Gastric surgery as a weight loss option

Obesity is well documented as one of the epidemics of our modern age. In a society, with such a proliferation of highly processed foods and easy fast food options it is all too easy to overindulge. Alcohol too plays its part in expanding our waistlines. The medical complications from excessive weight include diabetes, heart disease and other life threatening conditions and medical professionals are keen to try and regulate and educate to stem the tide of obesity that threatens the length and quality of life. So what are the answers?

Weight loss options
Traditional weight loss approaches are centred on dietary control and physical activity, while pharmaceuticals and supplements are also now widely available and sometimes appeal to those wanting a quicker fix to their weight gain issues. The key aspect of any traditional weight control is that requires sustained effort to provide consistent results. We have all seen the before and after success stories for dietary plans, kitchen gizmos and exercise equipment on late night TV, but the reality is that many people struggle with the discipline it takes to gain lasting results.

Of course it will always be preferable to maintain a healthy weight without radical intervention, but for those who struggle with significant excess weight issues and who maybe suffering health complications as a result, gastric weight loss surgery presents a viable option. The important advantage it offers is the treatment of the problem at its source. By reducing the size of the stomach it naturally limits the amount of calorie intake and while it does need to be combined with a healthier diet, it is not dependant on will power and therefore gives a more sustainable solution.

What does gastric weight loss surgery involve?
There are three different approaches to gastric surgery - all have the objective of reducing stomach capacity, but the methods are quite different.

Gastric sleeve surgery is the most common form of weight loss surgery and involves removing around 80% of the stomach lengthwise and leaving behind only a “sleeve”. This results in a much smaller amount of food being needed before the person feels full. While this method is very successful, it is also non-reversible because of the permanent removal of part of the stomach.

Gastric banding, on the other hand, is reversible. It involves a band being placed around the upper part of the stomach, creating a pouch which restricts the amount of food that can be taken. The band is inflatable via a port placed under the skin and connected by a tube to the band. This allows the surgeon to inject fluid that inflates the band to regulate the restriction. While this method is also generally successful, in a few cases it can result in side effects such as vomiting and reflux.

Gastric bypass is a different technique again. It involves firstly dividing the stomach using staples to create a pouch at the top and secondly connecting the upper part of the lower intestine to the stomach pouch, effectively bypassing the duodenum. The duodenum is the part of the digestive system immediately below the stomach which is responsible for a lot of the absorption of nutrients into the body. By bypassing this it reduces the amount of fats and calories that your body takes on. Gastric Bypass is a reversible procedure.

How long does recovery take?
These procedures are now all usually performed laparoscopically, which mean the incisions and scarring are greatly reduced and allow quicker recovery times. Generally it involves a 3 or 4 day hospital stay, followed by a couple of week’s home rest for healing to occur, before returning to work on light duties.

Maximising the benefits
One aspect that the surgeon will want to establish before performing the procedure is to ensure that the patient is psychologically well prepared for the life change that the surgery will bring. It is also vital to couple the surgery with a healthier approach to diet to support the effects of the surgery and to ensure the intake of essential nutrients is not left lacking due to the lower food intake. A dietician is therefore normally involved in the consultation process before and after surgery.

Apart from the weight loss benefits of the surgery, there can also be improvements in blood pressure, cholesterol and diabetic conditions.

What are the downsides?
There can be some side effects, such as reflux, vomiting and food intolerance. In some cases the surgery may not be fully effective and may not produce desired results. For the majority, however, there is a good success rate and it offers a more lasting and easily managed solution, compared to a reliance on self-discipline and dieting alone.

For more information visit the Obesity Surgery Society of Australia and New Zealand at Ossanz.