Methods

Modern bariatric surgeries are typically performed laparoscopically, involving small abdominal incisions and the use of specialized instruments. This minimally invasive approach reduces recovery time and complications.

Successful surgery requires thorough preparation and ongoing care from a multidisciplinary team, including endocrinologists, surgeons, psychiatrists, and nutritionists. Lifelong follow-up and consistent monitoring are critical for maintaining results and addressing potential complications.

Bariatric procedures fall into two main categories:

• Restrictive Surgeries: Reduce stomach volume to limit food intake.
• Malabsorptive Surgeries: Alter the digestive system to reduce nutrient and calorie absorption.

Common surgical methods include gastric banding, gastric bypass, sleeve gastrectomy (tubular stomach), and biliopancreatic diversion with duodenal switch.

 

Gastric Band

Gastric banding reduces the capacity of the stomach, resulting in early feelings of fullness and satiety. 

 

Careful Evaluation

Careful consideration must be given to the following contraindications:

• Unstable mental health conditions
• Substance dependency

• Consumptive diseases
• Untreated Bulimia Nervosa
• Chronic illnesses such as liver cirrhosis

Gastric Bypass

Gastric bypass is currently the most common bariatric surgery. This procedure involves reducing the stomach's size and bypassing a portion of the small intestine, altering the digestive process to limit calorie absorption. Key effects include:

• Reduced digestion of fats and proteins.
• Decreased secretion of the hunger hormone Ghrelin, which helps regulate appetite.

However, this surgery also reduces the absorption of essential fat-soluble vitamins (D, B1, B12) and trace elements (iron, zinc, magnesium, calcium). Lifelong supplementation of these nutrients is necessary.

Gastric bypass typically results in an average weight loss of 50–60% of excess body weight within two years.

 

Sleeve Gastrectomy (Tube Stomach) 

Sleeve gastrectomy, a relatively newer bariatric procedure, involves reducing the stomach to a small tube-like structure. This method results in weight loss comparable to gastric bypass. 

 

Extreme Obesity

For cases of extreme obesity, biliopancreatic diversion with duodenal switch is the most invasive bariatric surgery available. This procedure involves significantly reducing stomach volume and shortening the digestive tract by bypassing sections of the intestine. While it is highly effective, achieving weight loss of 70–80%, it carries a high risk of digestive issues and long-term nutrient deficiencies.