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What Happens During Weight Loss Surgery?

The term "bariatric" refers to the treatment of obesity. Bariatric surgery -- also called weight loss surgery -- has been practiced in one form or another since the 1950s, but for decades it remained a relatively uncommon weight loss treatment in the U.S.

Recently, however, the number of people having bariatric surgery has spiked. In 1998, about 13,000 weight loss surgeries were done in the U.S. Just five years later, about 121,000 were done. The American Society for Metabolic and Bariatric Surgery says an estimated 220,000 people with severe obesity had weight loss surgery in 2008.

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Pros and Cons of Weight Loss Surgery

As a treatment for severe obesity, weight loss surgery's popularity is growing. When diet and exercise fail the more than 60 million Americans considered obese, surgery, for some, can literally be lifesaving. But it isn't for everyone. While generally safe, bariatric weight loss surgery (also called simply weight loss surgery) has risks. And losing weight after bariatric surgery is far from automatic; it takes commitment to lifelong changes in eating patterns and lifestyle. According to the Na...

Read the Pros and Cons of Weight Loss Surgery article > >

This figure may be nowhere near the peak. Only 1% of obese people in the U.S. who could potentially benefit from weight loss surgery have had it.

As more people are having weight loss surgery than ever before, medical researchers have also begun to report solidly favorable study results on its safety and weight loss potential.

People who have bariatric surgery can have dramatic weight loss. What's more, they can often maintain much of their initial weight loss for as long as 10 years after surgery.

Bariatric surgery works in three basic ways:

  • Restricting how much food your stomach can hold at any time
  • Preventing your digestive system from absorbing all the nutrition in the food you eat
  • A combination of these two ways

Restrictive Weight Loss Surgery: Gastric Banding and Gastroplasty

The two purely restrictive types of weight loss surgery done today are called gastric banding and vertical sleeve gastrectomy.

Both operations make less room in the stomach for food right after it's swallowed.

A small part of your stomach is partitioned off to make a pouch at the end of your esophagus (the tube connecting your mouth to your stomach). This pouch holds only about ½ ounce -- roughly the capacity of a shot glass. It fills up quickly and empties slowly, through a narrow opening to the larger part of the stomach.

Gastric banding involves placing a band around the top end of the stomach. There are two approved gastric banding devices and procedures approved in the U.S. -- LAP-BAND and the Realize band.

Vertical Sleeve Gastrectomy involves removing about 75% of the stomach. What remains of the stomach is a narrow tube or sleeve, which connects to the intestines.

Sometimes, a sleeve gastrectomy is a first step in a sequence of weight loss surgeries. It can be followed up by gastric bypass or biliopancreatic diversion, if more weight loss is needed. However, in other cases, it might be the only surgery needed.

Malabsorptive Weight Loss Surgery: Gastric Bypass and Billiopancreatic Bypass

Gastric bypass surgery also involves creating a small pouch. The difference between gastric bypass and gastric banding is that food doesn't pass through the pouch to be further digested in the larger part of the stomach.

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