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Surgical Options for Obesity
Surgery is a widely acceptable method of treatment for clinically severe obesity because it has been shown to be the only option which can provide long-term maintained weight loss in patients with clinically severe obesity. In fact, the number of patients undergoing surgical treatment of obesity has steadily increased in recent years. Currently, the two leading approaches to weight-loss surgery in the United States are sleeve gastrectomy and Roux-en-Y gastric bypass. Adjustable gastric banding, the duodenal switch and the single-loop duodenal switch are also surgical options for the treatment of obesity. Weight-loss surgeons should be skilled in more than one surgical approach as the specific procedure needs to be carefully matched to the individual patient.
Surgery's Effect on Other Health Problems
The degree of improvement of various obesity-related problems depends on the extent of the illness and the length of time the patient has had it. In general, more than half of surgical patients find an improvement of their comorbidities, such as hypertension, hyperlipidemia, diabetes mellitus and sleep apnea. In fact, nearly 80 percent of non-insulin dependent diabetes is controlled without medication after surgery. Obesity-related respiratory problems, including sleep apnea and shortness of breath with minimal exercise, will become asymptomatic, improve or completely resolve. Joint and back pain associated with obesity, urinary incontinence, venous problems in the legs, acid reflux, menstrual irregularities and certain types of headaches are also improved with weight loss after surgery.
Types of Surgery
How Surgery Causes Weight Loss
Procedures for weight loss are either restrictive and/or malabsorptive: they restrict the intake of food and/or cause some of the food to be poorly digested and absorbed, and, therefore, eliminated in the stool. The LAP-BAND® is an example of a "restrictive" operation, whereas the Roux-en-Y gastric bypass and duodenal switch are "combination" type procedures resulting in both a restrictive and malabsorptive effect.
In surgery for obesity management, your stomach is reduced in size. Since your stomach pouch is very small, you will feel full very quickly. Overeating can be very uncomfortable and may result in vomiting. Your eating habits will therefore change drastically and you will likely never be able to eat the quantity of food that you can currently eat. For example, a typical size lunch for most patients is half a sandwich and a piece of fruit.
Expected Weight Loss
Weight loss varies widely, depending on many factors, such as the patient’s age, starting weight, ability to exercise and the type of operation used. On average, patients lose one-half to two-thirds of their initial excess weight at the end of one year.