Weight loss surgery, also known as bariatric surgery in medical terminology, refers to a group of gastrointestinal surgical procedures carried out on patients suffering from chronic morbid obesity (i.e., at least 100 lbs overweight, or a body mass index, BMI, of 40 or greater, for more than 5 years). It is used to facilitate weight loss and avoid the risk to life-threatening diseases associated with morbid obesity, such as type II diabetes, heart disease, sleep apnea, degenerative arthritis, etc.

Weight loss surgery is normally resorted to as a last measure when an all other conventional weight loss methods, such as diet control, exercise and weight loss medications, have failed in treating the person for morbid obesity. It may be pointed out that weight loss surgery is distinct from liposuction in that the latter is more of a cosmetic procedure rather than a medical procedure.

What does weight loss surgery involve?

According to The American Society for Bariatric Surgery, there are basically two approaches to weight loss surgery:

1. Restrictive procedures, which help reduce the capacity for food intake in a single meal but do not interfere with the normal absorption (digestion) of food.

2. Malabsorptive procedures, which help reduce absorption of calories from food by altering the process of digestion.

Restrictive procedures are mainly of two types:

1. Lap band surgery, which involves placing laproscopically a silicone gastric band around the top of the stomach in order to create a very small stomach pouch. As a result, the person starts feeling full with just a small portion of food. Food will then slowly empty from the smaller pouch into the lower part of the stomach and into the rest of the digestive tract.

2. Gastric bypass surgery, which involves stapling of the smaller, upper part of the stomach to separate it from the rest of the stomach and rerouting the small intestine to connect it to the smaller stomach pouch.

Lap band surgery is a relatively simple and less risky procedure compared to gastric bypass surgery. It requires just 1 to 3 days of hospital stay as opposed to 5 to 8 days in the latter case. Moreover, there is no malabsorption of vitamins and minerals after lap band surgery, which is not always the case with gastric bypass surgery. However, the expected weight loss over a period of 18 months is lesser (50 to 60% of the excess weight) compared to gastric bypass surgery (70 to75%). Both the procedures are reversible, but lap band surgery is much more easily reversible.

There is a third type of restrictive procedure too, called sleeve gastrectomy, that is less commonly used. In this the surgeon removes approximately 60% of the stomach laparoscopically so that the stomach takes the shape of a tube or “sleeve”.

Malabsorptive procedures are rarely used these days due to the problems of malnutrition and nutritional deficiencies caused by them.

Any risks?

In addition to general risks associated with any kind of major surgery, weight loss surgery can pose its own complications. Discomforting symptoms such as nausea, vomiting, weakness, hernia, gallstones and nutritional deficiencies can crop up after weight loss surgery.

Is it for you?

Though the ultimate answer to the question whether you qualify as a candidate for weight loss surgery or not rests entirely with your bariatric surgeon, here are some pointers that can help you in your decision-making process. If you have been more than 100 lbs overweight for more than 5 years, if your body has failed to respond to the conventional weight loss methods, and if you are not suffering from any major disorder that makes surgery difficult, you can seriously consider weight loss surgery as a feasible option. Consult your doctor for detailed information in order to weigh the risks against benefits of weight loss surgery.

Finally, remember that even if you keep realistic goals in mind, the real success of weight loss surgery is strongly dependent on your making long-term changes in your diet and lifestyle.

It was hard to imagine that Vinay, a boy who I had seen grow up with my children in the school where they studied, was no more, at the age of 21. As the news spread among us parents, we grieved, shocked that the boy who had for many years been known as the fattest boy in school had not lived even up to 25.

But what made the thought of this loss harder to bear for those who had known him, was that vinay had died during a surgery to cure his morbid obesity. Vinay had always stayed in our memory as a lovable personality who participated fully in academics and sports in spite of his girth. During his school years, he was extremely popular with both teachers and students. However, as a young adult, he was persuaded to undertake anti-obesity surgery to improve his personality.

