Weight Loss: Restrictive Surgery

Restrictive surgeries are those operations most often used for producing weight loss. Food intake is restricted by creating a small pouch at the top of the stomach where the food enters from the esophagus. The pouch initially holds about 1 ounce of food and expands to 2-3 ounces with time. The pouch's lower outlet usually has a diameter of about 1/4 inch. The small outlet delays the emptying of food from the pouch and causes a feeling of fullness so you eat less.

Restrictive surgery for obesity includes gastric banding and vertical banded gastroplasty (VBG) procedures. Both operations serve only to restrict food intake. They do not interfere with the normal digestive process, like gastric bypass surgery.

What Is Vertical Banded Gastroplasty?

Also known as "stomach stapling," this procedure is a commonly used restrictive operation for weight control. During the procedure, both a band and staples are used to create a small stomach pouch.

What Are the Risks Associated With VBG?

Risks of VBG include:

• Erosion of the band used to create the stomach pouch.
• Breakdown of the staple line used to create the stomach pouch.
• Leakage of stomach juices into the abdomen requiring an emergency operation.
• In a very small number of people who get the surgery (less than 1%), infection or death from complications can occur.

What Is Gastric Banding?

During this procedure, a band made of special material is placed around the stomach near its upper end, creating a small pouch and a narrow passage into the larger remainder of the stomach.

What Are the Risks of Gastric Banding?

The risks associated with gastric banding are similar to the risks associated with VBG.

How Does Eating Change After Surgery?

After restrictive surgery, you usually can eat only one-fourth to one-half cup of food without causing discomfort or nausea. Fluids are limited to small sips and should not be included with meals since the new smaller stomach may not be large enough to hold fluid and food at the same time. Also, food has to be well chewed. For most people, the ability to eat a large amount of food at one time is lost. Therefore, it is necessary to eat several (8-10) small meals throughout the day to get enough nutrients.

How Much Weight Can I Lose With Surgery?

Restrictive surgery leads to significant weight loss in almost all patients. However, rates of weight loss vary, and weight regain does occur in some people.

Reviewed by the Department of Nutrition Therapy at The Cleveland Clinic.