Weight-Loss Surgery
March 2007
Obesity is a major health problem. Weight-loss (bariatric) surgery is an important new treatment, but since
the operations carry risks, surgery is not for everyone. The best candidates are people with a body
mass index (BMI) above
40 or those with BMIs above 35 who also have obesity-related
illnesses, such as diabetes or high
blood pressure. Patients should have failed other methods of weight loss and should be healthy enough to undergo surgery
without an undue risk of complications. They should also be committed to a lifelong program of a healthful lifestyle, vitamin
supplements, and regular medical care.
At present, most bariatric operations are performed through laparoscopes, and two procedures are most common:
Gastric banding. In the popular lap-band procedure, doctors place a silicone band around the upper part
of the stomach. The band is connected to a port under the skin, so doctors can adjust the band by injecting saline (salt
water). The small stomach pouch limits the amount of food the patient can eat.
Roux-en-Y gastric bypass. This technique creates a small, non-adjustable stomach pouch and also bypasses
part of the intestines. It produces faster and more dramatic weight loss than the lap-band. But because it is a simpler
operation, the lap-band has fewer complications.
How can you decide what’s best for you? First, get a comprehensive medical evaluation to find out if you are a
good candidate for surgery. Next, ask about the risks and benefits of each operation. Finally, consider the experience
of your surgical team and hospital. When it comes to your weight, less is better—but when it comes to surgical experience,
more is better.
[back to top]