Among the side effects of prosperity and a lifestyle marked by the absence of physical effort is growing obesity among children and adults. While herbal slimming pills, specialized diets, nutritional powders in place of food and other such means are tried by many, a few try surgery to restore their bodies to more manageable proportions. As people get more preoccupied with the need to maintain their public image, cosmetic surgery of all kinds is gaining currency. Rhinoplasty or a nose job has become a much more accessible surgery today, for instance, than it was even ten years ago.

But what needs to be clearly understood is that anti-obesity surgery is not a minor cosmetic surgical procedure. It is a major operation that can have life-threatening consequences. Bariatric surgery, or weight loss surgery, is usually adopted by those who have been diagnosed as morbidly obese, or over 50 kg above their normal weight (according to height and age) and are unable to lose weight by any other means. This type of surgery includes a spectrum of procedures known as either restrictive, or malabsorptive, or those that combine the two. Restrictive procedures like Adjustable Gastric Banding and Vertical Banded Gastroplasty (VBG) reduce the size of the stomach, and malabsorptive and combined procedures such as RNY Gastric Bypass, Bilio-pancreatic Diversion, Fobi Pouch and Duodenal Switch (DS) reduce the bodys ability to absorb calories and nutrients from food.

The shocking demise of Vinay forced me to find out more about these surgical procedures that are often spoken loosely about in drawing room conversation as the medical equivalent of an appendix operation. In trying to gather more information, I found a long list of horror stories. If the surgery is truly as successful as it is claimed by some doctors, and the percentage of failures is very low, then so many deaths and so much post-operative suffering is truly alarming. An account of life after Gastric Bypass shows what patients may actually have to suffer, which doctors have not educated them sufficiently about, before the surgery.

Some doctors, I have been told, have actually told their patients they can continue with their lives as if nothing has changed, speaking as someone who has had this done I can tell you without a doubt If you have this surgery your life will never be the same again. Several people I know or have spoken with online have had this operation and not changed their life style, meaning they continue to eat as they did before the surgery, they have had very little weight loss as a result. If you do not change your eating habits, and the way you think about food your success will be limited, and this is way to painful as well as physically and emotionally exhausting to waste it by not doing your very best to make it a success. I can only eat a few ounces of food at a time and must eat 4 or 5 small meals a day as opposed to the usual 3.

If you choose to have this operation, one of things you will have to give up is hot meals because you are forced to eat so slow in order to control the nausea that your food gets cold long before you finish, and eating a diet of almost nothing but soft foods gets so depressing sometimes. Sometimes I would give anything just to be able to eat a slice of pizza or a bowl of ice cream like a regular person. To give you a better understanding of the portions you will be eating get a childs tea set, that is about the size of the the plates and cups you will need. Most people find that they can no longer eat and drink at the same time, but must wait for a half hour or so after meals before drinking. Another side effect not all doctors mention is the hair loss. Hair loss after this is very common, it is due to the body not getting enough vitamins and minerals any more, you will have to take supplements, quite likely for the rest of your life. Your system has enough stored so that you may not have any hair loss for a 4 to 6 months after the operation, but I have found that if you dont supplement your diet you will have significant hair loss.

The patient who described the above died four years after her Gastric Bypass. A very moving account of the suffering and loss that can accompany such a procedure is also provided by a patients husband, who has documented the circumstances leading to her death.

While it is unlikely that every person meets the same fate in any circumstances, considering the reported complications of Bariatric weight loss surgery, it is best that we stay informed and aware.

For millions of overweight people who have walked through the endless revolving door of weight loss and weight gain there may come a day when having weight loss surgery becomes a decision with which they are faced. And while weight loss surgery represents the final frontier for many who have battled the bulge for years, it is fast becoming an accepted and commonplace procedure. What was once considered a risky last resort has now become a customary course of action among those looking to lose significant weight.

However, one thing that has remained the same is that weight loss surgery is meant for those who are clinically and dangerously overweight. It is not a quick fix for those who just need to lose a few pounds. When the dangers of obesity far outweigh the dangers of a surgical procedure then weight loss surgery becomes an option.

