Weight Loss Surgery: What Are The Options?

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Please consider this free-reprint article written by:

Ellis

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Article Title: Weight Loss Surgery: What Are The Options?

Author: Ellis

Word Count: 1146

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To understand how surgical procedures aid the grossly

overweight person to reduce their body fat, it helps to first

understand the digestive process that is responsible for

handling the food we take in.

Once food is chewed and swallowed, it’s on its way through the

digestive tract, where enzymes and digestive juices will break

it down and allow our systems to absorb the nutrients and

calories. In the stomach, which can hold up to three pints of

material, the breakdown continues with the help of strong

acids. From there it moves into the duodenum, and the digestive

process speeds up through the addition of bile and pancreatic

juices. It’s here, that our body absorbs the majority of iron

and calcium in the foods we eat. The final part of the

digestive process takes place in the 20 feet of small

intestine, the jejunum and the ileum, where calorie and

nutrient absorption is completed, and any unused particles of

food are then shunted into the large intestine for elimination.

Weight loss procedures involve bypassing, or in some way

circumventing the full digestive process. They range from

simple reduction of the amount you can eat, to major bypasses

in the digestive tract. To qualify for many of these surgeries,

a person must be termed “morbidly obese”, that is, weighing at

least 100 lbs. over the appropriate weight for their height and

general body structure.

Gastric Bypass

In the mid 1960s, Dr. E. Mason discovered that women who

had undergone partial stomach removal as the result of peptic

ulcers, failed to gain weight afterwards. From this

observation, grew the trial use of stapling across the top of

the stomach, to reduce its actual capacity to about three

tablespoons. The stomach filled quickly, and eventually emptied

into the lower portion, completing the digestive process in the

normal way. Over the years, the surgery evolved into what is

now known as the Roux-en-y Gastric Bypass. Instead of

partitioning the stomach, it is divided and separated from the

rest, with staples. The small intestine is then cut at

approximately 18” below the stomach, and attached to the “new”,

small stomach. Smaller meals are then eaten, and the digested

food moves directly into the lower part of the bowel. As weight

loss surgeries are viewed overall, this is considered one of the

safest, offering long-term management of obesity.

Gastric Banding

A procedure that produces basically the same results as the

stomach stapling/bypass, and is also classed as a “restrictive”

surgery. The first operations, involved a non-flexing band

placed around the upper part of the stomach, below the

esophagus, creating an hourglass shaped stomach, the upper

portion being reduced to the same 3-6 ounce capacity. As

technologies advanced, the band became more flexible,

incorporating an inflatable balloon, which when triggered by a

reservoir placed in the abdomen, was capable of inflating to

cut down the size of the stoma, or deflating to enlarge it.

Laparoscopic surgery means smaller scars, and less invasion of

the digestive tract.

Biliopancreatic Diversion

A combination of the gastric bypass, and Roux-en-y

re-structuring, that bypasses a significant section of the

small intestine, thereby creating the probability of

malabsorption. The stomach is reduced in size, and an extended

Roux-en-y anastomosis is attached to the smaller stomach, and

lower down on the small intestine than is normal. This permits

the patient to eat larger amounts, but still achieve weight

loss through malabsorption. Professor Nicola Scopinaro,

University of Genoa, Italy, developed the technique, and last

year published the first long-term results. They showed an

average 72% loss of excess body weight, maintained over 18

years, the best long-term results of any bariatric surgical

procedure, to date. BPD patients require lifelong follow-ups to

monitor calcium and vitamin intake. The advantages of being able

to eat more and still lose weight, are countered by loose or

foul smelling stools, flatus, stomal ulcers, and possible

protein malnutrition.

Jejuno-Ileal Bypass

One of the first weight loss procedures for the grossly obese,

was developed in the 1960s, a strictly malabsorptive method of

reducing weight, and preventing gain. The jejuno-ileal bypass

reduced the lower digestive tract to a mere 18” of small

intestine, from the natural 20 feet, a critical difference when

it came to absorption of calories and nutrients. In the

end-to-end method, the upper intestine was severed below the

stomach, and re-attached to the small intestine much lower

down, which had also been severed, thereby “cutting out”, the

majority of the intestine. Malabsorption of carbohydrate,

protein, lipids, minerals and vitamins, led to a variation, the

end-to-side bypass, which took the end of the upper portion, and

attached it to the side of the lower portion, without severing

at that point. Reflux of bowel contents into the

non-functioning upper portion of small bowel, resulted in more

absorption of essential nutrients, but also less weight loss,

and increased weight gain, post-surgery. As a result of the

bypass, fatty acids are dumped in the colon, producing an

irritation that causes water and electrolytes to flood the

bowel, ending in chronic diarrhea. The bile salt pool necessary

to keeping cholesterol in solution is reduced by malabsorption

and loss through stool. As a consequence, cholesterol

concentration in the gall bladder rises, increasing the risk of

stones. Multiple vitamin losses are a major concern, and may

result in bone thinning, pain and fractures. Approximately one

third of patients experience an adjustment in the size and

thickness of the remaining active small intestine, which

increases the absorption of nutrients, and balances out the

weight loss. However, over the long term, all patients

undergoing this bypass are susceptible to hepatic cirrhosis. In

the early 1980s, one study showed that approximately 20% of

those who had undergone JIB, required conversion to another

bypass alternative. The procedure has since been largely

abandoned, as having too many risk factors.

While surgical methods of reducing weight are valuable to the

morbidly obese, they are not without risks. Patients may

require more bed rest post-surgery, resulting in an increased

chance of blood clots. Pain may also cause reduced depth of

breathing, and complications such as pneumonia.

Before undergoing any fat/weight reduction surgery, a severely

overweight person needs to thoroughly understand the benefits

and risks, and must make a commitment to their future health.

Having a smaller stomach is not going to stop the chronic

sugar-snacker, from “grazing” on high calorie sweets. Nor does

a steady supply of pop, concentrated sweet juices and milk

shakes, reduce the calorie intake. With some bypass surgeries,

certain foods can aggravate side-effects that need not be that

severe, if common sense diets are adhered to. Surgery can be a

“shortcut” to weight loss, but it can also reduce your

enjoyment of life, if you are unable to adhere to the regimens

that go with it.

About The Author: Fitness Consultant Ellis has helped

thousands of individuals lose fat and build more muscle. To

read more about his fat loss recommendations please check out

his site at http://www.fatlosstips.com

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