Achieving meaningful weight loss can often seem like an impossible hurdle, especially if you’ve struggled with your weight for years or cycled through diet programs and exercise regimens without a lasting payoff.
It can be even more daunting when that extra weight has a negative impact on your health, quality of life and overall wellness. Even though weight loss surgery has been proven highly effective, it’s often viewed as a last resort.
“Many patients are reluctant to choose weight loss surgery, fearing that the process is too complicated, or risky, or that they may be judged for their decision,” says Malcolm Kenneth Robinson, MD, FACS, a bariatric surgeon in the Division of General and Gastrointestinal Surgery at Brigham and Women's.
However, for those who have continually struggled to lose weight through more conservative means or may be experiencing negative impacts to their health and wellness, weight loss surgery may be an option to seriously consider.
Weight loss surgery, also known as bariatric surgery, involves surgical manipulation of the stomach, and sometimes the small intestines, to achieve weight loss. The most common weight loss surgical procedures are gastric bypass, sleeve gastrectomy, and adjustable gastric banding (also known as LAP-BAND surgery).
Gastric Bypass Surgery
Gastric bypass surgery, also known as the Roux-en-Y gastric bypass, involves creating a small pouch from the top of portion of the stomach. The pouch, which holds 1-2 ounces of food, is then joined to the small intestine further down the digestive tract.
Weight loss occurs because food intake is limited by the small size of the new stomach pouch and because digested food bypasses the first section of the small intestine. This rerouting of food also produces hormonal shifts that reduce feelings of hunger.
Gastric bypass has long been the most effective form of weight loss surgery—producing more weight loss over time than other procedures. After undergoing gastric bypass surgery, patients lose an average of 30 percent of their total body weight. Most patients stay in the hospital for 1-2 days and return to work in 2-3 weeks.
“All of our surgical weight-loss options, including gastric bypass, are performed as laparoscopic, or minimally invasive, procedures to minimize risks and speed recovery. Most patients are amazed at how well they do after surgery—many realize they didn’t need as much pain medication as they feared they would,” says Dr. Robinson.
The sleeve gastrectomy involves removing the outer section of the stomach. This procedure results in a stomach shaped like a tube, or sleeve, and leaves the small intestine intact.
Weight loss occurs because the stomach’s capacity to hold food is reduced by about 75 percent. With a smaller stomach size, patients experience a reduction in appetite and eat less. In addition, the portion of the stomach that is removed is also where a hormone that regulates appetite is produced. As such, patients experience a dramatic reduction in hunger after the procedure.
Sleeve gastrectomy is the most popular weight loss procedure and is highly effective at producing weight loss over time. After undergoing sleeve gastrectomy, patients lose an average of 25 percent of their total body weight.
“The majority of our patients choose sleeve gastrectomy, as it balances the prospect of significant weight loss with a lower risk of complications. The recovery is also a bit faster with this weight-loss option. Most patients leave the hospital a day after their procedure,” says Dr. Robinson.
Gastric Band (LAP-BAND)
Adjustable Gastric Banding involves the placement of a small band around the upper part of the stomach. The band contains an inflatable chamber that is attached to a hollow port that sits underneath the skin. During a clinic visit, the band can be tightened or loosened by injecting or removing saline solution through a port, affecting the amount of food one is able to consume.
Gastric banding used to be a popular weight-loss procedure, but it’s rarely performed today due to its limited effectiveness in producing weight loss, especially when compared to gastric bypass and sleeve gastrectomy. After undergoing adjustable gastric banding, patients only lose an average of 10 percent of their total body weight.
Weight Loss Can Treat Many Health Conditions
Weight loss surgery has been shown to be an effective treatment for many obesity-related health conditions, including type 2 diabetes, sleep apnea, and high blood pressure.
Many patients also report improvements in overall wellness after weight loss surgery. These benefits include increased energy, less aches and pains, and better sleep.
Weight Loss Surgery at Brigham and Women's
The Center for Weight Management and Wellness at Brigham and Women's has one of the oldest and most experienced weight loss surgery programs in New England and has performed thousands of weight loss surgeries with excellent outcomes.
Patients are supported by a team of surgeons, physician assistants, psychologists and dietitians who have expertise in caring for patients who have chosen to undergo weight loss surgery.
The Brigham’s multidisciplinary team also offers a lifetime of support and guidance in the years following surgery to ensure that the weight stays off.
“We support our patients every step of the way and help turn their fears into joy,” says Dr. Robinson. “I tell my patients that they will be amazed at what they gain when they lose.”