Luckily, weight loss surgery is now much safer and is performed by a host of experienced doctors who have delivered results for thousands of people around the world. It is of the utmost importance however to find a highly regarded doctor who is vastly experienced in weight loss surgery. Word of mouth can be a great place to start; once you hear of a particular doctor – from a variety of sources – who has earned a stellar reputation you can then go about researching his/her more factual credentials.

There are several types of weight loss surgery. During restrictive procedures the stomach is actually made smaller to decrease the amount of food that can be ingested. Malabsorptive techniques limit the contact ingested food has with the intestines thus reducing the amount of food that is absorbed into the body.

Weight loss surgery promises to become less invasive in the future as surgeons explore safer, non-invasive surgery in the form of laparoscopic procedures.

Regardless of anything, the decision to have weight loss surgery should not be made lightly. Every effort should be made to lose weight through diet and exercise first.

If you feel as though this is the solution for you, consult with your doctor on whether your risk factors for obesity-related diseases outweigh your risk factors for surgery. Do your research; talk to others who have had the procedure, go online to access the enormous amount of information available there; read every book and piece of literature you can find. Being educated on what to expect during and after surgery will help you make an informed decision.

And know that weight loss surgery does not mean that you are off the hook in being mindful of diet and exercise. Having surgery and then going back to your old lifestyle will only sabotage your chances of success. Be smart about weight loss surgery and a new healthy life can be yours to have.

All across our state, the number of overweight and obese individuals is rapidly increasing. In the Evergreen State alone almost 60% of the population is overweight or obese. Obesity leads to millions of preventable deaths in the United States annually, and may lead to life-threatening ailments, including diabetes, certain kinds of cancer, heart conditions, and hypertension.  According to a recent study, the diseases caused by obesity directly cost the people of Washington at least $1 billion each year, with the productivity losses stemming from obesity-related physical inactivity sapping more than $4.6 billion more annually from Washington’s economy. 

Find a Way Out

Living with obesity can be a struggle. Many of those suffering from this condition attempt to lose their excess weight by means of crazy diets, brutal exercise programs, or fake “weight-loss pills”.  Often, these efforts lead them to lose significant weight, but many quickly regain it after they discontinue their weight loss program.

Fortunately, another option exists: weight loss surgery. Surgical weight loss – also known as bariatric surgery – has been proven to address obesity-related health problems for individuals with a body mass index of 35 or higher and lessen their chances of developing weight-related health problems in the future.

About Weight Loss Surgery

The three main types of weight loss surgery are malabsorptive procedures, such as the sleeve gastrectomy; restrictive procedures, like the Lap-Band; and combination procedures, like gastric bypass surgery. All of these are performed under general anesthesia, usually laparoscopically, and each has different risks and benefits. Some procedures, however, may need to be performed through open surgery.

Lap-band surgery, or gastric banding, is the most common weight loss procedure. An inflatable silicone prosthetic band is placed around the top portion of the stomach using a laparoscope, creating a small pouch. The band is inflated with saline and adjusted via a small port placed just under the skin. Because of the way the stomach is restricted, patients feel hungry less often and feel full more quickly, causing them to eat smaller portions and thereby lose weight. The procedure is minimally invasive and generally has a faster recovery time with lower risk of postoperative complications compared with the gastric bypass. However, Lap-band surgery requires the patient to make periodic visits with their bariatric surgeon for band readjustment.

Considering Surgical Weight Loss

Weight loss surgery can be a true lifesaver. However, patients who fail to follow postoperative instructions may regain any weight lost or quickly hit a plateau in their weight loss. Those considering bariatric surgery as an option for the management of obesity should carefully weigh the risks and possible outcomes of these procedures in consultation with their physician, and determine whether they are willing to make the long-term commitment to changing their diet and exercise habits that is needed for lasting success.

It’s time we got on the ball, Washington. We must defeat this plague of obesity, and with determination we can.