Surgical procedures for obesity may be appropriate for some dangerously obese people, and they may reduce heart problems and many of the risks associated with obesity. These risks include high blood pressure, sleep apnea, and diabetes. In fact, surgery provides much greater control of weight and diabetes than nonsurgical weight-loss methods. Studies are reporting significant reductions in diabetes, and the need for diabetic medications, after surgery. Other medical conditions that often improve after surgery include heartburn, arthritis, and other joint and circulation problems.
The care of patients undergoing bariatric surgery, before and after surgery, requires specialized expertise and facilities. Studies have shown that the likelihood of complications is significantly associated with the experience of the surgeon and staff.
Bariatric surgeries produce weight loss through one of two approaches:
- Restrictive Banding Procedures. These procedures restrict the amount of food by closing off parts of the stomach with bands.
- Malabsorptive Bypass Procedures. This approach restricts the amount of food and also reduces absorption by using a bypass of parts of the intestine.
The malabsorptive procedures are more successful in achieving weight loss than the banding approach, but they carry a greater risk for nutritional deficiencies.
Benefits of Bariatric Surgery
Most people who have bariatric surgery lose about two-thirds of excess weight within 2 years. In addition, diseases associated with obesity (such as diabetes, high blood pressure, sleep apnea, joint pain, and incontinence) often improve.
A number of studies have been published showing that bariatric surgery leads to improved control of diabetes and hypertension.
Other studies have shown that even though most patients maintain significant weight loss, the majority regain about 10% of their weight. Patients must still develop a healthy lifestyle and be calorie conscious after the operation. Follow-up must be lifelong.
Review Date: 04/14/2010
Reviewed By: A.D.A.M. Editorial Team: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital (4/14/2010).