Weight loss surgery (also known as bariatric surgery) involves carrying out a range of medical procedures on people who are obese to reduce their weight. The procedure can be achieved by cutting down the stomach’s size with a gastric band, removing a part of the stomach or by re-routing and resecting the small intestine to a smaller stomach pouch. Undergoing weight loss surgery is quite a drastic measure which is why it should only be considered as a last resort.
Studies have shown that the procedure results in significant long-term weight loss, improvement in cardiovascular risk factors, recovery from diabetes, and a significant reduction in mortality (from 23% to 40%) in obese people. It is recommended for people with body mass index of 40, as well as for people with body max index of 35 who have serious medical conditions like diabetes.
So for those who fall in this category and have to go for bariatric surgery below is the list of the top five weight loss surgeries:
- Gastric Banding
Gastric banding is a reversible procedure and doesn’t involve the removal of the stomach or part of the digestive tract. It is the safest procedure for weight loss after commanding a low mortality rate. The procedure scored 0% death rate after a 12 year study. It also comes with a lesser post-operative complication rate when compared to other weight loss procedures.
Gastric banding is performed with minimally invasive laparoscopy thereby lowering the risk of complications and infection. A surgeon squeezes the stomach into two sections (smaller upper pouch and larger lower section) using an inflatable band. Both sections remain connected by a small channel, which makes emptying the upper pouch slower. After undergoing the surgery most people can be full after eating only 1/2 or 1 cup of food.
- Sleeve Gastrectomy
Sleeve gastrectomy is a weight-loss procedure that involves reducing the stomach to nearly 15% of its size by surgically removing a large part of it. The open edges are attached together (with surgical staples and/or sutures) leaving the stomach shaped like a tube or sleeve. The procedure reduces the size of the stomach permanently. It is not reversible.
This weight loss approach has been shown to tremendously decrease the risks associated with bariatric surgeries for specific patients, even when there is the added risk of two surgeries. Most patients begin to lose 30 to 50% of their weight within a 6 to 12 month period after sleeve gastrectomy. The second procedure’s timing varies according to the rate of weight loss, usually within 6 to 18 months.
- Gastric Bypass Surgery
Gastric bypass surgery is a procedure involving the division of the stomach into a small upper pouch and larger lower pouch after which the small intestine is made to connect both parts. Specialists have developed several techniques to reconnect the intestine, which has lead to different gastric bypass procedures. GBP leads to decline in the stomach’s functional volume, along with an altered physical and physiological response to food.
According to several studies, this procedure has a 0.6% success in terms of death rate.
- Maestro Rechargeable System
This is a surgical procedure that involves planting a device in the abdomen. The device comes with a remote control which is used to adjust it outside the body. The system works as a pacemaker delivering electrical pulses to the nerve (known as the vagus nerve) between the stomach and the brain. The nerve sends signals to the brain whenever the stomach is full.
The Maestro Rechargeable System is designed to deliver a pulse to the nerve when the subject is awake. It is supposed to turn off during sleep. This procedure is the least invasive (though not as effective as some) of the bariatric surgeries available. The outpatient procedure might take up to one hour and 30 minutes while the subject is under an anesthesia.
- Intra-gastric Balloon
Intra-gastric balloon (also known as the gastric balloon) is a surgical procedure that involves putting a deflated balloon in the stomach, and filling it to reduce gastric space. The balloon may be kept in the stomach for no more than 6 months and it results in a weight loss rate of 5–9 BMI through a 6 month period. The procedure may also be used before undergoing another weight loss surgery. The intra-gastric balloon is inserted prior to another weight loss procedure to help the patient reach a weight suitable for surgery. However, it can be used on other occasions if necessary. This is now commonly performed in Nigeria. The challenge I have seen so far is weight gain a few months after the balloon has been removed. I think in the best interest of these patients, they should use the bottom up approach by changing their lifestyle first before embarking on the surgery.
Surgery or pills, you still need a lifestyle modification for a sustainable change.