Bariatric Surgery Alternatives

Bariatric Surgery

Obesity is growing to epidemic proportions in the U.S. and industrialized nations around the world. Obesity and obesity related diseases have become the second leading cause of death in the U.S... In the U.S. alone there are over 65 million Americans with BMI’s (Body Mass Index) over 30, and of these there are 15 million Americans with BMI’s over 40, otherwise known as morbidly obese, or 100 pounds over target body weight. Obesity can be responsible for severe health complications or co-morbidities. These can include Type II diabetes, hypertension, stroke, heart disease, infertility, arthritis in weight bearing joints, gastroesophageal reflux disease, and some forms of cancer. Many individuals suffering from obesity have tried dieting, drug therapies, exercise, and psychotherapy, and are still unsuccessful in losing weight. In some patients Bariatric surgery may be the only alternative.

Bariatric surgery was originally pioneered by Drs. Mason and Ito in the 1960’s. Over the years there have been multiple variations to the original surgical approaches pioneered by Dr. Mason. Today gastric bypass with roux-en-y is the most commonly performed weight loss procedure and is approximately 65% effective in losing target weight. Early procedures were performed through large mid-line open incisions and were considered painful with slow recovery periods of up to two months following surgery. In 1995, Drs. Whitgrove and Clarke performed the first laparoscopic gastric bypass with roux-en-y procedures which radically decreased post operative pain and allowed for quicker convalescence and return to normal activity. Today approximately 200,000 people per year undergo this procedure in the U.S. In some cases surgery may be the only option for losing life threatening weight.

While considered highly effective, gastric bypass with roux-en-y involves resecting a large portion of the stomach and re-routing the digestive tract to aid in weight loss. In 2001 the lap band was introduced in the U.S. which offered a simpler less invasive procedure that is considered fully reversible. The lap band, in the simplest terms is a band that is surgically placed around the top of the stomach and tightened to create a small pouch which limits the patient’s food intake resulting in weight loss. The lap band has grown in popularity in recent years and is now the leading surgical treatment for obesity. Patients considering Bariatric surgery should consult a surgeon that offers both procedures to understand what surgical solution best meets their needs.

With the advent of NOTES, or Natural Orifice Translumenal Endoscopic Surgery (performing surgical procedures through natural orifices such as the mouth), thought leading surgeons are pioneering new endoluminal procedures which require no skin incisions. This approach was originally conceived in 2005 by Drs. Chung and Kantsevoy of the Apollo Group. They published their experiences in placing an internal lap band which mimicked the lap band and resulted in acceptable weight loss. Others have explored endolumenal gastric partitioning, intragastric balloons and more sophisticated technologies such as placement of pacing or blocking devices which regulate vagus nerve function. Ultimately, experts believe in the near future patients will have outpatient endoluminal less invasive options to consider, which will provide acceptable weight loss in many patients while reducing the risks of surgery and decreasing recovery time following Bariatric procedures.

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Why Bariatric Surgery Is Not The Quick Fix Solution For Permanent Weight Loss

Bariatric surgical procedures are major gastrointestinal operations. It is done by securing or sealing off the stomach to reduce the amount of food one can eat, then rearrange the small intestine to reduce the calories the bodies can absorb. However it is not a quick fix method for permanent weight loss. Bariatric surgical procedures are only considered for people with severe obesity.

Conventional treatments such as diet, exercise and lifestyle counseling are cited to be relatively ineffective ways of losing weight. Many medical experts support surgical methods like bariatric surgery to help reduce morbid obesity. Since bariatric surgery for obesity has associated risks and long-term consequences, individuals considering this surgical procedure must discuss risks and possible benefits with their doctor.

Patients achieve effective weight loss after undergoing bariatric surgery for obesity. An ample number of patients with disorders like diabetes, hyperlipidemia, hypertension, and obstructive sleep apnea experienced complete improvement after bariatric surgery.

Bariatric surgery for obesity is not an instant solution for weight loss. Plus, it is not an easy option for people with obesity conditions. Bariatric surgery completely forces patients to change their eating habits radically. Bariatric surgery's after effect makes patients very ill if they overeat. In addition, patients remain at a lifelong risk of nutritional deficiencies after undergoing a bariatric surgery.

It is imperative for patients to abide strictly to the proper dietary and exercise guidelines instructed to them. They must have realistic and informed expectations about the impact of surgery not only on their weight, but on their body shape and eating habits as well. After bariatric surgery for obesity, patients should have long-term follow up with experienced doctors. Lifelong vitamin supplementation is essential to avoid life-threatening complications.

Unfortunately, many bariatric patients think that having surgery is going to solve their obesity problem without further effort. Nothing is further from the truth! It is only after having lap band or gastric bypass that the struggle begins. To begin with, it is vital for all patients to follow their post-operative dietary guidelines, about what foods to eat, how fast to eat and what types of food to avoid.

In addition, it is vital to start taking exercise and gradually raise your fitness levels in order to recover mobility and health. Lastly, patients who undergo bypass and some restrictive surgeries are required to follow a lifelong plan of nutritional supplements to maintain adequate intake of vitamins and minerals. No bariatric surgeon can guarantee weight reduction after any type of bypass or stomach banding operation without proper dietary and exercise compliance by the patient.

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