Last Resort: Weight Loss Surgery Options

There are basically two approaches when considering weight loss surgery. One surgery attacks weight loss through a variety of restrictive procedures that help eliminate food intake. The second one involves malabsorptive procedures that impact your digestive system, which causes the foods you ingest to be poorly digested. This enables it to not be completely absorbed and makes it be eliminated through your stool.

Gastric Restrictive Procedure – Vertical Banded Gastroplasty (VBG)

VBG is a procedure that is strictly restrictive in nature. When you undergo this procedure, surgeons will staple the upper stomach (near the esophagus) for approximately 6 centimeters, or 2/2 1-2 inches. This is done to create a small pouch, which is restricted by a ring or a band that slows down the emptying of food. You lose weight with this procedure as this create a feeling of fullness much quicker than if you had a larger stomach pouch.

Vertical Banded Gastroplasty (VBG) is a purely restrictive procedure. In this procedure the upper stomach near the esophagus is stapled vertically for about 2-1/2 inches (6 cm) to create a smaller stomach pouch. The outlet from the pouch is restricted by a band or ring that slows the emptying of the food and thus creates the feeling of fullness.

The main advantage of the VBG surgery is that as the surgery is restrictive; a reduced quantity of food enters and passes throughout the digestive tract. This allows vitamins and nutrients to be fully consumed by the body. Studies have shown that patients are able to reach and maintain 50% of excess weight loss. While there are major benefits of this surgery, there are also many risks that you must undertake – including infection, re-hospitalization due to malnutrition, and even possibly weight gain.

Malabsorptive - Biliopancreatic Diversion (BPD)

This also involves limiting the size of the stomach, albeit the pouch created in this form of surgery is much larger. The primary goal of malabsorptive procedures is to limit the amount of food that is consumed and modify the process of digestion. Surgeons change the anatomy of the small intestine and re-arrange the bile and pancreatic juices so that they both intercept the food closer to the end or the middle of the small intestine. As with the vertical banded gastroplasty, this reduces the nutrients and calories consumed, but at a much greater rate.

BPD takes out about ¾ of the stomach to restrict food intake, as well as reduce the amount of acid that is outputted. Then, the small intestine is split with one end attached to the stomach pouch – this creates something that is called an “alimentary limb.” All food consumed moves through this limb, but not much is absorbed because of bile and pancreatic juices coming from the other end which is connected to the side of the intestine.

Surgeons are able to vary the length of this to control the amount of absorption on things like protein, fat, and fat-soluble vitamins that your body intakes.

Weight loss surgery is an absolute last resort, but it's important you know the facts.

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