If you and your physician have decided that you are a good candidate for weight loss surgery, there is basic information you should be familiar with so that you can participate effectively in future decisions.
There are two typical surgical approaches to weight loss.
1. One kind reduces the size of the stomach so that you feel full after consuming a much smaller amount of food. The capacity of the normal stomach is about three pints. Surgery may restrict this capacity to as little as one or two ounces. This approach is called restrictive surgery. Each surgeon will decide on a specific technique to cause this restriction. The most commonly used type of restrictive surgery is gastric banding in which a band is wrapped around the stomach to divide it into two parts of unequal size.
2. A second surgical approach is a combination of restrictive (reducing the size of the stomach) and "rearranging" the passageway of food from the remaining stomach to the intestine.
There are pros and cons to each type of surgery.
• BANDING: On the positive side, banding is typically safer because it is a relatively simple procedure. It is usually done laparoscopically (which simply means that the procedure is performed by inserting an instrument through the abdomen). The band can be tightened or loosened in the doctor's office.
- The disadvantage of banding is that there is a smaller weight loss than with the more invasive procedures. Vomiting is fairly common after the band is in place. Food intake must be slow and small in size.
• ROUX-EN Y (Gastric bypass): This is a more complicated procedure because it involves both restriction of the stomach and sewing one portion of it to a lower position in the small intestine so as to bypass a portion of the upper small intestine where the most calories are absorbed. The advantage is that weight loss occurs rapidly and in substantial amounts. Studies have shown the weight loss to be long-lasting as well. The state of health usually improves rapidly after surgery because of the dramatic loss of pounds and the positive effect this has on other conditions such as diabetes and heart disease.
- On the downside, the gastric bypass puts one at risk for nutritional deficiencies because the normal location of vitamin absorption has been bypassed. "Dumping syndrome" may occur because the food is suddenly dumped into a part of the intestine that is accustomed to received a bulk that is usually more digested. This syndrome may result in nausea, bloating, pain, and diarrhea. Further, bypass surgery may cause gallstones and hernia. This surgery cannot be reversed.
Clearly surgery is not the optimal approach to weight loss. However, in some cases it is better than the continued effects of obesity.
Only you and your doctor can decide that.
Look at this "eating plan" before considering surgery.
By Sue Bristol, R.N.
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