Americans’ interest in weight-loss surgeryhas expanded as quickly as their waistlines.
And there’s good reason. The national success rate for people losing half of their excess weight through diet and exercise hangs at a mere 5 percent compared with the 60 percent success rate for gastric bypass patients, according to Mayo Clinic gastrointestinal surgeon Michael Sarr.
In no way is it a shortcut to weight loss, but rather a medical solution that helps to head off high blood pressure, degenerative joint disease, diabetes, heart disease, sleep apnea and other health ravages associated with obesity, Dr. Sarr says. The surgery is “an attempt to change the anatomy of the digestive system, to prevent people from absorbing too many calories for their metabolism,” he adds.
But even though obesity has reached epidemic proportions, surgery is an extreme decision that patients and doctors have to weigh thoroughly. Here’s your guide to some of the most common surgeries to shrink patients’ waistlines and improve their health.
Gastric band: Imagine a doughnut placed around the top of the stomach, shrinking the connection between the swallowing tube and the stomach. “It limits the rate at which stuff passes through,” Sarr says. But he warns that the band doesn’t prevent patients from cheating on their diets. They could still load up on high calorie ice cream or sweets that can slip easily through the band.
Roux-en-Y gastric bypass: This technique, probably the most common weight-loss surgery, creates a new stomach pouch connected directly to the middle of the small intestine so that food bypasses part of the stomach and small intestine. The process functions in two ways, Sarr explains. “It works by decreasing the amount that you can eat, and it works such that you decrease the part of the small intestine where most of the absorption occurs,” Sarr says.
Sleeve gastrectomy: This procedure reduces the stomach to about the size of a man’s thumb. “That’s kind of the hot operation now because there’s no bypass,” Sarr says. Short-term data suggests sleeve gastrectomy is almost as good as a gastric bypass. A bypass is a surgically created pathway circumventing the normal anatomical pathway. “Everything that you eat goes through the normal channel. It’s just that you can’t eat very much.”
Duodenal switch biliopancreatic diversion: This one is as complicated as it sounds. It reduces stomach size, bypasses 85 percent of the small intestine and reroutes the flow of bile and pancreatic juices. As Sarr explains it: “Functionally, the food goes one way. The digestive enzymes go the other way. They meet and then there is three feet of intestine for the food to be broken down chemically and absorbed.” The surgery reduces the amount of time the body has to take up calories from food in the small intestine and limits fat absorption.
Ultimately, Sarr says, success for any of the procedures depends on a patient’s lifelong commitment to healthy eating and exercise.