Surgery as a Last Resort

Diet and Weight Loss Tutorial

Obesity surgery, also called bariatric or gastrointestinal surgery, is the most extreme solution for severe obesity. While it may be better to undergo surgery than to continue to threaten your health, obesity surgery should not be looked at as the next step in the search for an instant fix. It is a big step beyond the latest diet fad, the latest diet pill, or the solution that most always works, eating healthy foods and exercising regularly.

If you became overweight simply because you ate too much, surgery may solve your problem. But if you became overweight because you enjoy eating, it is important to understand that surgery will very likely limit both how much you can eat and what types of food you can eat -- just as dieting does -- only more permanently.

If you research obesity surgery, you will find a common statement in most publications:

The success of your surgery depends on your willingness to adopt a lifetime plan of healthy eating and regular physical activity.

Clearly obesity surgery is not the "magic pill" people keep looking for. It may improve your health and lessen your risk for disease and early death, but it is a major surgery that will change your life in many ways.

Obesity Surgery Options

Candidates for obesity surgery are generally severely obese people who cannot lose weight through other means and either suffer from obesity-related medical conditions or are threatened by them. Examples of such medical conditions include:

  • Type 2 diabetes
  • Hypertension (high blood pressure)
  • Arthritis & osteoarthritis
  • High cholesterol & triglyceride levels
  • Sleep apnea

Candidates for obesity surgery are carefully evaluated to ensure that the benefits of surgery outweigh the risks. In Gastrointestinal Surgery for Severe Obesity, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) discusses who is a candidate for surgery. The article also discusses surgery options and examines the advantages, disadvantages, and risks of each.

We briefly describe two of the most common procedures here:

  • Gastric Bypass Surgery (GBS): GBS involves two distinct procedures. First, and most significant, the size of your stomach is surgically reduced. This may be accomplished by dividing the stomach into two sections with surgical staples, explaining why the procedure is often referred to as "stomach stapling."

    • Second, your small intestine is re-connected to your new, smaller stomach, bypassing the lower part of your stomach and, in some cases, a portion of your small intestine.

    The procedure works by restricting the amount of food you can eat with your new, smaller stomach. In addition, when a portion of your small intestine is bypassed, it reduces the amount of food that is digested and absorbed.

  • Gastric Banding: In this newer and simpler procedure, a band is placed around the upper part of your stomach separating it into two compartments.

    • The food you eat initially enters the upper compartment, which is much smaller than your stomach was before surgery. As with GPS, gastric banding restricts the amount of food you can eat. In addition, the food passes slowly between the upper and lower compartments, making you feel full longer.

    A unique feature of the gastric band is that it can be adjusted by your doctor without additional surgery. The band is actually an inflatable balloon filled with saline solution. It can be inflated or deflated as needed by injecting a needle into a reservoir that is placed just below your skin during surgery.

A Note about Liposuction

Liposuction is the most popular form of cosmetic surgery. It can help sculpt the body of a normal weight person by removing fat from stubborn areas that do not respond to traditional weight loss methods.

Liposuction is not a cure for generalized obesity, however, because relatively little body fat can be removed safely. It is also not an effective treatment for cellulite because it does not change the appearance of the skin.

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