For over 50 years doctors have been researching and performing Bariatric Surgeries. Bariatric deals with the causes, treatment, and prevention of obesity through weight loss surgeries. Weight loss surgeries are generally performed as malabsorptive procedures which reduce absorption of calories, proteins, and nutrients or restrictive operations that decrease food intake. These surgeries are important because obesity affects millions of people in the United States. In a report from 2016 statistics show that 36.5% of American adults are obese compared to 14% in the mid 1970’s (procon.org). Obesity has been known to cause high blood pressure, heart disease, cause stroke, type 2 diabetes, and certain cancers. This is why bariatric research and surgeries like Roux-En Y Gastric Bypass better known as gastric bypass and Sleeve Gastrectomy better known as gastric sleeve are so beneficial because they help decrease these issues in people and sometimes make them go away. Weight loss surgery is not a quick fix but a stepping stone in the right direction to a healthy life style change and here to help.
This report will benefit those who are obese and considering bariatric surgery, also those wanting more insight into the process of weight loss surgery. Providing information for families of people considering the surgery and just show we are doing something to help with long term weight loss. Also this will give background for people to determine is weight loss surgery the best option for me? People must keep in mind that you can’t just have weight loss surgeries performed off a basic request. Know that these procedures typically cost around $9,000 to $15,000 depending on the type and where you are located. Some insurance companies will cover the surgery and some will not. Medicare and Medicaid programs cover three types of surgery, the gastric bypass, gastric sleeve, and gastric band. I’ll be discussing the gastric bypass and the gastric sleeve in more details because these are two of the main weight loss surgeries performed today.
Before one can even be considered a candidate for any weight loss surgeries you must meet some requirements. It was determined by the National Institute of Health that a body mass index (BMI) of 35% or higher is considered morbidly obese and doctors say this qualifies you for weight loss surgery or if you had a disease which could be improved by weight loss. Also other non-surgical treatments should have failed to give and maintain beneficial weight loss for 6 months. You will be required to have physical exams, blood test, ultrasounds of organs, and nutritional counseling. Doctors will also look at if patients have other health issues such as diabetes, high blood pressure, or heart conditions. Many different factors can affect a person’s safety when going in to have these weight loss surgeries performed. I personally have looked into weight loss surgery and was informed that the process leading up to the surgery can take up to a year to complete the pre op process. More research has been done over the years and doctors know what to look at overall besides just getting weight loss results. Another thing to consider is you will be required to undergo psychological counseling and classes to teach you about the weight loss process. Before anything can be done doctors must be sure you are ready to make this life style change so patients can have long term results. Even though you will be able to lose the weight after surgery if you don’t work out and eat correct to maintain the process you could gain weight back.
With that being said, here is some information about Bariatric Surgeries. Bariatric Surgery “is the only treatment that produces durable long-term weight loss” (S.S Jaunoo, Southall, P.J). Bariatric surgery was first tried in the 1950’s starting with a procedure called Jejunocolic bypass and Jejunoileal bypass. These procedures produced great weight loss results however, complications like liver failure, kidney failure, and some immune complex disease occurred which is why surgeons stopped these procedures. After these procedures surgeons knew what to look for and came up with other surgeries like gastric bypass in 1960’s, the Biliopancreatic Diversion in 1970’s, BPD with Duodenal Switch in 1980s and gastric sleeve in the late 1980’s. The new procedures kept the same benefits as the first two surgeries just corrected the complications.
Gastric bypass is a surgery which combines restriction and malabsorption technology, where surgeons create a small pouch and bypass that stops patient from absorbing everything they eat. This surgery can however be reversed unlike the gastric sleeve. Depending on the size of patient this can be done laparoscopically with laser or opened up by knife. This procedure was first performed in 1966 on a 50 year old woman with a BMI of 43kg and had hernia issues. Over a course of 9 months after surgery she lost 16kg of weight and her hernia was repaired. Surgeons continued to use the gastric bypass because they liked the results and over time just started modifying it to improve weight loss, avoid weight regain, or to lessen the morbidity, mortality, or detrimental side effects ( Baker, Matthew). People typically lose 70% of body weight over a course of two years (Stegemann,Obesity Action Coalition 2012) producing long term results. The gastric sleeve is a simpler procedure that is completely restrictive. The stomach is divided in this procedure and reduced down to about 25%, and is a non- reversible surgery. This procedure can also be done laparoscopic or opened with knife. In 1988 the first open sleeve gastrectomy was performed by Doug Hess in Ohio. He performed the procedure on 20 patients who had follow ups from 1 month to 16 months and seen weight results from 15 pounds in 1st month to 55 pounds by 16th month. Those who are at higher with having the bariatric surgery sleeve is recommended first depending on health situation. Gastric sleeve is a procedure which can be performed in a two part procedure if needed. First stage is performed than depending if patient is happy with results from surgery they can go back in and have either the gastric bypass performed or duodenal switch which is another type of weight lost surgery.
Taking a look at the gastric bypass and the gastric sleeve much research has been done to back these two surgeries up. At the University of Michigan there was a study ran on both surgeries from 2008 through 2013. Showing minor complications on both procedures, and similar results. Gastric bypass had more minor complications such as infections and hemorrhaging which is not that bad considering some of the other risks with these surgeries can be anastomotic leaks, acute dilatation, delayed gastric emptying, incisional hernia’s , and dumping syndrome. You may see some of these complications more with gastric bypass than with gastric sleeve. Also discovered with the study was that more weight loss was observed with gastric bypass, a decrease in blood pressure with both surgeries, and no major complications occurred which couldn’t be corrected. Unlike in the beginning of bariatric surgeries complications were higher and studies such as these can prove we are in the right direction with weight loss surgery.
I will not say weight loss surgery is for everyone but I do believe it is something one should consider when dealing with obesity. Research shows that it has been helping obese patients reach healthy weights, and lower cholesterol, blood pressure, and improve diabetes. Yes there are some complications and risk which is why we must be sure to do all the needed research before making any decisions. Understand that weight loss surgery is not a quick fix and you will have to work in order to maintain a healthy life style. We may have over 50 years research with gastric bypass and many years of research with gastric sleeve but you can never have too much information.
Do what is right for you and remember if you want to get healthier, and possibly extend your life than bariatric may be for you.
Baker, Matthew T. The history and evolution of bariatric surgical procedures. ” Surgical Clinics of North America 91.6(2011). pp:1181-1201
Jossart, Gregg H., and Gary Anthone ” The History of Sleeve Gastrectomy”. Bariatric Times 7.2 (2010), pp. 9-10
Jaunoo S.S and P.J Southall. ” Bariatric Surgery” International Journal of Surgery 8.2(2010)pp. 86-89
ProCon.org ” Obesity ProCon org” ProCon.org 27 June,2017
Zieve, David MD, MHA, Ogilvie, Isla, PHD., A.D.A m Editorial Team. ” Gastric Bypass Surgery”National Library of Medicine 8/5/16 http://www.medlineplus.gov
Lager, Corey J; et al. “Roux-En Y gastric bypass vs sleeve gastrectomy: balancing the risks of surgery with the benefits of weight loss” obesity surgery 27.1 (2017)