The number of patients undergoing weight loss surgery has risen sharply. Over the last ten years, the amount of bariatric surgeries performed each year in the United States has gone from less than 30,000 in 1999 to more than 200,000 in 2008. Yet this represents only a small percentage of the Americans who medically qualify for bariatric surgery and who can benefit from surgical intervention for extreme obesity.
Extreme obesity, which is generally 80 to 100 pounds or more overweight, is a chronic health condition that is very difficult to treat. According to the National Institutes of Health, bariatric surgery is considered the only permanent treatment for individuals who are morbidly obese.
With obesity reaching epidemic levels, the rising popularity of bariatric surgery is not expected to slow any time soon. However, the widespread obesity levels are not the only factor behind the increase in surgical weight loss treatment. A significant portion of the growth can be attributed to the development of safer surgical techniques and the availability of less-invasive bariatric options.
Surgeons first began to experiment with various intestinal and gastric bypass procedures for weight loss back in the 1950’s. Some of the earliest bariatric procedures were successful in terms of weight loss results, but they also led to serious health problems, including protein-calorie malnutrition, diarrhea, kidney stones, severe arthritis, and liver failure.
Through their attempts, surgeons learned more about the effects of altering various parts of the digestive system and made improvements to their methods. Although it took many years of trial and error, it was in the early 1990’s that bariatric surgery finally began to benefit patients more than it hurt them.
The most successful bariatric procedure over time has been the Roux-en-Y (RNY) gastric bypass surgery. The RNY gastric bypass was first performed in 1967 using open surgery methods, and laparoscopically in 1993. This procedure reduces the functional volume of the stomach and alters the body’s response to food through rerouting of the small intestine.
Almost four decades later, the RNY gastric bypass is still the most common type of weight loss surgery performed in the United States. It results in rapid weight loss and improves or resolves many obesity related health conditions. Gastric bypass patients are required to make lifelong changes in their eating habits and take nutritional supplements to minimize the risk of vitamin and mineral deficiencies.
It wasn’t until 2001, with the FDA approval of the LAP-BAND System, that there was a significant bariatric option other than gastric bypass surgery. More recently, the Swedish Adjustable Gastric Band, which is marketed in the United States as the REALIZE Band, was approved by the FDA in 2007. Both gastric band systems have been available worldwide since the mid 1990’s.
Laparoscopic adjustable gastric banding (LAGB) is a less invasive option to gastric bypass surgery with similar long-term weight loss results. This method does not require surgical alteration of either the stomach or intestines. Instead, a medical implant is placed into the body to restrict eating and control hunger. Gastric banding does not cause nutritional deficiencies as gastric bypass, and can be adjusted or reversed if medically necessary.
While gastric bypass surgery and laparoscopic adjustable gastric banding are the two most popular bariatric options, two other lesser known bariatric options, the gastric sleeve and duodenal switch, may be the preferred treatment option in certain situations.
Choosing to undergo a weight loss procedure is not the easy way to weight loss, but for some individuals it may literally be a life-saving step.
