The Procedures

Opting for weight-loss surgery is not an easy choice, but new treatments and safer techniques are making surgical intervention a suitable option for more people. While the goal of any bariatric procedure is ultimately to lose weight, results will vary depending on the procedure and the individual.

Adjustable Laparoscopic Gastric Banding (Lap Band)
In recent years, Lap Band has become one of the most popular bariatric surgeries. During this minimally invasive procedure, a circular silicone band with an inflatable balloon on the inner surface is placed around the top third of the stomach to reduce the food storage area. The band can be tightened or loosened by filling or emptying the balloon with saline solution through an opening, or “port,” that is created in the wall of the abdomen just under the skin. Patients usually go home the same day.

Weight loss with Lap Band surgery typically takes longer. Smaller amounts of food are eaten, but unlike gastric bypass, digestion occurs in the normal manner. Also, Lap Band patients must be more vigilant when it comes to food choices because the band allows them to eat high calorie foods not tolerated with the gastric bypass procedure. The band is adjusted every 4-8 weeks during the first two years following surgery, with a goal to achieve a restriction that is both physically and psychologically comfortable.

Roux-En-Y Gastric Bypass
During gastric bypass, a small stomach pouch is created by stapling an area that holds no more than 1-2 ounces of solid food or liquid. A Y-shaped section of the small intestine is then attached to the pouch to allow food to bypass the rest of the stomach and the first part of the intestines. The other end of the small intestine is reconnected to the intestinal tract.

With gastric bypass, the body can no longer tolerate many foods that are high in saturated fat, sugar or starch—the kinds often found in commercially processed food items. The key to successful after-care is the commitment to a lifetime behavior modification and maintenance plan, which includes a structured food plan and exercise regimen, plus regular follow-up with medical, nutritional and support group resources.