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Bariatric Surgery

Bariatric surgery is the process of surgically making the stomach much smaller so that the patient feels fuller and can not overeat. It comes with risks, but is very effective at getting people to lose the weight.

There are various ways to do the procedure. For example, you can get a gastric bypass, gastric banding, sleeve gastrectomy, or biliopancreatic diversion with duodenal switch.

Bariatric surgery is for the morbidly obese. You are classified as morbidly obese if your BMI is over 40 or if you are 100 pounds overweight. Some people with complications, like heart disease and hypertension, can be classified as morbidly obese with a BMI of 35. These conditions are referred to as co-morbid conditions.

How to Qualify

You can't just be a little overweight. You must fall into the morbidly obese category. You must have tried other weight loss methods and failed. You must be morbidly obese for five years or more. You can't have major untreated psychiatric problems. You can't be an alcoholic. And finally, you should be between the ages of 18-65.

The reasons for all the qualifications is that surgery is risky and it shouldn't be taken lightly. It should only be done as a last resort to help an individual to become much more healthy.

Gastric Bypass

In Gastric bypass surgery, the stomach is made severely smaller. The top of the stomach is formed into a pouch and then stapled to the middle of the small intestine. Since part of the intestine is removed, it also prevents the person from absorbing as many calories.

There can be complications. The staples may come out, there may be infections, nutrient deficiencies and more.


Sleeve Gastrectomy

Sleeve Gastrectomy is done laproscopically through a small keyhole incision. The stomach is cut down by 70%. The size of the stomach, after surgery, is about two ounces.

Sleeve Gastrectomy is preferred for patients that are too obese to get the gastric bypass. Some patients will undergo sleeve gastrectomy and then get the gastric bypass after they have lost enough weight.

Other patients prefer the sleeve gastrectomy because a foreign body is not left inside the person. The other advantage is there are less complications. One of the main reasons for less complications is that the stomach is left intact to the esophagus and the small intestine.

Complications of sleeve gastrectomy are stomach leakage, discomfort from overeating, and the stomach stretching out to a larger size.

Gastric Banding or Lap Band

The Lap Band is a marvelous piece of engineering. It is a silicone device that wraps around the upper part of the stomach and squeezes it to a smaller shape. This bottleneck effectively creates a smaller stomach that will feel fuller. There are many benefits to laproscopic bands over gastric bypass.

Lap band surgery is safer. You do not need to cut the stomach or the intestines. A surgeon simply inserts a band around the upper part of the stomach through a laproscope.

The other good part about the Lap Band is that it can continually be adjusted. The band has a control device that is located just under the skin in the abdomen. A doctor can add saline or take saline solution away and that will increase or decrease the size of the stomach. This makes it more of a long term technique.

Lap band surgery does not lose weight as quickly as gastric bypass. The important thing is that over a three year period lap band and gastric bypass patients are pretty much even. Here is a good link to see how the procedure works. http://www.lapband.com/get_informed/about_lapband/how_it_works/details/

Biliopancreatic Diversion with Duodenal Switch

Duodenal Switch surgery is the most sure surgery to lose weight. It is often recommended for those that can't lose weight through gastric bypass and lap band surgery. Patients will pretty much be guaranteed to lose 85% of their weight.

Duodenal switch surgery is performed by cutting the stomach down by about 85%. Then, the small intestine is divided. Food is then rerouted to bypasse much of the small intestine. This makes it so that there is less time to absorb calories and nutrients. The desired effect of the reroute is malabsorption of calories.

Malabsorption has a significant drawback. You don't absorb nutrients. That is why many physicians will not perform the surgery. They are worried about the long term malabsorption effects. Some physicians refuse to do it and others think that it is still in the experimental stage since the outcome of malabsorption is uncertain. Anyone who undergoes this surgery, should be careful to take supplements to make sure they are getting enough vitamins and minerals.

The absolute best part about Duodenal Switch surgery is that it has the best success rate for losing the most weight and keeping it off. Rerouting the duodenum has been a great way to help people from regaining the weight. It is much harder to gain weight when your body won't absorb calories well.

The complications of the surgery are higher than other bariatric forms. There is an increased chance of chronic diarrhea, death, duodenal leakage, and bowel obstruction, to name a few. Some patients are still able to absorb carbohydrates well and that can lead to weight gain. There is truly no “silver bullet” weight loss plan for everyone.







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