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Different Types of Surgery For Weight Loss

Understand the Risks and Benefits of Each Bariatric Procedure

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Updated February 15, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Different Types of Surgery For Weight Loss

Gastric Banding

A.D.A.M.

If you are considering weight loss surgery, you may find yourself overwhelmed with the information about each procedure. Learning about the risks and benefits can be confusing and scary.

In recent years, bariatric surgery has become a safer procedure, due in part to the number of procedures performed annually. In his interview with About.com about preparing for surgery, Dr. Ninh T. Nguyen, MD, the President-elect of the American Society for Metabolic and Bariatric Surgery (ASMBS), stated that most procedures are now performed laparoscopically, which is a less invasive approach. He says that for eligible patients, the risks of obesity can outweigh the risks of surgery itself.

But choosing to undergo the procedure is still a major life-altering decision. Your surgeon will be able to explain each procedure in detail, but here is a list of three common types of surgery for weight loss and the benefits and drawbacks of each procedure.

Roux-en-Y Gastric Bypass

During a Roux-en-Y gastric bypass operation, your surgeon makes a small pouch in the upper part of your stomach and connects that pouch to your small intestine. Food then bypasses the stomach and goes right into the intestinal track.

Gastric bypass is a “restrictive” method of weight loss surgery. This means that it works by limiting the amount of food that you can consume at any given time. But this method also changes the way food is absorbed in the digestive process. When food bypasses parts of the digestive tract, fewer calories are absorbed.

  • Gastric bypass benefits: Some patients choose gastric bypass because the rate of weight loss is often faster than with other types of surgery, like gastric banding. There is also no implantable device left in the body as there is with the band.

  • Gastric bypass drawbacks: Because food is absorbed differently, patients who undergo gastric bypass may develop vitamin deficiencies that require them to take medication. Gastric bypass is also difficult to reverse and is not adjustable. Some patients experience surgery-related side effects including hernia, vomiting, and infection, and some may require additional surgeries to repair the pouch.

Adjustable Gastric Banding or Lap Band

Banding requires the surgeon to place a small inflatable band around the upper part of the stomach. This creates a small pouch similar to the one created when a patient undergoes gastric bypass. But unlike bypass surgery, the pouch stays connected to the stomach.

The gastric band is also a restrictive procedure because it limits the amount of food that may be consumed at any given time. But because food still continues into the stomach and the rest of the digestive system, food is still absorbed the same way it was prior to surgery.

  • Gastric banding benefits: Some patients choose this method because it is both reversible and adjustable. If you are not losing enough weight or if you are dropping pounds too quickly, your surgeon can inflate or deflate the band through a port that is left in place on the body. For this reason, weight loss tends to be slower but steadier than with other procedures.

  • Gastric banding drawbacks: Patients may experience many of the same side effects as with other surgeries including vomiting and nausea. It is also possible for the band to slip or to erode through the stomach. Some studies have reported lower rates of weight loss with gastric banding, although other reports show that after 3-5 years, the rates for all three procedures tend to even out.

    Another drawback to this procedure is the port. Gastric banding is the only procedure where a device is left in place on your body. This port remains accessible permanently unless the procedure is reversed.

Sleeve Gastrectomy

During a sleeve gastrectomy, your surgeon sections off a vertical piece of your stomach and creates a new, smaller, tube-shaped stomach. This restricts the amount of food that you can eat. It may also help reduce the production of ghrelin, a hormone that regulates your appetite.

  • Sleeve gastrectomy benefits: Patients often lose weight more quickly with this procedure. Some studies also report the highest level of weight loss success with this procedure as measured by the percentage of excess body weight lost.

  • Sleeve gastrectomy drawbacks: As with any invasive procedure, patients may experience bleeding or infection after this surgery. Vomiting, nausea, gastritis and heartburn are also symptoms reported by patients who have had this procedure. Complications may also include scarring or damage inside the stomach near the incision.
A board-certified bariatric surgeon will be able to provide more information about which procedure may be best for you. Your medical condition, your size, and your lifestyle will also play a role in the type of surgery that will work best. Be sure to ask questions and do your research before choosing the type of weight loss surgery that is right for you.

Sources:

Joshua B. Alley, M.D., F.A.C.S., Stephen J. Fenton, M.D., F.A.C.S., Michael C. Harnisch, M.D, Donovan N. Tapper, M.D, Jason M. Pfluke, M.D., Richard M. Peterson, M.D., M.P.H., F.A.C.S. "Quality of life after sleeve gastrectomy and adjustable gastric banding." Surgery for Obesity and Related Diseases March 5, 2011.

Access to Care. Morbid Obesity & Metabolic and Bariatric Surgery Fact Sheet. American Society for Metabolic & Bariatric Surgery. Accessed: July 12, 2012. http://asmbs.org/

American Society for Metabolic & Bariatric Surgery. Accessed: July 12, 2012. http://asmbs.org/

Managing the Severely Obese Patient: An Integrated Approach. Allergan Lap Band System. Continued Medical Education Course. July, 2011

Medline Plus. Roux-en-Y stomach surgery for weight loss. U.S. National Library of Medicine/National Institutes of Health. Accessed: July 12, 2012. http://www.nlm.nih.gov/medlineplus/ency/imagepages/19268.htm

Medline Plus. Vertical sleeve gastrectomy. U.S. National Library of Medicine/National Institutes of Health. Accessed: July 12, 2012. http://www.nlm.nih.gov/medlineplus/ency/article/007435.htm

Metabolic and Bariatric Surgery Fact Sheet American Society for Metabolic & Bariatric Surgery. Accessed: July 12, 2012. http://asmbs.org/

Nguyen, Ninh T., MD, President-elect, American Society for Metabolic and Bariatric Surgery. Interview. July 16, 2012

Weight Control Information Network. Bariatric Surgery for Severe Obesity. National Institute of Diabetes and Digestive and Kidney Diseases. Accessed: July 12, 2012. http://win.niddk.nih.gov/publications/gastric.htm

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