What About Weight Loss Surgery?

Diet and exercise are the preferred twin partner methods for losing weight and excess body fat. A proper diet and age-appropriate, regular exercise will help almost anyone stay fit and in the correct weight range.

But, unfortunately for some, other methods are sometimes needed. Whether through long-term poor development of willpower, genetic disposition, disease or other factors, maintaining the proper weight for the obese sometimes requires outside assistance.

Fad diets rarely work, and almost never for very long. Some nutritional supplements and other compounds can help to a degree. But for many in this situation, weight loss surgery is the only hope.

There are many forms of surgery these days and all have pros and cons. The most important criteria are effectiveness, risk and side effects.

Surgical techniques have evolved over the past few decades, and most are effective, in the sense that they do typically lead to substantial weight loss. That loss comes about usually as the result of restricted caloric intake by eating less or by absorbing less of the food that is eaten.

One of the earliest forms was gastric bypass surgery. All or part of the stomach was removed and the digestive system reconnected. Originally extremely dangerous, it has evolved but still carries substantial risks. It is no longer the preferred method. Patients who undergo the procedure have to take supplements forever after and the risk of disease and nutritional deficiencies remains high.

Stomach stapling is one technique that has been around for many years now. Initially highly dangerous, it has become much safer in the past 10 years. There are still substantial risks, however, as with any major surgery.

The procedure consists of opening the patient and clamping portions of the stomach with specialized surgical staples. Newer methods sometimes make possible laparoscopy, in which a small hole is created through which the surgeon works, but the patient isn't opened up.

There are risks of bleeding, though small. Patients can become ill if they attempt to eat more than the recommended amount. They may also suffer from nutritional deficiencies that can be lifelong, requiring supplements.

The net effect is to create a smaller stomach, leading to a more rapid feeling of fullness. The patient simply eats less and therefore takes in fewer calories. The body turns to stored fat for energy and the result is less fat and lower weight.

A newer form involves installing an adjustable Lap Band around the stomach. This eliminates the need to puncture the stomach and makes it possible for the physician to adjust the effect as the patient loses weight.

Generally safe, the procedure can be done on an outpatient basis. Most consider it a minor inconvenience, though like any medical procedure it's expensive and insurance companies increasingly won't pay for it. The band itself is not painful.

Patients typically experience rapid weight loss, but at the same time (as fat comes out of adipose tissue) many hormonal changes take place. Close, regular medical observation is important for the success of the procedure and the health of the patient.

There are dozens of names for the various procedures, Biliopancreatic Diversion, Vertical Banded Gastroplasty, Adjustable gastric band, sleeve gastrectomy (with or without Duodenal Switch), Roux-en-Y gastric bypass and others. All are termed bariatric surgery.

But whichever procedure an individual considers, careful thought should be given to weighing the risks and benefits. For many, a commitment to long-term dietary and lifestyle changes is a better option. For those who believe surgery is the best option, consulting with an experienced physician is essential.