Weight Loss Procedures: Comparing Surgical and Non-surgical Options
JANUARY 01, 2019
Weight loss surgery can have life-altering, even lifesaving, effects. If you are 100 pounds overweight (the equivalent of a body mass index, or BMI, of 40), you may be considering weight loss surgery. Non-surgical options may be the right choice if you need to lose less weight.
Weight loss procedures can result in significant weight loss, which helps to improve obesity-related health conditions, like cardiovascular disease, sleep apnea, high blood pressure and Type 2 diabetes. You can also lessen your risk of certain types of cancer, including those of the colon, uterus and breast.
However weight loss surgery is not for everyone. The decision should come after consultation with your primary care physician and weight loss specialists, like surgeons and dietitians. If, after talking it over with your doctors, you decide to move forward with a weight loss procedure, you’ll be faced with another decision: which type is right for your health and lifestyle.
Gastric sleeve, or sleeve gastrectomy, is the best choice for more and more patients. For this reason, BIDMC performs a high volume of gastric sleeve procedures.
Using a laparoscope, the surgeon removes approximately 60% of the stomach, so you feel full after eating a small meal. “You can think of it as your stomach decreasing from the size of a cantaloupe to the size of a banana,” says Dan Jones, MD, Chief, Bariatric and Minimally Invasive Surgery at BIDMC. “This procedure also helps decrease the hunger signals that go the brain.”
During gastric bypass, the stomach is essentially divided, creating a small pouch that can hold the equivalent of a small meal. Next, the surgeon attaches a Y-shaped section of the small intestine to the pouch. That creates a bypass for food, as it skips part of your digestive system. “As a result, you can’t eat as much as you used to and your body doesn’t absorb as many calories,” says Jones.
With a gastric band, also called LAP-BAND ® (short for laparoscopic adjustable gastric band), the surgeon makes a few small incisions in the abdomen. The band is placed around the upper portion of the stomach, limiting the amount of food the patient can eat.
For all three types of weight loss surgery, BIDMC follows a unique approach to recovery after surgery. "We reduce the need for narcotics by using different types of pain medications and nerve blocks,” says Jones. "This means patients are more awake immediately after the procedure, are in less pain and often get to go home the next day. We are using the latest science to make recovery easier."
The intragastric balloon is a newer, non-surgical procedure for those who don’t have as much weight to lose and don’t qualify for weight loss surgery. Gastroenterologists fill a saline balloon and place it endoscopically (a flexible tube with a light and camera is placed down the throat) into the stomach to limit the amount of food someone can eat.
"This procedure can help lower the potential risk of heart disease, high blood pressure, type 2 diabetes, gastroesophageal reflux disease (GERD, or acid reflux), high cholesterol and sleep apnea," said Jonah Cohen, MD, Director of the Bariatric Endoscopy Program at BIDMC.
Cohen recognizes the weight loss journey is a personal one but is proud of the expertise and capabilities BIDMC can offer patients. "We have an opportunity, here at BIDMC, to offer solutions that can allow people to lose weight they've been trying to lose for a long time but have been unable to do so."