Diet and Weight Loss Weight Loss Surgery

Ask Your Doctor Discussion Guide: Questions for Your Weight Loss Surgeon

Advantages of restrictive procedures:

• These procedures are simpler to perform and generally safer for patients. Adjustable gastric banding is the safest surgical weight-loss procedure to date, with lower rates of complications and death.
• These procedures require less time in the operating room, shorter hospital stays and less time for recovery.
• Weight loss is more gradual over time, with steady, healthy weight loss. After three to five years it is similar to patients undergoing restrictive/malabsorptive procedures (such as gastric bypass).
• Adjustable gastric banding has an added benefit of changing the level of restriction to fit each patient’s individual needs without additional surgery.
• No dumping syndrome (the process of quickly passing food into the small intestine).

Disadvantages include:

• Less weight loss occurs than with gastric bypass in the first year to three years.

Risks commonly associated with restrictive bariatric surgery include:

• An adjustable gastric band can slip out of place, or part of the stomach can slip through the band, resulting in a revisional surgery to correct the placement.
• An adjustable gastric band may penetrate a hole in the stomach (erosion) and necessitate a corrective surgery.
• Infection.
• Eating too much or too quickly or eating certain kinds of food may cause nausea and vomiting. If not controlled, regular vomiting may continue for years after the surgery and may lead to malnutrition (as not enough vitamins and minerals are absorbed).

Restrictive/malabsorptive procedures
These surgeries reduce the size of the stomach and shorten the small intestine, which permanently alters your anatomy. The smaller stomach also makes you feel satisfied and full after eating less food. However, a change to the intestine also reduces the amount of nutrients and calories the body can absorb. These operations include:

• Roux-en-Y gastric bypass (this is by far the most common type of bariatric surgery)
• Biliopancreatic diversion with duodenal switch

Advantages of restrictive/malabsorptive procedures:

• Faster and greater immediate weight loss in the first six months to 3 years compared to restrictive procedures

Disadvantages include:

• These procedures are more difficult to perform and carry higher risks during and after surgery.
• The surgery, the hospital stay and the recovery time are all considerably longer.
• During the first year after surgery, patients may experience dumping syndrome, a condition associated with sweating, weakness and low blood sugar levels. This condition mostly occurs after a meal containing too many high-fat and high-sugar foods is consumed.
• They carry higher risks for malnutrition and permanent dependency on supplements.
• This surgery also permanently alters anatomy.

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