes.
In addition, certain health conditions may disqualify a patient from eligibility, and a thorough medical evaluation is essential to determine if you’re a candidate for weight loss surgery.
What to Expect During Recovery for Each Procedure
Recovery times and experiences vary depending on the type of surgery performed. Recovery for a gastric bypass surgery takes several weeks, with most patients resuming normal activities after 4–6 weeks.
For a sleeve gastrectomy, recovery typically involves a hospital stay of 1–2 days, with full recovery in 4 weeks. Recovery for an adjustable band procedure is usually faster, taking 1–2 weeks, but adjustments may be needed over time. Given its complexity, recovery from BPD/DS can take up to 6 weeks, requiring close monitoring for nutrient deficiencies. During recovery for any of these procedures, patients follow a specific diet progression, starting with liquids and gradually reintroducing solid foods. Pain management and adherence to medical guidelines are essential for a smooth recovery.
Questions to Ask Your Doctor Before Choosing a Procedure
Before deciding on weight loss surgery, it’s important to have an open discussion with your doctor. Key questions include:
- Which procedure is most suitable for my specific health conditions and weight loss goals?
- What are the short-term and long-term risks of the procedure?
- What is the surgeon’s experience with bariatric procedures?
- What are the hospital’s success rates with bariatric procedures?
- How will this surgery impact my lifestyle and daily habits?
- What support is available for post-surgery nutrition and exercise?
Tips for Long-Term Success After Weight Loss Surgery
Weight loss surgery is just the first step in a lifelong journey. To maintain weight loss and improve overall health, healthy diet and lifestyle habits must be adopted. Staying active, following a post-bariatric surgery diet, and drinking plenty of water are essential elements to long-term success. The fundamentals include the following:
- Follow Your Nutrition Plan: Work closely with a dietitian or provider to ensure proper nutrition and to avoid nutritional deficiencies. Plan your meals, eat no more than three meals a day, and avoid snacking. Eat protein first every meal to ensure you stop eating before you feel full.
- Incorporate Regular Exercise: Physical activity is crucial for maintaining weight loss and improving cardiovascular health.
- Drink Plenty of Water: Drink 64 ounces of water or more a day and avoid drinks that contain calories or flavorful liquids that encourage snacking.
- Attend Follow-Up Appointments: Regular check-ins with your healthcare team are essential for monitoring progress and addressing any concerns.
- Seek Support: Consider joining a weight loss surgery support group for motivation and advice from others who are on a similar journey.
When to Talk to Your Doctor
If obesity is impacting your health or quality of life, it may be time to talk to your healthcare provider about weight loss surgery. Discuss your medical history, weight loss attempts, and personal goals with your doctor. Early intervention can prevent complications like type 2 diabetes, heart disease, and joint problems, ultimately improving your overall health and quality of life.
Weight loss surgery has a high success rate, with 90% of individuals losing 50% of their excess weight. Losing weight is about your whole health and can help improve health problems related to obesity. If you suffer from type 2 diabetes, high blood pressure, heart disease, unhealthy cholesterol levels, sleep apnea, urinary incontinence, or knee, hip, or other body pain related to obesity, bariatric surgery may be the best choice for you. If you have questions about bariatric surgery or want to discuss your eligibility for weight loss surgery, reach out to a health provider to learn more.
