Weight loss 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 such as heart disease, type 2 diabetes, high cholesterol, or severe sleep apnea.
Have tried and failed to lose weight by nonsurgical means such as diet and exercise.
Fully understand the risks associated with weight loss surgery and are motivated.
In early 2011, the FDA approved the use of Lap-Band restrictive surgery in those with a BMI of 30 or higher who have at least one obesity-related condition, such as diabetes.
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. A normal stomach can hold about three pints of food. After weight loss surgery, a stomach may only hold one ounce of food, although over time it may be able to hold two or three ounces of food.
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 intestine, 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 Various Weight Loss Surgeries?
Gastric Banding Surgery
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.
The band can be tightened or loosened in the doctor's office to control weight loss and nutritional needs. To tighten the band, saline solution is injected into the band. To loosen it, the liquid is removed with a needle.
Serious complications are uncommon. But gastric bands can slip out of place, become too loose, or leak. Should this occur, additional surgery may be necessary.
Your weight loss may be less dramatic than with gastric bypass. The average loss is 21% of your excess weight after one year, and 47% of your excess 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%.