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Weight loss surgery, also known as bariatric surgery, encompasses a group of operations that help you lose weight by making changes to your digestive system. It is also known as metabolic and bariatric surgery, where "metabolic" means "related to how your body gets energy" and "bariatric" means "related to treatment for heavy weight".
Weight loss surgery is a common type of surgery for weight loss, particularly for individuals who have obesity and have not been able to lose weight or keep it off using other methods such as diet and exercise. According to the National Institutes of Health (NIH), it is nearly impossible for people with class III obesity to sustain weight loss through diet and exercise alone. Once your body has registered your higher weight as “normal,” it continues to try to return to that weight.
Weight loss surgery works by changing how your body manages what you eat, allowing healthy diet and lifestyle changes to be effective for sustained weight loss and health.
During weight loss surgery, the surgeon creates a small pouch at the top of the stomach. The pouch is the only part of the stomach that receives food. This greatly limits the amount that you can comfortably eat and drink at one time. The small intestine is then cut a short distance below the main stomach and connected to the new pouch. Food flows directly from the pouch into this part of the intestine. The main part of the stomach, however, continues to make digestive juices. The portion of the intestine still attached to the main stomach is reattached farther down. This allows the digestive juices to flow to the small intestine. Because food now bypasses a portion of the small intestine, fewer nutrients and calories are absorbed.
Weight loss surgery changes how we experience hunger because of how our hormones and metabolism work. Understanding how surgeries like gastric bypass and sleeve gastrectomy impact hormones like ghrelin, leptin, and GLP-1 is important for helping people with obesity achieve their weight loss goals and improve their overall health. Bariatric surgery, such as gastric sleeve and gastric bypass, reconfigure the anatomy of your gastrointestinal tract (stomach) which recalibrates your energy balance and fat metabolism.
The most pronounced change is the reduction of the intestinal hormone called ghrelin, also called ‘the hunger hormone’. This reduction in Ghrelin is believed to play a significant role in the post-surgical changes in appetite and satiety experienced by patients who undergo the procedure.
This surgery is often recommended for individuals who are severely obese and have not been able to lose weight or keep it off using other methods such as diet and exercise.
There are several advantages of weight loss surgery:
Significant Weight Loss: Weight loss surgery can help individuals lose a significant amount of weight. This is achieved by reducing the size of the stomach, which makes individuals feel full sooner and eat less.
Reduced Hunger: The surgery often involves removing a part of the stomach that produces ghrelin, a hormone associated with hunger. This leads to a decrease in hunger and an increase in the feeling of fullness after meals.
Improved Mobility: Weight loss surgery can increase mobility, allowing individuals to enjoy more of life's daily joys.
Improved Self-Esteem: Weight loss surgery can increase self-esteem, improving work and social interactions, and sexuality.
Decreased Depression and Anxiety: Weight loss surgery can decrease feelings of depression and anxiety.
Weight loss surgery can improve overall health and reduce the risk of premature death. The surgery can lower the death rate from most causes, including diabetes, cardiovascular disease, and cancer. It can also reduce the risk of possibly life-threatening weight-related health problems, including certain cancers, heart disease, stroke, high blood pressure, high cholesterol levels, nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH), sleep apnea, and type 2 diabetes. For people with severe obesity, weight loss surgery can extend years of life. As an added benefit, individuals may be able to take fewer prescription medications as they move into a healthier weight, which can reduce the cost burden.
Despite its advantages, weight loss surgery also has some disadvantages and potential risks.
One of the main disadvantages of weight loss surgery is that it requires significant lifestyle changes. Patients must adhere to a strict diet and exercise plan, and those who do not may regain the weight they lost. Additionally, weight loss surgery is irreversible, meaning once the surgery is done, it cannot be undone.
Another disadvantage is that weight loss surgery can be expensive. While many insurance companies cover the cost of weight loss surgery, not all do, and the out-of-pocket costs can be significant.
As with any major procedure, weight loss surgery poses potential health risks, both in the short term and the long term. Risks associated with weight loss surgery can include excessive bleeding, infection, adverse reactions to anesthesia, blood clots, lung or breathing problems, and leaks in your gastrointestinal system. Rarely, complications of weight loss surgery can be fatal.
Longer-term risks and complications of weight loss surgery can include gastrointestinal obstruction, hernias, gastroesophageal reflux, low blood sugar (hypoglycemia), malnutrition, vomiting, and in some cases, the surgery may not be successful in achieving the desired weight loss.
While weight loss surgery can offer significant benefits, it also carries potential risks and complications. Therefore, it's important for individuals considering this surgery to discuss these pros and cons with their healthcare provider to make an informed decision.
Weight loss surgery provides substantial, reliable results. Because weight loss surgery involves a physical restriction on the body, average quantifiable weight loss results are expected. Depending on the surgery, patients can expect to lose around one to two pounds a week, or up to 40 percent of excess body weight within six months after surgery.
On the other hand, non-surgical weight loss methods, also known as medical weight loss, involve weight management with help provided by medical providers. These methods can include diet and exercise plans, medication, and behavior change therapies. While these methods can be effective, they often require more effort and discipline from the individual, and the results can vary widely.
In conclusion, understanding the pros and cons of weight loss surgery and other weight loss methods is crucial for anyone considering these options. Both methods can offer significant benefits, but they also carry potential risks and challenges. Therefore, it’s important to have a thorough discussion with your healthcare provider about these pros and cons to make an informed decision. Your doctor can provide personalized advice based on your health history, weight loss goals, and lifestyle.
Remember, the choice to undergo any weight loss method should be made in consultation with your healthcare provider, considering your personal health and circumstances.
Weight-loss surgery is considered successful if you lose 50% of your excess weight and keep it off. By this standard, the success rate is 90%. Many people experience steady weight loss for the first two years, then stall or regain some weight after that. Studies show that many people who have weight-loss surgery lose on average 15 to 30 percent of their starting weight, depending on the type of surgery they have.
Contrarily, weight-loss surgery can actually extend your lifespan. A study found that bariatric surgery was associated with increases in life expectancy among severely obese patients. However, it's important to note that the surgery requires long-term lifestyle changes to be successful.
Weight-loss surgeries are generally considered safe. However, as with any major procedure, they pose potential health risks, both in the short term and the long term, including excessive bleeding, infection, reactions to anesthesia, blood clots, lung or breathing problems, leaks in your gastrointestinal system, and rarely, death.
The best surgery for weight loss depends on the individual's specific circumstances. However, research suggests that of the three common surgical weight loss procedures, gastric sleeve surgery was the safest procedure with the lowest risk of side effects. Other common types include gastric bypass and gastric band.
While a moderate amount of discomfort should be expected after weight loss surgery, pain levels vary among individuals. Most modern weight loss surgeries are performed laparoscopically, which means small incisions, faster healing, and less pain and scarring than traditional open surgery.
Failure rates after weight loss surgery vary. In a recent long-term study of patients who had undergone Roux-en-Y gastric bypass (RYGB), 93% of patients maintained at least a 10% weight loss from baseline, 70% maintained at least a 20% weight loss, and only 40% maintained at least a 30% weight loss after 12 years. However, about 20% of patients will experience long-term complications that can range from food tolerance problems to weight gain and even relationship issues.
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