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What is bariatric surgery?

Bariatric surgery is performed on obese patients who haven’t had success in losing weight and keeping it off. This type of surgery works by decreasing hunger caused by the sleeve removal which eliminated most of the hunger hormone ghrelin. This surgery can also restrict the amount of food your stomach can hold and therefore reduce the amount of nutrients absorbed.

This type of surgery is never the first course of action to lose weight—in fact, it’s only appropriate when diet and exercise have failed over extended periods of time. Each type of surgery has specific requirements that are usually determined by your body mass index (BMI), which is a weight-to-height ratio that acts as an indicator of whether a person is obese or underweight. Qualifications for bariatric surgery usually require a BMI equal to or greater than 40 or being more than 100 pounds overweight, according to the American Society for Metabolic and Bariatric Surgery. In some cases, surgery can be recommended if an individual has a BMI equal to or greater than 35 with the presence of one or more obesity-related diseases such as type 2 diabetes.

Who is a good candidate for bariatric surgery?

You might be a good candidate for bariatric surgery under the following circumstances:

  • You’ve tried and failed to lose weight and keep it off over an extended period.
  • You have realistic views about the surgery, what it can accomplish and what will be required of you.
  • You’re committed to completing any suggested counseling and following the diet and exercise plan your healthcare team devises for you.
  • You meet the BMI requirements and any other prerequisites for the type of surgery you’re considering.

What types of bariatric surgery are available?

There are several types of bariatric surgery available, each of which has its own pros and cons. Many are performed using a laparoscope—a small instrument with a tiny camera attached to its tip that allows the surgeon to avoid making large incisions by providing a better view inside the abdomen. The smaller incisions help make recovery a quicker process.

If you and your doctor determine that a weight loss procedure is appropriate, your doctor can recommend one of the following:

  • Gastric sleeve: In this surgery, most of your stomach is removed from your body, resulting in smaller portion sizes and decreased hunger.
  • Gastric bypass: This type of bariatric surgery creates a small pouch which bypasses the majority of your stomach and your intestines are rerouted to carry food away from the pouch.
  • Duodenal switch: This procedure combines qualities of the gastric bypass and gastric sleeve operations. It’s a drastic surgery compared to other types but offers the chance to lose a significant amount of weight as well as greater resolution of many comorbidities.
  • Obalon intragastric balloon: This procedure uses space-occupying balloons in your stomach to decrease hunger and caloric intake.

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