Understanding the Different Types of Bariatric Surgeries: Which One is Right for You?

If you want to lose weight and improve your health, you probably tried different diets and exercises, but nothing seems to work. If so, you might be interested in learning about different types of weight loss surgery.

In this blog, we will explore some of the most common and effective bariatric surgeries and share some tips, benefits, and risks for people considering or having undergone bariatric surgery.

Keep reading to know more!

What is Bariatric Surgery?

Bariatric surgery, also known as weight loss surgery, is the type of surgery that helps people lose weight and improve their health by changing their digestive system.  Doctors may suggest bariatric surgery if other ways of losing weight have not worked and if obesity seems to be more harmful to your health than surgery balancing the risk benefits of surgery vs not having surgery..

How does Bariatric surgery work?

This surgery changes your digestive system — mainly by reducing the capacity of your stomach, and sometimes re-routing the intestines to alter the path the food takes after entering the stomach — To control how many calories you can eat(stomach capacity) and absorb(re-routing the intestines). They also lower the hunger signals from your digestive system to your brain by changing the hormonal release from the stomach and intestines. This usually makes you less hungry and makes you feel full much quicker than normal.

There are also emerging information that it changes the interior environment and microorganisms (microbiome) within the intestines which helps not only in losing weight but improving conditions such as diabetes etc.

Who’s a good candidate for Bariatric Surgery?

Bariatric surgery is not for everyone and requires careful preparation and follow-up. Here are some tips on who might be a candidate for bariatric weight loss surgery:

  • A body mass index of 40 or higher, or 35 or higher, with a severe health problem linked to obesity has been the traditional cutoff.  It has been revised in October 2022 to include patients with a BMI of 35 on it’s own or a BMI of 30 with co-morbidities. The cut off is even lower for the Asian population due to the predisposition to develop diabetes and other health problems at a lower BMI.
  • A documented history of weight loss attempts and weight management with supervised diets and exercise programs.
  • No indication of active alcoholism, active drug addiction, or a major psychiatric disorder.
  • An understanding of the risks and benefits of the surgery and the lifestyle changes required after the surgery.
  • A commitment to follow lifelong healthy eating and physical activity habits, medical follow-up, and the need to take extra vitamins and minerals.

Different Bariatric Surgeries :

Each type of bariatric surgery has its own pros and cons. So it is essential to talk to your doctor about them. Here’s a look at common different types of weight loss surgery:

Sleeve Gastrectomy: 

This surgery removes most of your stomach, leaving a small tube-shaped pouch that makes you feel full faster and lowers your appetite. It can help you lose about 50-60% of your excess weight within 18 months to 2 years.

Some advantages of this surgery are that it does not involve any foreign objects, such as a band or a balloon, and does not affect nutrient absorption. However, some disadvantages are that it is irreversible, it may increase the risk of acid reflux, and it may cause leaks or bleeding in the stomach. The incidence of weight regain is relatively higher than the bypass.

Standard Roux Y Gastric bypass: 

This surgery creates a small pouch in your stomach and connects it to the middle part of your small intestine, bypassing the rest of your stomach and the upper part of your small intestine. It involves 2 areas of joining between the stomach/intestine. This surgery can help you lose about 60-70% of your excess weight within 18 months to 2 years.

Some of the advantages of this surgery are that it can improve or resolve diabetes, high blood pressure, and high cholesterol and is the best surgery for anyone who has acid reflux disease. Some of the disadvantages are that it is relatively difficult to perform, difficult to reverse, it may cause dumping syndrome, which is when food moves too quickly into the small intestine and causes nausea, vomiting, and diarrhea, and it may lead to vitamin and mineral deficiencies.

It remains the ‘Gold Standard’ surgery for Obesity.

One Anastomosis ( Mini) Gastric bypass: 

This surgery creates a relatively longer pouch in your stomach than a standard bypass and connects it to the middle part of your small intestine with just one joint bypassing the rest of your stomach and a variable portion of your small intestine. This surgery can help you lose about 60-70% of your excess weight within 18 months to 2 years.

The advantages of this surgery is that it is less complicated than the standard bypass as it has only one joint, gives good weight loss and can improve or resolve diabetes at the same extent or more than a standard bypass. Some of the disadvantages are that it may cause bile reflux and some chance of malabsorption, diarrhea and excess weight loss if a long length of intestine is bypassed. 

SADI-S procedure.

This newer type of surgery is predominantly reserved for patients with a very high BMI or in patients with weight regain after a Sleeve Gastrectomy.

This surgery involves a Sleeve Gastrectomy and also  bypasses most of your small intestine with one anastomosis, reducing the amount of food you can eat and the calories you can absorb. There is no chance of dumping syndrome due to the way it is done. This surgery can help you lose upto 70%  of your excess weight within 18 months to 2 years.

It is one of the most effective surgeries and can be a rescue operation after a failed Sleeve Gastrectomy. It is however more technically challenging and should be done by experts in the field. Some of the disadvantages are that it is irreversible, it may cause severe diarrhea and malabsorption or excess body weightloss and it may require lifelong supplementation of vitamins and minerals.

Bariatric revision surgery.

Bariatric revision surgery is a second surgery that can help people who have had a previous weight loss surgery but have experienced complications, insufficient weight loss, or weight regain. It can be more complex and risky than the first surgery and may result in a different amount of weight loss.

Revisonal surgery is also done for complications such as reflux (after a Sleeve Gastrectomy), dumping, excess weight loss, marginal ulcers etc.

There are different types of bariatric revision surgery, depending on the original procedure and the reason for revision.

What are the risks?

Bariatric surgery is usually immensely beneficial if the patient is carefully selected, prepared, counseled and operated by an expert in an appropriate setting.  

However there is a small chance of complications such as bleeding, infection, anesthesia, blood clots, hernias, leakage from the staple lines, injury to other organs, need for open surgery  and internal hernias. 

Long term effects as change in bowel habits, loose stools , development of gall stones etc are uncommon but are not unknown.  Loose skin is inevitable to varying degrees as a result of significant weight loss.

One of the most important advice is for lifelong vitamin, iron and mineral supplementation and  follow up with the doctor and dietician is very important

More about bariatric surgery

Which Bariatric surgery is most successful?

There is no definitive answer to which bariatric surgery is most successful, as different types of surgery may have various benefits and risks for different patients. It is important that the doctor takes into account all the factors before advising the best type of surgery to suit individual patients.

In general the Standard Roux Y Bypass is the gold standard operation and is better served for patients with diabetes and reflux. The Sleeve is the easier operation and hence the most commonly done surgery but stands a chance of weight regain and developing new reflux.

Sleeve Gastrectomy and Gastric banding (not done frequently any more)  are the commonest surgeries  for which revisional surgery is indicated.

Consult Dr. Balaji Nagammapudur for different bariatric surgeries in Dubai.

If you are interested in getting bariatric surgery and losing weight, you should consult Dr Balaji Nagammapudur, one of the leading bariatric surgeons in Dubai.

Dr. Balaji Nagammapudur has more than 15  years of experience and expertise in performing different types of weight loss surgery in Dubai. He can help you find the best option based on your medical condition, lifestyle, and expectations. He can also provide you with the best care and support before, during, and after the surgery. 

Don’t wait any longer; contact Dr. Balaji Nagammapudur today and take the first step towards a healthier and happier life.

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