Thursday, June 13, 2013

Three types of weight loss surgery - A lay person's perspective

Keep in mind that I am not in the medical profession and in fact am a bit squeamish. This is all from my perspective.

There are three common weight loss surgeries these days, lap band, gastric bypass, and gastric sleeve.  Here is a brief description of each with pros and cons. If I was more blog literate, I could post illustrations, but let's face it, I'm not.

The lap band is basically a big rubber band that is filled with liquid that is inserted around your stomach. The more liquid, the tighter it squeezes your stomach.  You can adjust depending on how much or little you want to be able to eat.  I have heard of people abusing this by expanding their band so they can eat more on vacation.  This surgery used to be very desirable, but a lot of surgeons don't do them anymore.  There have been a lot of problems with the bands getting clogged up and/or slipping down the stomach and causing problems.  Studies also show that lap band patients are actually hungrier than non-surgical people.  So basically you are hungrier than before and can't eat much.  A lot of band patients have their band removed for various reasons.  The band patients average a loss of about 35% of their extra weight in the first year.  Vitamins should be taken because of limited food intake.
Pros: Reversible, least invasive. Cons: Still hungry, problems, least weight loss success

In a gastric bypass, the doctors form a small pouch in your stomach and re-route part your intestines to the pouch.  With a gastric bypass, part of the digestive process is bypassed.  The part of the stomach that isn't being used contains hunger hormones so you aren't hungry.  The pouch is small and can't hold much food.  Some patients report that their tastes change.  I think it has something to do with how the pouch goes straight to the intestines.  Because the process of digesting sugar has changed, bypass patients can have what is called dumping syndrome.  Basically if they eat a high sugar or high fat meal, they may get light headed and their heart may race.  Then the food is "dumped", resulting in a very quick run to the bathroom.  Because the way sugar is digested has changed, this surgery reverses diabetes in over 85% of patients.  In fact, studies are being done to perform the surgery without the stomach pouch in normal weight patients to reverse diabetes.  The way they do this surgery has changed from the early years.  Apparently in the beginning, too much of the digestive process was bypassed resulting in malnutrition.  The way this procedure is performed has changed.  There is still malabsorption, but the surgery is much safer.  Bypass patients can expect to lose 70% of their extra weight in the first year.  Vitamins should be taken because of limited food intake. 
Pros: Reversible, most weight loss, not hungry, can reverse diabetes.  Cons: Most invasive, dumping syndrome, taste changes

The surgery I opted for is a gastric sleeve which is kind of in between the lap band and gastric bypass.  Basically, doctors lop off 85% of the stomach and sew it back up.  The stomach is then a small tube about the size of a banana.  The digestive process is not disrupted.  The sleeve started as a pre-surgery to the bypass in patients that were very large or too at risk for the bypass.  The sleeve would help the patients lose enough weight so that the bypass surgery could then be done.  Studies found that a lot of patients were so successful in losing weight with the sleeve that they opted not to have further surgery.  The part of the stomach that is removed has the hunger hormones so you are not hungry.  The stomach is small and can't hold much food.  No studies have been done to see how many diabetics are in remission from this surgery, but it does cure diabetes in a lot of cases.  This is thought to be due to weight loss and not the digestive process like it is for the bypass.  Sleeve patients can expect to lose 60% of their extra weight in the first year. Vitamins should be taken because of limited food intake.

Pros: Not hungry, normal digestion, might reverse diabetes.  Cons: Not reversible.

No comments:

Post a Comment