Bariatric Surgery Options

Learn about gastric bypass and other bariatric surgery procedures at the Bariatric Skinny. Find comprehensive article and video content about the Roux-en-Y gastric bypass, Lap-Band – Gastric-Band, gastric sleeve and other weight loss surgery options.

Bariatric Surgery Overview

The bariatric branch of medicine offers a variety of surgical procedures for controlling and treating obesity. Often referred to as weight loss surgery or obesity surgery, these operations drastically reduce the size of the stomach by removing a portion or by implanting a banding device. These techniques alter the digestive system to limit how much can be eaten, to reduce the absorption of nutrients, or both. The two types of bariatric surgery most commonly employed are gastric banding and gastric bypass surgery.

Most medical guidelines only recommend bariatric surgery for patients with a BMI of 40 or greater after attempting, and failing, a strict diet and exercise regimen. However, increasingly, bariatric surgery is being used to manage Type 2 diabetes for eligible patients with a BMI between 30 and 35. Patients who undergo surgical treatment will lose weight quickly, but they must also commit to a lifetime of healthy eating and regular exercise to maintain the weight loss surgery improvements.

Types of Bariatric Procedures

Restrictive Bariatric Procedures: Gastric Sleeve and Gastric Banding / Lap-Band Surgery

Restrictive procedures limit the stomach’s volume with a gastric band or gastric sleeve. With gastric banding, an inflatable silicone device is placed around the upper part of the stomach to create a small pouch. The new pouch holds ½ cup of food as opposed to 6 cups of food in a normal stomach. This laparoscopic approach requires a small incision in the abdominal wall to create a small tunnel behind the stomach for inserting, and locking in, a band. The gastric band, or lap-band, restricts food intake, reduces appetite, and slows digestion. Patients feel fuller faster and learn to eat smaller portions. Gastric banding is the least invasive procedure. Since no part of the stomach is removed and the intestines are not re- routed, patients continue to absorb foods normally after implementation. With gastric sleeving, more than half of the stomach is removed leaving a tube or banana-like shape. Surgical staples are used to close the new stomach. This irreversible surgery requires that patients make major lifelong changes to their diet habits including eating only smaller portions and healthy, vitamin-rich foods.

Malabsorptive Bariatric Procedures: Biliopancreatic Diversion / Duodenal Switch

Malabsorptive procedures change how food nutrients are absorbed during digestion. One type of malabsorptive surgery is biliopancreatic diversion with duodenal switch where approximately 70% of the stomach is removed along the greater curvature. A lengthy part of the small intestine is then rerouted, creating two separate paths that lead to one common channel. The shorter path takes food from the stomach to the common channel. The longer path takes bile from the liver to the common channel. In the common channel, the food contents mix with the bile before heading into the large intestine. This reduces the amount of time calories and fat are able to be captured and absorbed in the small intestine.

Mixed Bariatric Procedures: Gastric Bypass Surgery

Gastric bypass surgery combines malabsortive and restrictive techniques simultaneously. This type of surgery makes the stomach smaller and causes food to bypass part of the small intestine. In normal digestion, food passes through the stomach, enters the small intestine where nutrients are absorbed, before passing into the large intestine. In Roux-en-Y gastric bypass, a small stomach pouch is created in the upper portion of the stomach and is connected directly to the middle portion of the small intestine, bypassing the larger portion of the stomach and the first portion of the small intestine. This surgery reduces the amount of foods patients are able to eat and causes them to feel full more quickly. Total food intake and nutrient absorbance are dramatically reduced. Patients must follow doctors’ orders for what, when, and how often to eat. Calcium, iron, protein, and multi-vitamin supplements also become very important to maintain adequate nutrition.

More on Bariatric Surgery

Kresha's Successful Gastric Bypass Surgery

One-Year Later She is 119 lbs Lighter!

In this video, Kresha Artis discusses her weight loss surgery experience one year after her procedure.  Kresha had successful gastric bypass surgery that has resulted in her losing 119 lbs.  She credits much of her success to the diet and exercise-related lifestyle changes she made prior to surgery which she continued after her procedure. Kresha encourages people that are considering bariatric surgery to also make changes in how they eat and their activity level in conjuction with the surgery.  She watches what she eats and exercises regularly and the results are obvious when…

From the Bariatric Surgery Journals

  • Sick of it posted by jlbundy
    I am so sick of trying to keep track of calories, protein, fat and fiber! I just want to eat healthy and not think about it. I had gastric bypass done 10/8/2008. I almost got down to my goal weight. I was playing with 5lbs for the last 4 years, but now I am gaining. I know it is my fault. I don't use my tool. I drink with meals and I eat too many starchy carbs and not enough protein....

From the Message Boards

  • surgery posted by stacyannette
    I don't understand this surgery I have been suffer every since I had this surgery. I can't eat always throwing and follow everything the doctor has told me. I think that they need to give more classes on how some people can end up really sick doing this surgery. That it may help you lose weight but you also lose so many others thing also.

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