What is bariatric surgery?

Bariatric surgery refers to weight-loss surgery. Bariatric surgery can help obese adults and adolescents achieve significant weight loss. Weight loss can lower the risk of heart disease and resolve and improve  diseases associated with obesity. This includes type 2 diabetes, hypertension, and high cholesterol. Bariatric surgery requires a lifelong commitment to healthy dietary and exercise habits, vitamin supplementation, and regular follow-up care.  

Bariatric surgery can be a life-saving treatment for people whose obesity seriously threatens their health. Bariatric surgery is used for people who have not lost weight through diet, exercise, counseling, and medication.

Bariatric surgery is only one part of a complex obesity treatment plan. Less invasive treatment options that have less risk of complications are available to help you lose weight. Consider getting a second opinion about your treatment choices before having bariatric surgery. 

Types of bariatric surgery

Bariatric surgeries incorporate one or two general techniques that work in different ways to reduce your calorie intake. These include:

  • Restrictive procedures reduce the size of the stomach. This limits the amount of food you can eat. Restrictive procedures include adjustable gastric banding (Lap-Band), vertical sleeve gastrectomy (stomach stapling), and vertical banded gastroplasty (stomach stapling and banding).
  • Malabsorptive/restrictive procedures (gastric bypass) alter the normal digestion process. The stomach is stapled down to a small pouch (typically the size of a small test tube). It is then attached to the middle of the small intestine. This allows food to bypass most or all of the first section of the small intestine (the duodenum). It reduces the amount of calories and nutrients absorbed into the body. Procedures include the Roux-en-Y gastric bypass (RYGB) and the biliopancreatic diversion with a duodenal switch (BPD-DS). This technique combines the restrictive and malabsorptive procedures to increase weight loss success.

Why is bariatric surgery performed? 

Your doctor may recommend bariatric surgery to treat obesity and reduce the risk of life-threatening complications of obesity. Complications include diabetes, heart disease, and severe sleep apnea. 

Bariatric surgery is not a treatment option for people who are mildly overweight. It is generally used for adults with a body mass index (BMI) of 40 or more. This means being about 100 pounds overweight for men and 80 pounds overweight for women. People who are less obese with a BMI of about 35 to 39.9 and have serious weight-related health problems, such as type 2 daibetes or high blood pressure may also have bariatric surgery.

Bariatric surgery may be an option if other treatment options that involve less risk and fewer complications have not helped you lose weight. Other options include diet, exercise, behavioral and nutritional counseling, and medication. Ask your doctor about all of your treatment options and consider getting a second opinion before having bariatric surgery.

Who performs bariatric surgery?

A bariatric surgeon or general surgeon performs bariatric surgery. Bariatric surgeons are often general surgeons who have specialized in bariatrics. Bariatrics is the field of medicine that deals with the causes, prevention, and treatment of obesity. A general surgeon specializes in the surgical treatment of a wide variety of diseases, disorders and conditions. 

How is bariatric surgery performed?

Your bariatric surgery will be performed in a hospital. It is often a minimally invasive surgery. This involves  inserting special instruments and a laparoscope through small incisions in the abdomen. The laparoscope is a long, thin camera that transmits pictures of the inside of your body to a video screen viewed by the doctor during surgery.

Minimally invasive surgery generally involves a faster recovery and less pain than open surgery. This is because it causes less trauma to tissues and organs. Your surgeon will make several small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery.