Bariatric surgery is a weight loss procedure that involves modifying the stomach and/or small intestine to help people with severe obesity lose weight. There are several types of bariatric surgery, each with its own benefits, risks, and outcomes. In this article, we will discuss the different types of bariatric surgeries and outcomes, safety, and efficacy rates.

1. 1. Gastric Bypass Surgery: Gastric bypass surgery is one of the most common bariatric surgeries. It involves creating a small stomach pouch and bypassing a portion of the small intestine. This reduces the amount of food that can be consumed and the amount of calories absorbed. Gastric bypass surgery has been shown to result in significant weight loss, with patients losing an average of 60-70% of their excess weight within 12 to 18 months. It also has been shown to improve or resolve many obesity-related conditions, such as type 2 diabetes, high blood pressure, and sleep apnea. However, it has a higher risk of complications compared to other bariatric surgeries, including leaks, bowel obstruction, and nutritional deficiencies.
   2. Gastric Sleeve: Sleeve gastrectomy involves removing a portion of the stomach to create a smaller stomach pouch. This limits the amount of food that can be consumed and reduces the production of the hunger hormone ghrelin. Sleeve gastrectomy has been shown to result in significant weight loss, with patients losing an average of 50-60% of their excess weight within 12 to 18 months. It also has been shown to improve or resolve many obesity-related conditions, such as type 2 diabetes, high blood pressure, and sleep apnea. Sleeve gastrectomy is less invasive than gastric bypass surgery and has a lower risk of complications. However, it may increase the risk of acid reflux and long-term nutritional deficiencies.
   3. Adjustable Gastric Banding: Adjustable gastric banding involves placing an adjustable band around the upper part of the stomach to create a small stomach pouch. This limits the amount of food that can be consumed and slows down digestion. Adjustable gastric banding has been shown to result in moderate weight loss, with patients losing an average of 40-50% of their excess weight within 12 to 18 months. It is less invasive than other bariatric surgeries and has a lower risk of complications. However, it may require frequent adjustments and has a higher risk of long-term complications, such as band slippage or erosion.
   4. Biliopancreatic Diversion with Duodenal Switch: Biliopancreatic diversion with duodenal switch is a less common bariatric surgery that involves removing a portion of the stomach and rerouting the small intestine. This limits the amount of food that can be consumed and the amount of calories absorbed. Biliopancreatic diversion with duodenal switch has been shown to result in significant weight loss, with patients losing an average of 70-80% of their excess weight within 12 to 18 months. It also has been shown to improve or resolve many obesity-related conditions, such as type 2 diabetes, high blood pressure, and sleep apnea. However, it has a higher risk of complications compared to other bariatric surgeries, including nutritional deficiencies and malabsorption.
   5. Endoscopic Procedures: Endoscopic procedures are minimally invasive weight loss procedures that do not require surgery. They involve using an endoscope to insert small sutures or a balloon into the stomach to limit the amount of food that can be consumed. Endoscopic procedures have been shown to result in moderate weight loss, with patients losing an average of 20-30% of their excess weight within 12 to 18 months. They are less invasive than laparoscopic procedures.

If you are in the process of choosing the best bariatric procedure for you, feel free to contact us and schedule your virtual consultation. We will help choose and find the most safe and effective bariatric surgery for you.

References

• Katherine A. Elder, Bruce M. Wolfe, Bariatric Surgery: A Review of Procedures and Outcomes, Gastroenterology, Volume 132, Issue 6, 2007, Pages 2253-2271,
• English, W. J., DeMaria, E. J., Hutter, M. M., Kothari, S. N., Mattar, S. G., Brethauer, S. A., & Morton, J. M. (2020). American Society for Metabolic and Bariatric Surgery 2018 estimate of metabolic and bariatric procedures performed in the United States. Surgery for obesity and related diseases, 16(4), 457-463.
• Welbourn, R., Hollyman, M., Kinsman, R., Dixon, J., Liem, R., Ottosson, J., … & Himpens, J. (2019). Bariatric surgery worldwide: baseline demographic description and one-year outcomes from the fourth IFSO global registry report 2018. Obesity surgery, 29, 782-795.

Last Updated: April 5th 2023

Written by: Dr. Alberto Carlos, MD