Deciding to pursue bariatric surgery can be a huge step for most people, and trying to understand the different surgeries can be very confusing. There are many surgeries that can be done for weight loss, but most surgeons promote three procedures: (1) gastric bypass, (2) gastric band and (3) gastric sleeve. All three have been studied in large numbers with comparable results and have the lowest rates of complications along with excellent sustained weight loss results.
1. Gastric Bypass
The oldest and most studied option is the gastric bypass. This surgery works through restricting the amount of food one can eat while bypassing a segment of intestine to cause decreased absorption. Of the three procedures, the bypass provides the largest amount of sustained excess weight lost over time. It provides the best results for improving or resolving medical problems long term.
2. Gastric Band
A second weight loss procedure is the gastric band. This procedure wraps a plastic band around the top part of the stomach to create a small pouch. It works by restricting the amount of food one can eat, and the band is adjustable. The band requires a port to sit underneath the skin on the abdomen and is the access point for adjustments. In order to have an adjustment, a needle is inserted through the skin and a sterile solution is used to increase or decrease the restriction in the band. This procedure requires multiple follow-ups with the physician in order for the band to be adjusted to fit perfectly.
3. Gastric Sleeve
The newest surgery of the three is the gastric sleeve. This surgery was originally done as part of another weight loss surgery but has evolved into its own procedure. It is done by removing a portion of the stomach to create a narrow tubular stomach which looks like the sleeve of a shirt. This small stomach does not stretch and helps control portion sizes. Some advocates speak of a hormonal change that alters the hunger sensation, helping to change the amount one eats. This surgery provides great results for improving medical problems but is still being studied for long-term results.
As technology improves, more procedures will become available for weight loss. A recent advancement is the intragastric balloon, which was approved in 2015 to facilitate weight loss. A special balloon is released in the stomach with the idea that it will keep your stomach full to restrict the amount of food eaten. There are a few studies on this technology right now, and there appears to be some benefit in weight loss initially. The sustainability of this weight lost is yet to be determined, as there is the potential for weight regain once the balloons are removed. Other interesting techniques are still being investigated and will likely be available in the near future.
The results of each procedure are slightly different, and doctors will help guide the patient to the most appropriate surgery. For more detail about each surgery and weight loss surgery in general, consult with a bariatric surgeon.