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How Does Bariatric Surgery Work, Anyway?


You already know that bariatric surgery helps you lose weight and gain health, but how?


Weight loss surgery works in a few ways:

1. Restricts the amount of food you can eat

2. Limits the number of calories & nutrients your body actually absorbs

3. Changes important hormones which affect your hunger levels



TYPES OF BARIATRIC SURGERY

According to The American Society for Metabolic and Bariatric Surgery (ASMBS), there are currently four main bariatric surgery procedures surgeons are performing today.


They are:

1. Roux-en-Y Gastric Bypass (RYGB)

2. Vertical Sleeve Gastrectomy (VSG)

3. Adjustable Gastric Band (AGB)

4. Biliopancreatic Diversion with Duodenal Switch (BPD/DS)


Let's talk a little bit about how each one works.


Roux-en-Y Gastric Bypass (RYGB)

  • Gastric Bypass for short

  • Called Roux-en-Y after the surgeon, Cesar Roux, who created the procedure and because of the fact that your new food system resembles the letter Y (See image below!)

  • Considered the "gold standard" of weight loss surgery

  • HOW IT WORKS: Your surgeon will create a small stomach pouch (about 1 ounce in size) by dividing the top of your stomach from the rest of it. Next, the surgeon will divide your small intestine in two, connecting the bottom of it to your new stomach pouch. Finally, the surgeon connects the top of your small intestine to the small intestine further down (that Y shape) so stomach acid & digestive enzymes can eventually mix with your food.

  • Your new stomach pouch is much smaller = you eat smaller meals

  • Changes in your gut hormones also occur which suppress feelings of hunger

  • Significant long-term weight loss is achieved: 60-80% excess weight loss

  • Patients maintain their weight loss, too! About 50% of excess weight loss was maintained at 3-5 year follow-ups.

Vertical Sleeve Gastrectomy

  • "The Sleeve"

  • HOW IT WORKS: The surgeon will remove approximately 80% of your stomach creating a new, smaller stomach pouch that resembles a tube or a banana.

  • Your new stomach pouch is much smaller and helps significantly reduce the amount of food you can eat.

  • There is a great influence on gut hormones that control hunger levels and blood sugar.

  • This surgery doesn't involve any foreign objects like the AGB, or any re-routing of your food like the RYGB.

  • Rapid and significant weight loss is achieved -> More than 50% of excess weight loss

  • This procedure is non-reversible.

Adjustable Gastric Band (AGB)

  • AKA Lap-Band or "The Band"

  • HOW IT WORKS: The procedure involves an adjustable band made of silicone rubber that's wrapped around the upper portion of your stomach, creating a small pouch separate from the rest of your stomach. It works because when you eat, the food will quickly fill your smaller stomach pouch, making you feel full off of a little bit of food. The food very slowly passes through the band into the rest of your stomach to go through the remainder of the digestive process. No cutting or stapling is involved.

  • With the band, eating just a small amount of food will satisfy your hunger.

  • The band is adjustable and is personally sized to fit you!

  • Average weight loss: 40-50% excess weight

Biliopancreatic Diversion with Duodenal Switch (BPD/DS) Gastric Bypass

  • That was a mouthful ... Haha

  • Mostly referred to as simply duodenal switch or "The Switch"

  • HOW IT WORKS: Roughly 1/2 of your stomach is permanently removed during this surgery, causing you to feel full pretty quickly after eating, in turn causing you to eat less. This surgery also involves changing the way you digest your food by bypassing the majority of your small intestine. About 3/4 of your small intestine is bypassed by your food stream. AKA your food makes a detour from your new stomach pouch to the last 1/4 of your small intestine where it's finished being digested. What's the point of this? Your body will absorb way fewer calories (and nutrients) than if it were to go through your entire small intestine.

  • This surgery promotes the greatest weight loss compared to the other 3 --> About 60-70% of excess weight is lost.

  • Like the others, this surgery changes your gut hormones to reduce your appetite

  • The BPD/DS is the most effective surgery against diabetes compared to the other 3.





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