New Year, New You
A doctor weighs in on what to do when diet and exercise aren't working
Holiday indulgence not withstanding, the start of a new year is a great time to take stock of your heath and weight. If you've noticed that diligent diet and extra exercise just don't seem to be working, perhaps it's time to consider bariatric surgery.
Don't let that second word — "surgery" — scare you. Bariatric procedures are a safe and effective way to lose weight when the traditional methods have stopped working.
Below, Dr. Sachin S. Kukreja, from the Methodist Weight Management Institute at Methodist Dallas, breaks down what people should know about bariatric surgery. He also explains why it might be a good fit for some, especially if those with a a BMI of 40 or higher, or a BMI of 35 with weight-related conditions such as hypertension, diabetes, sleep apnea, or joint pain.
What exactly is bariatric surgery?
These procedures cause weight loss by restricting the amount of food the stomach can hold. Most weight loss surgeries today are performed using minimally invasive techniques (known as laparoscopic surgery).
The most common bariatric surgery procedures are:
- Gastric bypass: Often considered the "gold standard" of weight loss surgery, the Roux-en-Y gastric bypass (its formal name) creates a smaller stomach pouch and results in fewer calories consumed.
- Gastric sleeve: This works by removing approximately 80 percent of the stomach, with a tubular pouch remaining. It also impacts gut hormones that deal with hunger, satiety, and blood sugar control.
- Adjustable gastric band: For this, an inflatable band is placed around the upper portion of the stomach, creating a small stomach pouch. The size of the opening is reduced gradually over time with repeated adjustments.
- Biliopancreatic diversion with duodenal switch: A procedure with two components. First, a smaller, tubular stomach pouch is created by removing a portion of the stomach (similar to the sleeve). Next, a large portion — roughly three-fourths — of the small intestine is bypassed.
How risky is bariatric surgery?
Patients are often surprised — and don’t believe — how safe bariatric surgery is. Whether you’re talking about sleeve, bypass, or duodenal switch, bariatric surgery is now considered safer than having your gallbladder removed. The reason is that patients undergoing weight loss surgery undergo thorough evaluations beforehand to make sure they are healthy enough to proceed.
Why is weight loss surgery also referred to as metabolic surgery?
Metabolism is the process of how the body breaks down food to be used as energy or stored in the tissues, and so a metabolic disorder is when that process is disrupted. Obesity can increase the risk of metabolic disorders such as diabetes, hypertension, and abnormal cholesterol.
Depending on the patient, disease and operation, bariatric surgery allows for diabetes remission in up to 98 percent of the time.
Furthermore, metabolism can be measured. The 2,000-calorie rule that is ingrained in us from the FDA doesn’t apply to all individuals, and doctors can calculate the caloric needs of a patient to lose or maintain weight.
Are there non-surgery options? What are gastric balloons?
Gastric balloons are non-invasive, and don’t require surgery for placement or removal. In fact, some can even be placed in your doctor's office while you are on your lunch break. The balloon is swallowed and then your physician inflates the balloon.
The balloon helps facilitate weight loss by taking up space in your stomach, so that you eat less. In a clinical study, patients lost twice as much weight than with diet and exercise alone.
As always, consult with your doctor before embarking on any weight loss plan, surgical or otherwise. Need a doctor? Find one here.