Gastric Surgery – A miracle cure for obestity or false hope?

There’s been quite a bit in the news lately about gastric bypass surgery and lap banding. It’s now being introduced for morbidly obese children who have no hope of losing weight in the “traditional” ways, but some people are questioning if this is really the way to go.

First, what exactly is gastric bypass surgery?

Gastric bypass surgery is surgery that is done to restrict your stomach from being able to receive more than a small amount of food. The idea is that if your stomach cannot take the food, you will not take in as many calories, thus losing weight and then maintaining a healthier weight in the future. If part of the intestine is bypassed, then not as many calories are absorbed from the food you do eat.

 One type of surgery, the roux-en-y, makes the stomach smaller when the surgeon uses surgical staples to make a pouch in the stomach that will receive the food. This smaller “stomach” is then connected to the intestines. Gastric banding involves having a band placed around the upper part of your stomach. This creates a small pouch to hold food. Because your stomach is made smaller, you are limited as to how much food you can consume in one sitting. The advantage that banding has over bypass surgery is the band can be adjusted to regulate how quickly or slowly the food passes through. This is done through a port that is under the skin. The doctor uses a needle to infect or remove water that fills the band.

Why do the surgery?

Gastric surgery for weight loss is supposed to be the last ditch attempt for people who are obese, not merely overweight. Many of those who undergo weight loss surgery have tried every diet or weight loss program they could, with little or no success. The surgery gives them a feeling that they can get control of this, lose weight, and keep it off.

Why not just lose the weight?

 It does seem fairly simple, right? Don’t eat as much, do a bit of exercise, and lose the weight. Unfortunately, this doesn’t work for everyone for a variety of reasons. Many people who are overweight do manage to lose some weight while dieting, but many also gain it right back because they haven’t addressed the problems that caused the weight gain to begin with.

 Complications

Gastric surgery for weight loss is surgery and comes with all the risks of surgery. While surgery is a risk for all people, it is even more so for people who are overweight or obese. Some common complications with surgery of any type are:

• Blood loss
• Blood clots in the legs (deep vein thrombosis)
• Infection at the surgery site
• Pneumonia

 
Complications specific to gastric bypass surgery include:

• Narrowing of the opening between the smaller stomach and the intestine
• Ulcers
• Iron and vitamin deficiences
• Loosening of the staples
• Stomach pouch may stretch after time.
• Injury to stomach during surgery
• Nausea and vomiting

Complications for gastric banding are:

• Band may cause irritation to the stomach or slip out of place
• Irritation and inflammation of the stomach lining, ulcers
• Reduced absorption of nutrients
• Nausea and vomiting
• Port may become infected

The success of surgery?

 Is the surgery successful? For some people, it is very successful. They learn new ways of eating and they change their lifestyle, in addition to having the surgery. For others, it isn’t a success, many times because they don’t make the necessary changes. Yet others experience the complications listed above and, unfortunately, some do die.

Future

A concern that many people have is we don’t know the long-term outlook for people who have had these weight reduction surgeries. While this may not be an issue for adults, it could be very much an issue for children who have the surgery. The decrease in nutrients could have a long-term effect on adult health; doctors just don’t know.

 If you are considering gastric surgery for weight loss, this is something that must be thought through and discussed with your doctor. It’s not a magic cure, but it may be the only one for some people.