Weight Loss Surgery
July 22, 2008
Severe obesity is a chronic condition that is very difficult to treat. For some people, weight loss surgery helps by restricting food intake or interrupting digestive processes. But keep in mind that weight loss surgery is a serious undertaking. You should clearly understand the pros and cons associated with the procedures before making a decision.
Obesity surgery is the most effective treatment for individuals with chronic weight problems who have been unable to achieve and maintain weight loss by other means. Obesity surgery reduces health risks, improves mobility, restores self-confidence and self-esteem and improves long-term survival. In experienced hands, obesity surgery is a remarkably safe form of treatment.
Candidates For Surgery
Gastric bypass surgery is recommended for those persons who are 90 pounds or more overweight and have or are likely to have medical complications that will be helped, and in many instances, cured by substantial weight loss. While weight loss surgery is not for everyone, there are a large number of patients for whom losing a lot of weight is imperative, including those suffering from diabetes, high blood pressure, heart trouble, shortness of breath, arthritis and orthopedic (bone) problems with their legs, hips or back.
Obesity linked to several cancers
Obesity raises the risk for several types of cancer, including cancers of the breast, colon, esophagus and kidney, as well as numerous other diseases.
The study buttresses findings published last year in the New England Journal of Medicine that obese people who have bariatric surgery have a lower risk of death from heart disease, diabetes as well as cancer compared to obese people who do not have such surgery.
WHAT IS GASTRIC BYPASS?
A gastric bypass means that you cut the stomach high up so that you separate the stomach in two parts - a small upper part and a large lower part. The upper part is then connected to the small bowel a bit downstream on the small bowel. The larger lower part of the stomach is just left lying idle. It is out of the food circulation and will never again be filled with food. So you end up with a small stomach and a shorter bowel. This means that you will feel full more quickly (because of the small stomach) and that you will absorb less of the food actually eaten (because of the shorter bowel).
Bariatric surgery involves a great deal of preparation and education before and after the surgery to ensure that the patient is able to gradually lose weight and remain healthy while doing it. Thus, weight loss surgery is a holistic program that involves a firm and lifelong commitment to certain lifestyle changes on the part of the patient. With this commitment, the patient is encouraged to develop and maintain these healthy habits for the rest of his/her life.
Weight-Loss Surgery Options
Currently, the procedures fall into three major categories.
Restrictive Procedures
In these operations, a surgeon creates a small pouch about the size of a walnut, at the top of the stomach where food enters from the esophagus. The pouch holds approximately 2 ounces of food. The lower outlet in the pouch is usually half an inch in diameter or even smaller. This tiny outlet slows the emptying of food from the pouch to the larger area of the stomach. This creates a prolonged sense of fullness with very little food.
Malabsorptive Procedures
Malabsorptive procedures shorten the digestive tract to limit the number of calories and nutrients that can be absorbed.
Biliopancreatic diversion (BPD) is a malabsorptive procedure in which the lower portion (three-fourths) of the stomach is removed and the small pouch that remains is stapled directly to the small intestine. The biliopancreatic diversion greatly reduces nutrient absorption and caloric intake, but is used less often than adjustable gastric banding and gastric bypass (described below), because it entails a high risk of nutritional deficiency, as well as higher operative complications and death rates.
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