Is Weight Loss Surgery for You?
Severe obesity is a chronic condition that is very difficult to treat.
For some people, surgery to promote weight loss by
restricting food intake or interrupting digestive
processes is an option. But keep in mind that surgery to
produce weight loss is a serious undertaking. You should
clearly understand the pros and cons associated with the
procedures before making a decision.
How Does Weight Loss Surgery Work?
The surgery helps you lose weight by changing the way
your body digests and absorbs food. Your body digests
food to break down what you eat into small pieces of
nutrients (carbohydrates, proteins, fats, vitamins and
minerals). When the pieces are small enough, the cells
of your body absorb the nutrients to give you
energy to live.
Normally, as food moves along the digestive tract,
appropriate digestive juices and enzymes arrive at the
right place and at the right time to digest and absorb
calories and nutrients. After we chew and swallow our
food, it moves down the esophagus to the stomach, where
a strong acid continues the digestive process. The
stomach can hold about 3 pints of food at one time. When
the stomach contents move to the duodenum, the first
segment of the small intestine, bile and pancreatic
juices speed up digestion. Most of the iron and calcium
in the foods we eat is absorbed in the duodenum. The
jejunum and ileum, the remaining two segments of the
nearly 20 feet of small intestine, complete the
absorption of almost all calories and nutrients. The
food particles that cannot be digested in the small
intestine are stored in the large intestine (made up of
the ascending colon, transverse colon, descending colon,
sigmoid colon and rectum) until eliminated.
Obesity surgery involves making changes to the
stomach and/or small intestine.
How Does Surgery Promote Weight Loss?
The concept of gastric surgery to control obesity
grew out of results of operations for
cancer or severe ulcers that removed large portions
of the stomach or small intestine.
Because patients undergoing these procedures tended
to lose weight after surgery, some doctors began to use
such operations to treat severe obesity. The first
operation that was widely used for severe obesity was a
type of intestinal bypass. This operation, first used 40
years ago, caused weight loss through malabsorption
(decreased ability to absorb nutrients from food because
the intestines were removed or bypassed).
The idea was that patients could eat large amounts of
food, which would be poorly digested or passed along too
fast for the body to absorb many calories. The problem
with this surgery was that it caused a loss of essential
nutrients (malnutrition) and its side effects were
unpredictable and sometimes fatal. The original form of
the intestinal bypass operation is no longer used.
Surgeons now use other techniques that produce weight
loss primarily by limiting how much the stomach can
hold. Two types of surgical procedures used to promote
weight loss are:
- Restrictive surgery. During these
procedures the stomach is made smaller. A section of
your stomach is removed or closed which limits the
amount of food it can hold and causes you to feel
- Gastric bypass. Most of digestion and
absorption takes place in the small intestine.
Surgery to this area shortens the length of the
small intestine and/or changes where it connects to
the stomach, limiting the amount of food that is
completely digested or absorbed (causes
Through food intake restriction, malabsorption or
both, you can lose weight since less food either goes
into your stomach or stays in your small intestine long
enough to be digested and absorbed.
What Are the Benefits and Risks Associated With
Weight Loss Surgeries?
Surgery to produce weight loss is a serious
undertaking. Before making a decision, talk to your
doctor about the following benefits and risks.
- Weight loss. Immediately following
surgery, most patients lose weight rapidly and
continue to do so until 18 to 24 months after the
procedure. Although most patients then start to
regain some of their lost weight, few regain it all.
- Obesity-related conditions improve. For
example, in one study, blood sugar levels of most
obese patients with diabetes returned to normal
after surgery. Nearly all patients whose blood sugar
levels did not return to normal were older or had
diabetes for a long time.