The prevalence of severe obesity has essentially doubled over the past 20 years, and that has also meant an increase in a number of serious, obesity-related medical conditions. In light of this, more and more people are turning to health interventions like bariatric surgery. In fact, according to the American Society for Metabolic and Bariatric Surgery (ASMBS), the number of people opting for a bariatric procedure of any kind has increased more than 60% since 2011. Yet as potentially beneficial as such procedures are, there remain significant risks that must be weighed with the benefits.
Also known simply as weight loss surgery, bariatric surgery is the general term for any medical procedure designed to help individuals with severe obesity lose weight and improve their overall health. A commonality in all types of bariatric surgery is the modification of the digestive system in a way that either reduces the capacity of the stomach or changes the way the body absorbs nutrients. Given that most procedures are permanent, bariatric surgery is typically only considered when traditional weight loss methods have been unsuccessful.
Not everyone is a good candidate for these weight loss procedures, however; to qualify for bariatric surgery, the patient has to first be healthy enough to go through surgery. Also, a determination must be made about the severity of obesity, and that is typically done by evaluating body mass index (BMI), which is essentially the ratio between a person’s height and weight. Generally speaking, a patient should have a BMI of 35 or higher or a BMI of 30-35 and an obesity-related condition like heart disease or type 2 diabetes.
In the last few decades, various types of bariatric surgery have been developed that each have their own particular aim and mechanism for promoting weight loss. The method selected will depend on the patient’s current weight, health status, preferences, and ability to tolerate surgery. Below are the main types of bariatric surgery available:
After decades of experience and research, it’s clear that overall bariatric surgery is an effective method for achieving long-term weight loss. While the figures vary depending on the study, patients often lose 30-50% of excess weight in the first six months after the procedure and then a steady amount as time goes on. One study showed that patients were able to maintain such a loss for more than 10 years after the surgery. Yet beyond offering significant weight loss, bariatric can also lead to improvements in some areas of health and reduced risk for certain obesity-related conditions:
Even though there are clear benefits to bariatric surgery, there are a number of risks and potential side effects that can’t be ignored. Many of these risks and side effects are associated with surgery in general. Most bariatric procedures are laparoscopic, and this means the surgeon makes small incisions in the abdomen that allow a special surgical scope to be inserted. While this is technically considered “minimally invasive,” that really only means less invasive than full open surgery. Below are some of the risks associated with these procedures:
In addition to the side effects directly related to the surgery, there are also a variety of gastrointestinal issues that may arise. For instance, gallstones may develop as a result of rapid weight loss. Malnutrition is also possible in cases where part of the small intestine was bypassed. There are also potential functional problems like a bowel obstruction or dumping syndrome, a condition involving food moving from the stomach to intestines too quickly. However, some of these problems will resolve on their own given enough time.
Weighing the risks and the benefits of bariatric surgery could leave anyone wondering if it’s really worth it. Fortunately, though, a state-of-the-art alternative has emerged in recent years that changes the whole calculation: endoscopic sleeve gastroplasty (ESG). The primary difference is that ESG is performed with an endoscope, a long flexible tube that is fed down the esophagus. This means that no incisions are necessary; the entire procedure is performed with the endoscope from inside the stomach.
As the name implies, ESG involves reshaping the stomach into a banana-shaped sleeve just like with a sleeve gastrectomy procedure. In this case, though, the tools on the end of the endoscope can close off 80% of stomach volume with sutures; and rather than removing this section of the stomach, it can safely remain unused in the body. Once the procedure is completed, the stomach has only about 20-30% of its original capacity and can similarly promote new eating habits and a calorie deficit.
Because an endoscope is used to perform ESG, it can be completed quickly and usually in only 30-45 minutes. Moreover, the lack of incisions means that the procedure is safer in general and requires a much shorter recovery time; whereas gastric bypass can take up to a month, most people can return to regular activities after only 2-3 days. The best part, of course, is that ESG also leads to similar weight loss. On average, patients can lose 23.1% of their total body weight and 70% of excess weight within a year. And 97% of patients will lose at least 10% of body weight within a year.
At True You Weight Loss, we are passionate about helping patients find the freedom they’ve been looking for, and we specialize in using ESG to make that a reality. While bariatric surgery may be the right choice for some people, the fact remains that there are risks associated with surgery. ESG is an alternative that our team is highly experienced at performing, and our patients have a proven track record of weight loss success. If you’d like to learn more about ESG or any of our other non-surgical weight loss procedures, please contact us today to request a consultation.