There are many types of surgeries for weight loss but each comes with its own set of pros and cons. So which one is the safest to choose? The answer to this question depends on several factors including the health status, requirement, and specific condition of the person.
The long-term success of the surgery largely depends on the cooperation of the person to adapt to a healthy lifestyle in order to maintain the correct weight and the best weight loss surgeon.
One must keep in mind certain points while deciding on a particular bariatric surgery for them, like –
- Targeted Weight-loss
- Reliability of the procedure
- Time period of weight loss
- Safety of the operation procedure
- Personal endeavour for follow-up
- Fear Factor for undergoing an invasive procedure
Bariatric surgery, mostly, work in two steps –
Restriction: This is to physically restrict the stomach’s ability to hold food and thereby reducing the amount of calories uptake.
Malabsorption: For this the surgery is done to bypass the portion of small intestine to limit the amount of nutrient and calories to be absorbed by the body.
Some procedure work by restricting the amount of food that the stomach can hold and some work by combination of both restriction and malabsorption.
The most common and popular weight loss surgeries procedure are:
1. Gastric Bypass
Also called Roux-en-Y Gastric Bypass, it is considered the best weight loss surgery. It combines both restrictive and malabsorption techniques
Procedure– Stomach is made smaller by creating a small pouch; intestines are rerouted. It is a Minimally invasive laparoscopic procedure in which the stomach is divided in two parts, and the upper section is sealed off from the lower one. The upper part of the stomach is then directly connected to the lower section of the small intestine. This creates a bypass from the lower section stomach and part of intestine, so that the food goes through a shortcut so that the body absorbs lesser amount of calories.
Pros: Studies report that it results in an average weight loss of 31 percent of the total body weight in 1 year and then 25 percent in the following five years. Problems associated with obesity like diabetes, hypertension, and heart diseases can also get resolved.
Cons: Development of dumping syndrome. In this the food gets dumped from the stomach too quickly into the intestines, even before it’s been properly digested. It is usually triggered by having sugary or high-carb foods, and symptoms may include nausea, bloating, pain, sweating, weakness, and diarrhoea. This procedure also involve more operation related risks like infection and blood clotting, and also increased risk of hernia and gall bladder stone.
2. Sleeve Gastrectomy or Gastric Sleeve
Procedure: In this a part of the stomach is removed from the body and remaining section of the stomach is formed into a tube or sleeve like structure. Part of stomach that is removed is responsible for producing appetite-regulating hormone – ghrelin, which may impact on the desire to eat. The smaller stomach cannot hold much food. However, it doesn’t affect the calories and nutrients absorption in the intestines.
Pros: 25 percent loss in total body weight in the first year and 19 percent loss of total body weight after five years. Also in this, no device is implanted and no intestinal rerouting takes place. It is a comparatively simpler procedure with lesser food intolerances than gastric banding.
Cons: involves the risk of infection, leaking from the sleeve, and blood clots.
3. Adjustable Gastric Band
Procedure: This laparoscopic procedure involves placing an inflatable Gastric band around the stomach which creates a small stomach pouch with a narrow opening towards the remaining stomach. This technique works by restricting excess food intake by reducing the appetite as one starts to feel fuller soon and slowing the digestion.
Pros: Result in an average 14 percent total weight loss in one year and 12 percent in another five years. It is a minimally invasive surgery for weight loss and the safest option with fast recovery time. It doesn’t involve any stomach stapling and intestinal rerouting. The band can be adjusted by the surgeon and it is a reversible procedure.
Cons: Slower weight loss than other procedures and doesn’t limit the amount of calories. A foreign implant remains in the body and has a risk of band slippage or erosion into the stomach in some patients. The follow up requires strictly adhering to the recommended diet and follow-up visits. Also this has the highest rate for re-operation.
4. Biliopancreatic Diversion with Duodenal Switch (BPD/DS)
This procedure is kind of a severe version of a gastric bypass.
Procedure: In this, a significantly large part of the stomach is removed as in gastric bypass to create a stomach pouch and a large portion of small intestine is then bypassed. So the food passes through the stomach pouch directly into the last segment of small intestine. This last segment is connected to the bypassed part of small intestine which carries bile and pancreatic juices necessary to digest proteins and fat.
Pros: Results in large percentage of weight loss at five years follow-up and allows a person to consume normal meals. It is the most effective method for diabetes patients.
Cons: Higher risk of surgery related infections and blood clots. It requires following strict diet and vitamin supplementation as it can cause deficiencies. Dumpling syndrome is also a potential risk.
5. Gastric Balloon/Intragastric Balloon System
It is a restrictive approach, also known as Gastric ballooning or intra-gastric balloon insertion.
Procedure: This is a minimally invasive procedure in which an inflatable balloon in placed in the stomach through mouth in deflated form. Then saline is used to inflate the balloon which gives a feeling of fullness in the stomach.
Pros: It doesn’t require any surgery and is a reversible procedure. It is a temporary set-up, usually for 6 months.
Cons: May cause nausea and vomiting.
