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Does Surgery Help Obesity?Surgery doesn't reduce obesity by itself. Instead, it makes it extremely difficult for patients to eat very much. Typically, the stomach is reduced from the size of a melon to the size of an egg. So food intake drops. In addition, a gastric bypass operation reduces calorie intake further by reducing the length of small intestine that can absorb calories and nutrients. All of this causes an immediate and drastic reduction in calories, and it is this calorie reduction that leads to weight loss. What Bariatric Surgery is Best For Weight Loss - Banding or Bypass?Weight loss after stomach banding surgery is typically slower than that following gastric bypass, as calorie reduction is not so great. Furthermore, stomach banding operations like vertical banded gastroplasty and lap-band are less permanent and allow greater opportunities for "cheating", than bypass surgery. By contrast, stomach bypass operations compel patients to eat less food and absorb less calories in the intestine. This typically leads to massive weight loss. Patient Compliance is Crucial to Weight Loss SuccessAll bariatric patients are given comprehensive guidelines for post-operative diet and exercise routines. In the case of bypass patients, these guidelines include advice about nutritional supplementation to reduce the risk of vitamin and mineral deficiencies caused by their malabsorptive operation. The success of each patient in losing weight and maintaining good health depends upon their compliance with these eating and fitness guidelines. In particular, if patients find their eating regime too arduous and start "cheating", their chances of significant long-term weight loss are slim. How Much Weight Do Bariatric Patients Lose?Exact figures are hard to come by, but during the first 2 years stomach banding patients typically lose 50-60 percent of their excess weight, while stomach bypass patients typically lose up to 90 percent of their excess weight. However, weight regain is not uncommon, especially among banding patients. Bariatric surgery is certainly no easy answer to obesity. Patients need realistic expectations, strong motivation and a willingness to comply fully with post-operative rules on diet and exercise. Pressure to Revert to Previous Eating HabitsDespite the opportunity which bariatric surgery offers for motivated patients, the same pressures to over-eat and take insufficient exercise - that applied before the bariatric operation - will exist in the post-operative period. So if you are seriously obese and are considering surgery to help reduce your weight, ask yourself whether you truly have the motivation to adapt your eating, exercise and general lifestyle habits over the long term. The Risk Factor Introduction For some seriously obese patients, bariatric surgery is a last-chance option to improve their health and weight. There are two main types of obesity surgery: stomach banding and stomach bypass, both of which can be performed using traditional "open" techniques or laparoscopy. (During laparoscopic operations, the surgeon makes smaller incisions and views the interior of the abdomen on a video screen which is connected to the operating instruments.) Risks of Surgery vs. Risks of ObesityBoth gastric banding and gastric bypass are serious operations, and (like all major surgery) carry serious health risks. However, the possible risks and health complications of this type of invasive abdominal surgery must be balanced against the known health dangers of morbid/malignant obesity. What are the Health Risks of Bariatric Surgery?The risks vary according to the type of gastric surgery performed and the technique used. In general, mortality and morbidity rates of follow-up operations are higher than those of initial surgeries. Stomach StaplingGastric stapling surgeries are slightly easier to perform and carry a lower risk of post-operative complications than does bypass. Furthermore, vertical banded gastroplasty typically produces more effective weight reduction than adjustable banding procedures that only use a gastric band or ring, instead of staples. However, stomach stapling remains less effective than stomach bypass. Risks of Stomach StaplingThese include: - Breakage of staples ----------------------------------------------- Lap BandLike stomach stapling, lap-band surgeries are less drastic, therefore more popular than bypass operations. However, patients can "cheat" more easily, thus weight reduction tends to be smaller. Risks of Lap Band- Band slippage/leakage ANY QUESTIONS PLEASE EMAIL THE MODERATORS
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