Weight Loss Surgery: Frequently Asked Questions

How does weight loss surgery work, and could it help you? Get answers to frequently asked questions about weight loss surgery here. 

Should I consider having weight loss surgery?

This type of surgery is not for everyone. Doctors generally recommend it only for people who:

Have a body mass index (BMI) of 40 or more -- about 100 pounds overweight for men, and 80 for women.

• Have a lower BMI (35 to 40) but also have serious health problems related to obesity -- heart disease, type 2 diabetes, or severe sleep apnea.
• Have tried and failed to lose weight by nonsurgical means, such as diets.
• Fully understand the risks and are motivated. 

How will weight loss surgery help me lose weight?

There are two basic types of weight loss surgery -- restrictive surgeries and malabsorptive surgeries. Each helps with weight loss in different ways.

• Restrictive surgeries (like adjustable gastric banding) work by physically restricting the stomach's size, limiting the amount of solid food you can eat.  Before the surgery, a normal stomach can hold about three pints of food. After surgery, the stomach may at first hold one ounce -- although that may later stretch to two or three ounces. You eat less when your stomach is smaller.

Malabsorptive surgeries (like gastric bypass) work by changing the way your digestive system absorbs food. This type of weight loss surgery is more complicated. The surgeon removes parts of your digestive tract, creating a shortcut for the food to be digested. This means that fewer calories get absorbed into the body. The combined malabsorptive/restrictive surgery also creates a smaller stomach pouch, which restricts the amount of food you can eat.

What are the pros and cons of these surgeries?

Gastric Banding Surgery

The Pros:

• Gastric banding is often a minimally invasive surgery -- performed with small incisions, a laparoscope (a tiny camera), and special instruments.
• There is no need to cut into the stomach or intestine, and recovery is usually faster than with gastric bypass surgery.
• The surgery can be reversed by surgically removing the band.
• Tightening the band further restricts stomach size, to increase weight loss. The band can be tightened or loosened in the doctor's office. To tighten the band, saline solution is injected into the band. To loosen it, the liquid is removed with a needle.
• The adjustable band allows a nutritionist to address nutritional issues that may occur after surgery.
• Serious complications are uncommon. But gastric bands can slip out of place, become too loose, or leak. Surgery is needed to correct this.

The Cons:

• Your weight loss may be less dramatic than with gastric bypass.  The average is to lose 21% of your weight after one year, and 47% of your weight after two years.
• You may regain some of the weight over the years. Ten years after surgery the average weight loss is about 13%.