What is weight loss surgery?

Who qualifiies for weight loss surgery?

Answer: You may qualify for obesity surgery if:

• You are severely obese (body mass index of 40 or more) or have a BMI of 35 to 39.9 with serious medical conditions such as high blood cholesterol, high blood pressure, sleep apnea and type 2 diabetes.
• You have tried other methods of weight loss including changes in eating, behavior, increased physical activity and/or drug therapy and are still severely obese.
• You are unable to physically perform routine daily activities and your quality of life is seriously impaired.
• You are motivated to making a lifelong behavioral commitment that includes well-balanced eating and physical activity habits which are needed to achieve the best results.

What types of surgery are available?

Answer: There are two types of obesity surgery: restrictive and combined restrictive and malabsorptive:

• Restrictive surgery uses bands or staples to restrict food intake. The bands or staples are surgically placed near the top of the stomach to section off a small portion that is often called a stomach pouch, which can hold about a half a cup to one cup of food. A small outlet, about the size of a pencil eraser, is left at the bottom of the stomach pouch. Since the outlet is small, food stays in the pouch longer and the patient feels full for a longer time.
• Combined restrictive and malabsorptive surgery is a combination of restrictive surgery with bypass surgery, in which a surgeon makes a direct connection from the stomach to a lower segment of the small intestine. This limits the amount of food that is digested.

What are the benefits?

Answer: Immediately following surgery, most patients lose weight rapidly and continue to do so until 18 to 24 months after the procedure. Although most patients then start to regain some of their lost weight, few regain it all.

Surgery improves most obesity-related conditions. For example, in one study blood sugar levels of most obese patients with diabetes returned to normal after surgery. Nearly all patients whose blood sugar levels did not return to normal were older or had had diabetes for a long time.

Patients have reported an enhanced quality of life, improved mobility and stamina, better mood, self-esteem and interpersonal effectiveness, and lessened self-consciousness.

What are the risks?

Answer: 10 percent to 20 percent of patients who have weight-loss operations require follow-up operations to correct complications such as abdominal hernias, breakdown of the staple line and stretched stomach outlets.

More than one-third of obese patients who have gastric surgery develop gallstones, which are clumps of cholesterol and other matter that form in the gallbladder. During rapid or substantial weight loss a person's risk of developing gallstones is increased. Gallstones can be prevented with supplemental bile salts taken for the first 6 months after surgery.

Nearly 30 percent of patients who have weight-loss surgery develop nutritional deficiencies such as anemia, osteoporosis and metabolic bone disease. These deficiencies can be avoided if vitamin and mineral intakes are maintained.

Women of childbearing age should avoid pregnancy until their weight becomes stable because rapid weight loss and nutritional deficiencies can harm a developing fetus.