What Is Bariatric Surgery?

Bariatric surgery, or weight loss surgery, is a surgical way for obese people to attain a healthier weight.

It's an option after diet and exercise have failed and your health is at risk.

There are several different types of bariatric surgeries, but the general aim of all of them is to limit the amount of food you can eat in one sitting, leading to weight loss.

Who Is Bariatric Surgery For?

Bariatric surgery is for clinically obese people with a body mass index (BMI) greater than 40, or people with a BMI greater than 35 and a serious health problem linked to obesity such as heart disease, type 2 diabetes, or sleep apnea.

For patients with a BMI of 30 or above and a serious health problem linked to obesity, the Food and Drug Administration (FDA) has approved use of laparoscopic adjustable gastric band (or LAGB) for weight loss surgery (more on LAGB below).

In addition to the weight requirements, the ideal bariatric surgery patient:

• Has been unable to lose weight and keep it off through diet and exercise
• Is motivated to lose weight and maintain a healthy lifestyle
• Is aware of potential side effects and risks of the surgery

Types of Bariatric Surgery

The most common types of bariatric surgery are:

Roux-en-Y Gastric Bypass: In this surgery, the amount of food you eat is limited and the way it is absorbed is altered.

The surgeon partitions off the top portion of your stomach into a walnut-sized pouch that can hold only 1 ounce of food. (Normally your stomach can hold 3 pints).

Next, your surgeon stitches a part of your small intestine onto the pouch, so food you eat bypasses the majority of your stomach and the first part of your small intestine, changing how it is absorbed.

Laparoscopic adjustable gastric banding (LAGB): In gastric banding surgery, your surgeon places a bracelet with an inflatable band around the uppermost part of your stomach to limit the amount of food you can eat in one sitting.

You may need to have the band inflated more over time.

Biliopancreatic diversion with duodenal switch (BPDS-DS): This surgery works in three ways: by removing part of the stomach so you feel full sooner and eat less; bypassing food away from a large portion of the small intestine so your body absorbs food differently, and changing how bile (a substance your liver produces to aid in digestion) affects the way you digest food and absorb calories.

Sleeve gastrectomy: Most of the stomach is removed during this surgery that changes your stomach into a tube to help you eat less.

In addition, ghrelin, the hormone that tells you that you're hungry, may be decreased as a result.

Sleeve gastrectomy may be performed alone or as the first part of BPDS-DS

Bariatric Surgery Diet

Following any type of bariatric surgery you'll need to follow a strict diet.

This allows your stomach to heal, helps you adjust to eating smaller amounts, prevents complications, and spurs weight loss.

But because your body is taking in less food and absorbing fewer nutrients, malnutrition is a possibility.

To prevent deficiencies, people who have had bariatric surgery are typically advised to consume:

• 60 to 120 grams of protein daily
• Daily multivitamin-mineral supplement
• Calcium and vitamin D supplements
• Additional supplements, such as vitamin B12 or iron, if necessary

In the days immediately following surgery, you'll only be allowed to have 2 to 3 ounces of clear liquids at a time, before moving on to other liquids.

These liquids are:

• Milk (skim or 1 percent)
• Broth
• Unsweetened juice
• Decaffeinated tea or coffee
• Sugar-free gelatin or popsicles

After you can easily tolerate liquids, you can add pureed foods that are blended with water, broth, or skim milk to your diet.

These include:

• Lean ground meats
• Beans
• Fish
• Eggs
• Soft fruits and cooked vegetables
• Cottage cheese

After a few weeks, with your doctor's approval, you can begin to eat soft foods, including ground or finely diced meats, canned or soft fresh fruit (without seeds or skin), and cooked skinless vegetables.

After about eight weeks, you can move on to solid foods, keeping your meals small and healthy.

Risks of Bariatric Surgery

Like all surgical procedures, bariatric surgery carries risks and can result in complications.

The risks and complications of bariatric surgeries may include:

• Infection
• Abnormal bleeding
• Dumping syndrome, causing diarrhea, nausea, or vomiting
• Gallstones
• Hernias
• Low blood sugar
• Bowel obstruction
• Malnutrition
• Stomach perforation
• Ulcers
• Death (rare)