Weight-Loss Surgery (Bariatric Surgery)

Weight-loss surgery is surgery to the stomach or intestine (or both) to help you lose weight. It's also called bariatric surgery.

• Doctors sometimes recommend weight-loss surgery for people who have obesity, particularly if they have weight-related health problems

• There are many different surgical procedures

• After surgery, you'll still need to make lifelong changes to what and how much you eat

• Weight-loss surgery can lessen weight-related health problems, such as diabetes

• Weight loss surgery can be more effective than dieting but has a higher risk of side effects

To qualify for weight-loss surgery, you must:

• Have tried other ways of losing weight

• Be physically and mentally able to have surgery

• Be ready to follow your doctors’ instructions after surgery about what to eat, how much to exercise, and when to get follow-up tests

Your stomach is where food first goes when you swallow it. The stomach starts digesting food and then passes it into the intestines. The intestines finish digesting food and take the nutrients into your body. Weight-loss surgery does one or both of the following:

• Makes your stomach smaller to limit the amount of food you can eat

• Bypasses part of your intestines so less food can be absorbed

The most common weight-loss surgeries include:

• Sleeve gastrectomy: Removing part of your stomach so what remains is a thin, small tube

• Gastric bypass: Making a small stomach pouch and connecting it to the middle part of your small intestine

• Adjustable gastric banding: Putting a band around your stomach to restrict its size

Gastric bypass is the most common type of surgery. After this surgery, your stomach can hold only a small amount of food. Food that leaves the stomach bypasses the first part of the small intestine.

Your doctor will recommend the type of weight-loss surgery best for you.

Doctors can do some weight-loss surgery with laparoscopy. Instead of cutting your belly open, doctors put a viewing tube (laparoscope) and surgical tools in through small cuts in your belly. Laparoscopy is generally safer and you recover quicker than with regular (open) surgery.

Bypassing Part of the Digestive Tract

In gastric bypass, part of the stomach is detached from the rest, creating a small pouch. The pouch is connected to a lower part of the small intestine.

Banding the Stomach

In adjustable gastric banding, an adjustable band is placed around the upper part of the stomach. It enables doctors to adjust the size of the passageway for food through the stomach as needed.

You may have to wait about 4 weeks to eat solid food. For the first 2 weeks, you'll drink protein drinks. For the next 2 weeks, you may start eating some soft, mushy, or pureed foods.

When you start eating solid foods, your doctor may recommend:

• Taking small bites of food

• Chewing food carefully

• Not eating high-fat and high-sugar foods, such as fast food, cakes, and cookies

• Eating only small meals

• Not drinking liquids when eating solid foods

Even though having a smaller stomach makes it easier to eat less, some people still eat too much. Some people drink lots of shakes or other high-calorie liquids. Others keep eating even when they're full and gradually stretch out their smaller stomach. Even though you had surgery, you still have to watch what you eat so you lose weight and don't gain it back.

Also, because you aren't absorbing food normally, you have to be careful you get enough vitamins, minerals, proteins, and other important nutrition.

Changing how you eat can be hard. Counseling or a support group may help.

Weight-loss surgery may help you lose weight that you couldn't lose by dieting. Also, you usually lose a lot more weight with surgery than with dieting.

Weight loss can help with weight-related health problems, including:

• Sleep apnea

• Diabetes

• High blood pressure

• Heart problems

• Depression

All surgeries have a chance of:

• Infections near the site of surgery

• Blood clots in your lungs

• Lung infection (pneumonia)

Weight-loss surgeries also have a small chance of:

• Blocked intestines

• Leaking from one of the surgical connections, which can cause belly infection

• Bleeding from the stomach or intestine, or in the belly area

• Gallstones or gallbladder problems

• Kidney stones

• Gout

• Not getting enough nutrition from your food

• Death

Because of these risks, doctors do weight-loss surgery only for people who have severe obesity or who are very overweight and have a serious weight-related health problem. Talk to your doctors about the risks of surgery.

Call your doctor right away if you have signs of infection around your wound, such as:

• Redness

• Severe pain

• Swelling

• Bad smell

• Oozing

Call your doctor right away if you have these warning signs after surgery:

• Severe belly pain

• Fever or chills

• Throwing up

• Bleeding

• Fast or skipping heartbeats

• Diarrhea

• Dark, tarry, bad-smelling stools

• Shortness of breath

• Sweating

• Sudden paleness

• Chest pain