Weight loss surgery: What are the options?

weight bandBeing overweight is a major cause of stress for those who find themselves in that predicament – and according to government statistics, that’s about two out of three Australians.

A Canstar Blue survey of adults who use weight loss (meal replacement) shakes in a bid to drop some kilos found:

  • 32% don’t have the confidence to apply for new jobs or promotions because they’re overweight
  • 28% don’t think they are taken seriously at work because they’re overweight
  • 41% find it hard to buy professional clothes because they’re overweight.

In addition, 65% of adults think other people judge them based on their appearance and 44% said that being overweight is the biggest cause of stress in their life.

So what do you do if you struggle to lose weight by ‘conventional’ methods – namely eating less and exercising more – or even by using those weight loss shakes? Surgery is usually only an option for the morbidly obese with related health problems. For those people, there are the following options:

Surgical weight loss options

Bariatric surgeries are surgeries designed to help people lose weight when they’re struggling with obesity. Most of these surgeries enable portion control by restricting the amount of food that the stomach can physically fit into it, so the patient feels “full” sooner. These surgeries can be successful in keeping the weight off long-term, when patients commit to eating a healthy diet and maintaining a regular exercise program.

Who is eligible for weight loss surgery?

Patients undertaking any form of surgery must understand the risks involved in a laparoscopic surgery and be dedicated to healthy eating habits and an exercise routine after it. According to Melbourne Bariatrics, patients must institute a daily diet of less than 1,000 calories.

The surgeon must also be satisfied that the patient represents an acceptable level of risk for operating, and that the patient has previously made reasonable attempts to lose weight using other techniques. Patients must be over 18-years-old, free of drug and alcohol addictions or uncontrolled psychological conditions, and their obesity must not be caused by endocrine issues (hormones).

For gastric banding, patients must have a BMI of 35 or higher, or a BMI higher than 30 with a major obesity-related disease such as Diabetes or Heart Disease. For gastric bypass and sleeve gastrectomy surgeries, patients must have a BMI of 40 or higher, or a BMI higher than 35 with a major obesity-related disease such as Diabetes or Heart Disease.

What is the Intragastic Balloon?

The Intragastic Balloon has been designed for patients who are not yet clinically obese, but need to lose 15-25 kilograms. It involves inserting a balloon through the mouth and into the stomach. The balloon is inflated, creating a space inside the stomach that is already “full”. This enables the patient to commit to a portion controlled diet and an exercise routine to lose the recommended weight. It does not require surgery and the balloon can be removed, so this is a low-risk, reversible option.

What is Lap-Band Gastric Banding surgery?

The Lap-Band gastric banding surgery involves fastening a band around the top of the stomach, which applies a constant, gentle pressure to the stomach. This makes a patient feel full after eating a small amount of food, so the impulse to over-eat is removed and patients are able to eat healthy regularly.

gastric band (1)It’s a keyhole surgery (laparoscopic surgery), so it is far safer and less invasive than other types of weight loss surgery. Because of this, the recovery time can be amazingly short – just a week for a patient to get back to work and other routines. However, the band does require re-adjustment every 4-6 weeks.

Gastric band surgery is a reversible procedure and carries the lowest risk of complications for surgical weight loss options because it does not alter the digestive process or patient’s anatomy.

The “lap-band” surgery was created by the Apollo Group in 1998, with the first clinical trials in 2001 and results published in 2002. The Apollo Group was an international think tank of world-renowned gastroenterologists and surgeons from Johns Hopkins, the Mayo Clinic, the Medical University of South Carolina, the University of Texas Galveston, and the Chinese University of Hong Kong.

Since 1994, over 800,000 people around the world have used Lap-Band surgery to lose weight, including around 95,000 Aussies. According to the Apollo Group, the average patient keeps off 70% of their excess weight for 2 years and 60% for 5 years, while other sources say patients can keep off 40-60% of excess weight for 10 years.

At the time of writing, certain obese patients may be able to access their superannuation funds early to cover the costs of the procedure, by applying to their super fund and to the Australia Prudential Regulation Authority (APRA).

What is Gastric Bypass surgery?

Gastric bypass surgery is a more invasive form of surgery that changes the natural digestion process, by attaching a small gastric pouch to the small intestine and bypassing one metre of intestine. The effect of gastric bypass surgery is that food passes through the digestive process faster, which significantly reduces meal sizes.

In this method, sugar or fat is prevented from affecting the body by the stomach “dumping” instead of absorbing them. This “dumping” can get rid of essential vitamins and nutrients as well in some patients, leading to deficiencies such as anaemia.

Gastric bypass is highly successful in creating the maximum amount of weight loss with up to 80% of excess weight lost, and creates rapid initial weight loss, while still being a reversible procedure. It is also proven to improve or resolve Type 2 Diabetes issues in obese patients. The recovery time is longer than for lap-band, at 2-4 weeks.

What is Sleeve Gastrectomy surgery?

A Sleeve Gastrectomy involves surgically removing most of the stomach, to make the stomach itself smaller in size. This is a drastic and non-reversible solution for enabling a patient to eat a portion controlled diet. Around 65-70% of excess weight can be lost using this surgery.

A sleeve gastrectomy was first performed in 1988, and longitudinal studies are needed to prove the long-term weight loss results. Surgical techniques have been greatly improved to reduce the rate of complications, and this surgery is now performed laparoscopically, making it less invasive.

It’s still a laparoscopic surgery, but unlike the other procedures mentioned in this article, it is not reversible. The recovery time is also longer than for lap-band, at 2-4 weeks. The sleeve gastrectomy is also known as the duodenal switch procedure, and non-adjustable gastroplasty.

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