Bariatric Surgery

For most people who are trying to lose some weight, the advice remains the same: Diet and exercise, diet and exercise. It can get a bit dull hearing it over and over again, but these lifestyle changes are generally the simplest and most effective way to manage your weight and your health more generally.

They won’t work for everyone, though. In cases where you’ve tried everything else and the obesity and its comorbidities are particularly severe, bariatric surgery may be recommended. Most research suggests it can have a very positive long-term impact, but as with any surgery, there can be complications.

Bariatric surgery comes in a few forms, but there are three main routes it can take. It can try to restrict how much you are physically capable of eating (such as by making your stomach smaller), attempt to reduce how much you take in from the food (such as by shortening the intestine so there is less opportunity for nutrient absorption) or interfere with the hormones and signaling that tell your body when it’s hungry or full.

One of the most common types of bariatric surgery is sleeve gastronomy, also known as a gastric sleeve. Around 85% of the stomach is removed, leaving just 15% behind. The name comes from the shape of the stomach after the procedure. It looks like a long, thin tube, curving like a banana. In addition to reducing stomach capacity, it may also change hormone levels. The procedure is irreversible but has less risk of complications than other surgeries.

Those other surgeries include the Roux-en-Y gastric bypass (RYGB). This involves dividing the stomach (therefore shrinking its capacity), rearranging the small intestine and basically “resetting” your leptin and ghrelin, the hormones responsible for satiety and hunger. Then there are less-common bariatric surgeries, such as biliopancreatic diversion with duodenal switch or vertical banded gastroplasty (stomach stapling). Gastric bands and intragastric balloons involve inserting a physical barrier in the stomach.

After surgery, there will be strict restrictions on what you can eat as well as other rules about postoperative care. Risks specific to bariatric surgery (as opposed to surgery in general) include ulcers, kidney problems and so-called “dumping syndrome.”

If you are in the category of people who are recommended for bariatric surgery, it could improve your quality of life, but it is still something you need to consider carefully.

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