Surgery for weight loss (Bariatric Surgery)

© Stephan Morrosch (Fotolia) Operation
© Stephan Morrosch (Fotolia)

Severe obesity occurs when the BMI of a patient is 35–39 kg/m2 with other illnesses, or a BMI greater than 40 kg/m2. Body Mass Index is measured by dividing the weight in Kg by the height in metres squared.

There are 4 types of procedures available in bariatric surgery:
Restrictive procedures reduce the size of the stomach to reduce the food intake by producing a feeling of fullness: Laparoscopic adjustable gastric banding (LAGB); sleeve gastrectomyMalabsorptive procedures create a diversion of the small bowel limiting the calorie uptake in the intestine: Biliopancreatic diversionRestrictive and Malabsorptive procedure: Roux-en-Y gastric bypassOther procedures: Gastric stimulation, intragastric balloonBariatric Procedures:
Restrictive:
LABG – a ring is placed around the stomach via open or keyhole surgery on the abdomen.

The band has an inflatable balloon which can be adjusted in clinic to regulate the amount of food eaten and thus weight loss. The ring can be removed through another procedure.

Sleeve gastrectomy – a large portion of the stomach is removed, reducing the size. This is not reversible.

Malabsorptive:
Biliopancreatic diversion involves an operation to bypass the stomach by attaching it to the most distant portion of small bowel, called the ileum.

This can lead to extreme malabsorption and weight loss through calorie reduction. This can be lessened with a procedure called the duodenal switch.

Both:
Roux-en-Y gastric bypass – the stomach is made smaller and then attached to a distant part of the small bowel, thereby restricting intake and reducing the calorie absorption.

Other:
Intragastric balloon is introduced via an endoscope via the mouth. A telescope is inserted and the balloon is inflated within the stomach. This makes the stomach feel full.
Benefits of Bariatric SurgeryWeight loss – generally 14-25%, but depends on motivation
Reduction of diseases associated with obesity, e.g. diabetes.
Reduction in deaths
There are, however, many complications associated with surgery and also the specific type of surgery. Bariatric surgery should only be contemplated after talking to your family doctor and a bariatric surgeon.