If you're very overweight and can't lose pounds with a healthy diet and exercise, weight loss surgery might be an option for you. The surgery is usually for those with a body mass index (BMI) above 40 or those with a BMI of 35 or greater with serious co-morbidities. In general, this means men who are more than 100 pounds overweight and women who are more than 80 pounds overweight. If you are somewhat less overweight, surgery still might be an option if you suffer from life-threatening pulmonary problems like diabetes, heart disease or sleep apnea.
Weight loss, or bariatric, surgery can promote weight loss by limiting the amount of food your stomach can hold, limiting calorie and nutrient absorption, or both. Some operations also restrict the amount of food you can digest. Restriction operations, such as gastric banding and vertical banded gastroplasty, are the surgeries most often used for producing weight loss. These operations restrict food intake by making the stomach smaller and delaying the emptying of food from the stomach, causing the person to feel fuller faster. These restrictive operations lead to weight loss in almost all patients, but some weight regain occurs because individuals are unable to adjust their eating habits.
Gastric bypass surgeries are restrictive operations that construct a pathway from the stomach to the small intestine to avoid nutrient and caloric absorption. These operations produce more weight loss than restriction operations. In fact, patients who have bypass operations generally lose two-thirds of their excess weight within two years of the surgery. Gastric bypass is the favored bariatric surgery in the United States because it’s safer and has fewer complications than other weight loss surgeries.
Most people who have any type of weight loss surgery lose at least 50 percent to 60 percent of excess weight in the first 18 to 24 months after the procedure. Plus, many of the patients’ obesity-related conditions, such as diabetes or sleep apnea, improved after the surgery. Bariatric surgery also can provide long-term, consistent weight loss when accompanied with a few lifestyle changes.
As with any surgery, there are possible risks with weight loss surgery. A common risk of restrictive operations is vomiting when food is not chewed well and stretches the stomach size. Gastric bypass surgeries may cause “dumping syndrome,” whereby stomach contents move too quickly through the small intestine producing symptoms like nausea, weakness, sweating or diarrhea. There is often the potential for small, treatable complications such as abdominal hernias, gallstones and nutritional deficiencies after weight loss surgery.