Obesity surgery, or weight-reduction surgery, known generally as bariatric surgery, changes the anatomy of your digestive system to limit the amount of food you can eat and digest.

Obesity surgery is becoming more and more popular, but bariatric surgery isn't for everyone who is obese. Obesity surgery is prescribed for people with extreme obesity or when the excess weight is causing them serious health problem such as diabetes or high blood pressure. Obesity surgery means lifelong commitment to specific diet and exercise.

Surgical treatment for obesity began in the early 1950s, doctors have used various operations to achieve weight loss. Of all obesity surgery operations, doctors in North America most often recommend gastric bypass.

In gastric bypass the surgeon creates a small pouch at the top of your stomach and adds a bypass around a segment of your small intestine. This redirects food, bypassing most of your stomach and the first section of your small intestine, so that food enters directly into the second section of your small intestine, limiting your ability to absorb calories. Even though food never enters the lower part of your stomach, the stomach stays healthy and continues to secrete digestive juices to mix with food in your small intestine.

With gastric bypass as obesity surgery, you achieve weight loss by reducing stomach size to limit the amount of food you can eat. A newer procedure - laparoscopic gastric bypass - is done with a small, tubular instrument with a camera attached through short incisions in the abdomen. The laparoscopic technique shortens your hospital stay and leads to a quicker recovery. Most surgeons prefer gastric bypass because it is safe and effective and has fewer complications.

Another type of obesity surgery, gastric partitioning, is particularly popular in Europe and Australia, but has been used only on a limited basis in the United States. The surgeon uses an inflatable band to partition the stomach into two parts wrapping the band like a belt, creating a tiny channel between the two stomach parts. The Food and Drug Administration in 2001 approved one form of banding — the Lap-Band — after reviewing several clinical studies.

Malabsorptive procedure is a less popular type of obesity surgery which allows losing weight by limiting the amount of nutrients and calories absorbed in the intestine. These surgeries are less common and run a greater risk of nutrient deficiencies.

Of all obesity surgeries, gastric bypass is the most popular procedure. Also weight loss is more predictable and usually maintained. Most people eventually lose at least half their excess weight and about two-thirds keep the weight off for 10 years and longer.

When appropriate, weight-loss surgery can result in dramatic improvements in weight and health. However, people with obesity surgery should follow strict nutritional guidelines to avoid iron and B-12 deficiencies. Another possible side effect is gallstones.

Obesity surgery requires certain changes in a way people eat food. After a gastric bypass a person will have a stomach pouch about the size of a small egg. In the first six months after surgery, eating too much or too fast may cause either vomiting or an intense pain under your breastbone. Instead of eating regular-sized meals three times a day, you'll be required to eat four to six very small meals — about 2 ounces each — throughout the day.

Surgery for weight reduction is not a miracle procedure. But don't underestimate the physical and social adjustments you'll have to make after obesity surgery.

SOURCE: MAYO CLINIC 

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