When considering bariatric surgery patients first need to know if they are a candidate for one of the procedures. The National Institute of Health defines eligible candidates for bariatric surgery as those suffering from morbid obesity. People with a Body Mass Index over 40 are considered morbidly obesity, and at this point the health risks associated with maintaining this condition outweigh any risks associated with the bariatric procedure. For those suffering from co-morbidities such as hypertension, glucose intolerance (Type II diabetes), and sleep apnea Bariatric Surgery is an indicated treatment at BMI of 35 and above because of the dual benefits of weight loss and secondary disease control.
About the Common Procedures
Roux-en-Y gastric bypass
The Roux-en-Y procedure is the most commonly preformed bariatric surgery in the US today, with 140,000 cases done in 2005. During the procedure a small sack is created from the upper section of the stomach and connected directly to the distal portion of the small intestine. This process change to the digestive tract anatomy diverts food from the upper section of the small intestine, where much of the absorptive process takes place. The combined effect of the decreased stomach size, coupled with decreased absorption usually results in rapid and substantial weight loss.
Adjustable Gastric Band
The adjustable gastric band, the second most common Bariatric Surgery, similarly creates a small pouch in the upper stomach by placing an adjustable band around the upper portion of the stomach. The band catches and holds ingested food creating the sensation of satiety. Weight loss achieved with the band process is more gradual but sustained, and for the procedure to be highly effective the patient must be dedicated to maintaining the post procedural regimens.
Although similar levels of weight loss can be expected a year or two after the Bariatric Surgery is completed, the path to that point and other effects on the body differ from the moment the patient leaves the OR. While the Roux-en-Y offers the potential for quick weight loss the digestive anatomy must be restructured. This alteration is permanent, but this may be desirable for type II diabetes treatment or other considerations. There are also unique dietary considerations that patients who under go the Roux-en-Y procedure may have to adhere to such as avoiding certain types of food and taking dietary supplements to compensate for the decreased absorptive capabilities. The lap band on the other hand provides a slower weight reduction, but the procedure is safely conducted laparoscoically and is reversible. This feature is particularly desirable for patients for whom pregnancy after the procedure is a possibility.
For those seriously considering surgery as a treatment for morbid obesity, the first step in making the right decision is contacting a knowledgeable physician to discuss their options and to determine if bariatric surgery is right for them.
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