Is Weight-loss Surgery for You?

Obesity can impact your day-to-day life, preventing you from doing the things you love and putting your health at risk. When other weight-loss methods have not worked, bariatric surgery may be an option for you.

Living with obesity not only affects your quality of life, it can have severe effects on your short- and long-term health too. Comorbidities such as type 2 diabetes, coronary artery disease, high blood pressure and stroke are related to obesity. Gastric bypass and other weight-loss surgeries, collectively known as bariatric surgery, can improve and sometimes resolve these comorbidities. If you struggle with weight loss and diet and exercise have not worked, you may be a candidate for bariatric surgery.

What is bariatric surgery?

“Bariatric surgery is better described as metabolic surgery. The gastrointestinal tract acts as an endocrine organ. Bariatric operations modify the anatomy of the gastrointestinal tract in ways that cause changes in gut hormone activity - leading to weight loss and improvement or resolution of metabolic diseases,” said Megan P. Lundgren, MD, a general surgeon specializing in Bariatric and Minimally Invasive Surgery at Penn Highlands Bariatric and General Surgery in DuBois. “Contrary to misinformed assumptions, it is not ‘an easy way out.’ Rather, it is an evidenced-based therapy to a serious metabolic health problem.”

Bariatric surgery is indicated for anyone with a BMI greater than 35 or BMI greater than 30 with an obesity related disease, such as diabetes, fatty liver disease, high blood pressure and cholesterol, reflux, PCOS, and more. There are medical guidelines patients must meet to qualify for the surgery, and patients must also be willing to make permanent changes that lead to a healthier lifestyle.

What are the various types of bariatric surgery?

There are several types of bariatric surgery, including those outlined below.

Gastric sleeve surgery: Laparoscopic sleeve gastrectomy is one of the most common weight loss surgery procedures available. During a laparoscopic sleeve gastrectomy, 75% of the stomach is removed, leaving a narrow gastric sleeve. The small stomach tube results in rapid delivery of macronutrients to the small bowel, which causes increases in gut hormone activity. Bariatric surgeons perform the procedure by making four or five small incisions in the abdomen and using a video camera, known as a laparoscope, and long instruments that are placed through these small incisions. No small intestines are removed or bypassed during gastric sleeve surgery.

Roux-en-Y gastric bypass: The Roux-en-Y gastric bypass involves connecting the stomach directly to the lower portion of the small intestine. This delivers macronutrients to the distal small intestine which causes gut hormone secretion that leads to weight loss and improvement in metabolic diseases. It also makes the stomach smaller, which is considered a “restrictive” element of the surgery, making you feel full. During a Roux-en-Y gastric bypass procedure, a bariatric surgeon creates a small pouch laparoscopically by dividing the upper portion of the stomach. That pouch is attached to a Y-shaped section of the small intestine, allowing food to bypass the lower stomach, as well as the part of the small intestine.

SADI-S surgery (single anastomosis duodenal ileal bypass with sleeve): This is a relatively new, simplified type of duodenal switch procedure endorsed by the American Society for Metabolic and Bariatric Surgery that is now available to select patients. Similar to gastric sleeve, SADI-S surgery involves a bariatric surgeon creating a smaller “tube” or “sleeve” shaped stomach. In addition, with SADI-S surgery, the bariatric surgeon attaches the smaller stomach directly to a more distal portion of the small intestine, which results in gut hormone secretion that results in improvement in metabolic diseases and weight loss.

How much weight loss can you expect?

While results differ for everyone, you can expect to lose up to 60 to 70% of your excess body weight after bariatric surgery. The majority of your weight loss will likely occur in the first 18 to 24 months after the surgery. After the first 24 months, you may continue to lose some weight.

How does bariatric surgery fit into a comprehensive weight-loss program?

Bariatric surgery is just a tool and part of a larger lifestyle change. One of the reasons it is such a serious decision is because successful weight loss after bariatric surgery is only possible with long-term lifestyle and dietary changes.

Bariatric surgery patients work with behavioral health experts to change their mindsets about weight and food and understand the thoughts and behaviors that may have contributed to weight gain. People also learn new coping mechanisms for dealing with stress and emotions and receive educational tools to help them achieve the most positive outcome possible.

Penn Highlands Healthcare offers a comprehensive bariatric surgery program that addresses a person’s physical and emotional needs before and after surgery. The approach helps ensure that people are successful at meeting and maintaining their weight loss goals. Each bariatric surgeon is fellowship trained and certified by the American Board of Surgery, and each surgeon has performed more than 100 bariatric surgery procedures