Types of weight loss surgery: Which is right for you?

If you are struggling with obesity after trying diets and exercise programs, please know that you are not alone. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), nearly one in three adults are overweight, and more than two in five adults have obesity. More than 40% of adults in the U.S. have a body mass index (BMI) of more than 30, which meets the definition of obesity, and nearly 10% of Americans have severe obesity (BMI of more than 40).

Not all people with obesity have other health problems, but they do have a higher risk of developing heart disease, type 2 diabetes, arthritis and some types of cancer. If you are experiencing obesity, losing significant weight may lower your risk of those diseases or lessen their severity. If you already have type 2 diabetes, losing weight can reduce your need for medications and even reverse the condition.

Who is a good candidate for weight loss surgery?

It is difficult for some people with obesity to achieve significant weight loss with diet and exercise alone. Weight loss (bariatric) surgery may be a good choice in these circumstances, especially if you have other health conditions that are made worse by obesity.

According to the NIDDK, weight loss surgery may be an option for adults who have:

• Severe obesity (BMI more than 40)
• A BMI of 35 or more and health problems such as type 2 diabetes, heart disease, high cholesterol or sleep apnea
• BMI of 30 or more with type 2 diabetes that doesn't respond to medication or lifestyle changes

People who get weight loss surgery can lose 30% to 75% of their excess body weight, depending on the surgical method and how well they are able to follow diet and exercise recommendations before and after surgery.

In recent years, weight loss surgery has become safer, and studies show that it can improve health and well-being for many people. However, it is not for everyone, and many factors go into deciding whether to try it and which type of weight loss surgery to try. People who undergo weight loss surgery still need to stay active and watch what they eat and drink — in fact, they may have to be more careful than ever.

Find out if you are a candidate for weight loss surgery by taking our free, confidential weight loss surgery health risk assessment. Your results will be emailed to you, and there is no further obligation.

Types of weight loss surgery

There are several types of weight loss surgery, and each has different risks and benefits to consider. Here are two of the most common bariatric procedures:

Gastric bypass surgery

In gastric bypass surgery, the surgeon creates a small pouch with the top of the stomach and attaches it to the small intestine. The new smaller stomach helps you feel full faster, and since food passes through only part of the digestive system, the body absorbs fewer calories and nutrients. The surgery also results in changes in appetite and how the body breaks down food.

This surgery is usually done through a small incision with a laparoscope, which is a long, thin instrument. The procedure is more complex than some others, and patients have a higher risk of complications and nutrient deficiencies afterward. However, it has a high rate of successful weight loss. On average, people lose about two-thirds to three-quarters of their excess weight. For these reasons, bariatric surgeons often recommend gastric bypasses to patients with BMIs over 40. If a patient has a BMI over 35, along with significant health issues, a gastric bypass could be recommended to them.

Sleeve gastrectomy

In a sleeve gastrectomy, the surgeon removes 80% of the stomach, specifically the part of the stomach that produces the hormones that make you feel hungry. After surgery, people feel less hungry and feel full faster. It is a simpler procedure than gastric bypass, with fewer complications and a faster recovery time. However, some people may experience reflux or heartburn. Weight loss tends to be a bit lower than it would be with gastric bypass surgery. For these reasons, a sleeve gastrectomy is commonly recommended to patients who have BMIs between 35 to 50. This procedure is not commonly recommended to patients who have severe diabetes or gastric-esophageal reflux because this surgery can worsen it.

Other considerations for weight loss surgery

In addition to looking at your health profile and the potential risks and benefits of the surgical procedure, there are a few other important aspects of this decision to consider. Health insurance companies have different guidelines about which types of weight loss surgery they'll cover and under what circumstances. Some policies may require patients to try a weight management program and see a behavioral health provider before approving weight loss surgery.

Choosing weight loss surgery is not an easy answer or a magic bullet. It involves making a commitment to lifelong changes in eating and physical activity patterns. If you feel weight loss surgery is the right choice for you and you are ready to commit to this option, ask a doctor about your weight loss surgery options.

If you are interested in weight loss surgery, find out more about Portsmouth Regional Hospital's bariatric surgical services or schedule an appointment with Dr. Bernard Benedetto.