Weight Loss Surgery

Bariatric surgery can help obese adults and teens achieve significant weight loss. This can resolve and improve diseases associated with obesity, such as type 2 diabetes. 

There are two main types of bariatric surgery: 

• Restrictive procedures reduce the size of the stomach and limit the amount of food you can eat. They include adjustable gastric banding (such as the LAP-BAND®), stomach stapling, and combination banding/stapling. 
• Malabsorptive/restrictive procedures — gastric bypass — alter the normal digestive process. They reduce the size of the stomach and diverts food past most or all of the first section of the small intestine where the body absorbs most calories. One type of bypass procedure is Roux-en-Y gastric bypass (RGB or RYGB).

Bariatric surgeons and general surgeons perform bariatric surgery. 

Reasons for Bariatric Surgery

If other medical weight loss programs haven't worked for you, your doctor may recommend bariatric surgery. People have bariatric surgery to:

• Achieve significant weight loss
• Control their blood sugar level — known as glycemic control, which can reverse type 2 diabetes in many cases
• Improve their overall health and capacity for physical fitness
• Enhance their quality of life  

In general, doctors use the following criteria in determining a good candidate for bariatric surgery:

• A body mass index (BMI) of 40 or more 
• A BMI greater than 35 with weight-related health problems, such as type 2 diabetes, heart disease, sleep apnea, or high blood pressure 
• You are ready to lose weight and improve your health, and accept the lifestyle changes that come with bariatric surgery

Risks and Complications 

The general risks of any surgery include reactions to anesthesia, bleeding, blood clots, and infections. Other risks of bariatric surgery include:

• Damage to organs or blood vessels
• Dumping syndrome — when food moves too quickly into the small intestine
• Gallstones
• Leakage of digestive juices
• Malnutrition
• Problems with the restrictive device
• Recurrence of weight gain

How to Prepare 

Your doctor will give you specific instructions about things you need to do before surgery. In general, you can prepare for bariatric surgery by:

• Checking with your insurance company about your coverage 
• Making arrangements for help during your recovery 
• Not eating for about eight hours before your surgery
• Stopping aspirin or other blood thinners about a week before your surgery

Recovery and What to Expect

Some types of bariatric surgery require more downtime than others. You will spend several days in the hospital. It may take 10 to 12 weeks to transition from a liquid diet to solid foods. Full recovery can take several months.

Bariatric surgery can improve your quality of life, decrease your risk of heart disease, and improve or resolve obesity-related diseases. However, it can also affect other parts of your life, such as changes in:

• Body image
• Diet including portions and consistency
• Social, work and family relationships 
• Bowel movements, such as chronic diarrhea in some cases