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Diet and Weight Loss

What Are the Different Types of Surgery for Obesity?

Summary & Participants

Many obese people are turning to stomach surgery to help them get on the road to a healthier life. Learn about the different procedures doctors are performing for weight loss.

Medically Reviewed On: July 06, 2008

Webcast Transcript

JEFFREY ALLEN, MD: The gastric bypass is a bit of a hybrid. It’s a combination of a restrictive procedure; the stomach is stapled in a very small pouch about the size of an egg or less is created. And then a portion of the small intestine is bypassed, and so that portion of the small intestine is not involved in digestion. It’s not involved in absorption.

ANNOUNCER: If you are considering a weight reduction surgery, it is important to understand the differences between restrictive and malabsorptive procedures.

JEFFREY ALLEN, MD: Restrictive operations are nice because of a couple reasons. First of all, the concern about vitamin and mineral deficiencies are very low. Furthermore, there’s no rerouting of the intestine. There’s less permanent damage done to the inside of the body.

CHRISTINE REN, MD: The downside of restrictive operations is that they absorb all their calories. So, therefore, if one is drinking high-calorie drinks such as juices or regular soda or milkshakes, all of those calories are being absorbed and, therefore, the person will not lose that much weight.

The upside or the advantage of malabsorptive operations is that there is a dramatic weight loss and the individual can really eat a larger portion of food.

However, the downside of this operation is that, because they're excreting almost all of their food, then also they're excreting a lot of their nutrients and their vitamins. And so they have to take up to fifteen pills a day in terms of vitamins in order to prevent any nutritional problems.

ANNOUNCER: Data suggests that the success rates of all weight loss operations are similar long term.

BRAD WATKINS, MD: Regardless of the operation, patients tend to lose between 50 to 75 percent of their excess weight at two years after surgery. If you look at average results, bypass patients tend to lose more pounds in the first year than band patients. But two or three years down the road, all of these operations have exactly the same average results.

ANNOUNCER: However, weight loss surgery is major surgery and comes with risks. With the banding procedure, these risks commonly include a slipping of the band, erosion of the band into the stomach, and infection.

With gastric bypass, risks can include leaks and bleeding at the location of staples, infection, and what’s known as “dumping syndrome.” This occurs when foods high in sugar are passed through the intestines too rapidly, causing abdominal pain, bloating, weakness, sweating, nausea, and sometimes diarrhea. However, dumping syndrome can be avoided by following a proper diet.

With either type of surgery, nausea and vomiting can occur if meals are too large or if they are eaten too quickly.

BRAD WATKINS, MD: Most commonly, when a patient chooses a restrictive operation such as LAP-BAND® over a gastric bypass, they’re mostly doing that because of the difference in the risk between the two procedures. A purely restrictive operation such as a gastric band is far less risky than a gastric bypass: lower death rate, lower rate of severe complications, things like that.

LAP-BAND® patients tend to lose the weight slowly and steadily and reach the average results of a gastric bypass after two or three years. The band is adjustable; the bypass is not adjustable. The band is reversible; the gastric bypass is irreversible.

ANNOUNCER: Although chances of success with weight loss surgery are high, patients should know there is no guarantee. Additionally, there are many things patients need to do after surgery to keep the weight off, including adopting a healthy diet, exercising regularly, attending support groups, if necessary, and meeting regularly with your surgeon for follow-up consultation.

Still, weight loss surgery is currently the most effective way for morbidly obese people to lose the weight and keep it off. And the first step for anyone interested n weight loss surgery is to contact you doctor for help in finding a surgeon.

CHRISTINE REN, MD: If a person wants to have bariatric surgery, they really should treat it like everything else. Go someplace to someone who's done a lot of them, who has experience, because the success and the rate of complications after surgery really are dependent on the experience of the surgeon and the experience of the hospital and the hospital staff.

Bariatric surgery is an amazing treatment for this population of people. It provides tremendous improvements in quality of life. There's no other happier person than a former morbidly obese person.

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