Bariatric Surgery Information

• You have been unable to lose weight through diet and exercise.
• You have health problems caused by obesity, such as:
  • Type 2 diabetes.
  • Heart disease.
  • Lung disease.

How does bariatric surgery help me lose weight?

• Decreasing how much food your body absorbs. This is done by closing off part of your stomach to make it smaller. This limits the amount of food your stomach can hold.
• Changing your body's regular digestive process so that food bypasses the parts of your body that absorb calories and nutrients.

If you decide to have bariatric surgery, it is important to continue to eat a healthy diet and to exercise regularly after the surgery.

What are the risks of bariatric surgery?

As with any surgical procedure, each type of bariatric surgery has its own risks. These risks also depend on your age, your overall health, and any other medical conditions you may have. Risks of bariatric surgery can be divided into two groups. There are short-term risks and long-term risks.

• Infection.
• Bleeding.
• Allergic reactions to medicines or dyes.
• A blood clot that forms in the leg and travels to the heart or lungs.
• Leaking of digestive juices into the abdomen.

• Not getting enough nutrients for your body (malnutrition).
• Narrowing of the digestive tract (stricture or stenosis).
• Diarrhea, nausea, or vomiting after eating (dumping syndrome).
• Failure of the device or procedure. This may require another surgery to correct the problem.

• Talk to your health care provider and choose the surgery that is best for you.
• Ask your health care provider about specific risks for the surgery you choose.

What are the different kinds of bariatric surgery?

• Restrictive surgery. This procedure makes your stomach smaller. It does not change your digestive process. The smaller the size of your new stomach, the less food you can eat. There are different types of restrictive surgeries.
• Malabsorptive surgery. This procedure makes your stomach smaller and alters your digestive process so that your body processes fewer calories and nutrients. These are the most common kind of bariatric surgery. There are different types of malabsorptive surgeries.

What are the different types of restrictive surgery?

Adjustable gastric banding

In this procedure, an inflatable band is placed around your stomach near the upper end. This makes the passageway for food into the rest of your stomach much smaller. The band can be adjusted, making it tighter or looser, by filling it with salt solution. Your surgeon can adjust the band based on how you are feeling and how much weight you are losing. The band can be removed in the future. This requires another surgery.

Sleeve gastrectomy

In this procedure, your stomach is made smaller. This is done by surgically removing a large part of your stomach. When your stomach is smaller, you feel full more quickly and reduce how much you eat.

What are the different types of malabsorptive surgery?

Roux-en-Y gastric bypass (RGB)

This is the most common weight-loss surgery. In this procedure, a small stomach pouch (gastric pouch) is created in the upper part of your stomach. Next, this gastric pouch is attached directly to the middle part of your small intestine. The farther down your small intestine the new connection is made, the fewer calories and nutrients you will absorb. This surgery has the highest rate of complications.

Biliopancreatic diversion with duodenal switch (BPD/DS)

This is a multi-step procedure. First, a large part of your stomach is removed, making your stomach smaller. Next, this smaller stomach is attached to the lower part of your small intestine. Like the RGB surgery, you absorb fewer calories and nutrients if your stomach is attached farther down the small intestine.

Where to find more information

• American Society for Metabolic and Bariatric Surgery: www.asmbs.org
• National Institute of Diabetes and Digestive and Kidney Diseases: www.niddk.nih.gov

Summary

• Bariatric surgery, also called weight-loss surgery, is a procedure that helps you lose weight.
• This surgery may be recommended if you have been unable to lose weight through diet and exercise, or you have health problems caused by obesity, such as type 2 diabetes, heart disease, or lung disease.
• Generally, risks of bariatric surgery include infection, bleeding, and failure of the surgery or device. Failure of the surgery or device may require another surgery to correct the problem.