Obesity is an epidemic not only in the United States but in the world. In the United States alone 1 in every 3 adults suffers from obesity. Today, most bariatric or weight loss surgery is performed laparoscopically and is considered some of the safest forms of surgery.
Any form of surgery comes with associated risks but in the case of bariatric surgery, the benefits almost always outweigh the risks. Today we are going to discuss different types of weight loss surgery and the safest kinds of bariatric weight loss.
Risks Of Obesity vs Surgery
Historically bariatric surgery was thought to be high risk for mostly cosmetic rewards but this decades-old thinking was and is completely incorrect.
Obesity increases the risk of several diseases and serious health conditions lower an individual’s quality of life and affects and limits their ability to function physically like navigating stairs, sitting in a chair, or playing with their children. It is also connected with mental and emotional health disorders such as anxiety and clinical depression.
The risks of fatal complications from bariatric surgery are extremely rare and when compared with the risk of death from one of the many side effects (comorbidities) of obesity pale in comparison.
Patients who undergo bariatric surgery and lose weight are:
- 40% less likely to die from heart disease;
- 92% less likely to die from type 2 diabetes;
- 60% less likely to die from cancer.
Obesity-Related Diseases
Obesity is directly associated with several illnesses that require ongoing medication or medical intervention and if left untreated can lead to an untimely death. Health issues that are weight-related include:
- Type 2 diabetes;
- Coronary disease;
- High blood pressure or hypertension;
- High cholesterol and other cholesterol issues;
- Stroke;
- Gallbladder disease;
- Osteoarthritis – a breakdown of cartilage and bone within a joint;
- Sleep apnea and breathing problems;
- Several different cancers.
Why Undergo Bariatric Surgery?
Obesity is not only a weight problem or one that shows a lack of willpower but a metabolic disease with complexity. In many cases, a patient’s metabolism is working against them while they are doing their best to follow their diet and exercise plan.
Bariatric surgery helps these patients counteract the metabolic changes their body attempts to enforce and is considered one of the most effective and safest ways to help patients with the challenges of losing weight.
According to the American Society of Metabolic and Bariatric Surgery (ASMBS), a patient whose body mass index (BMI) has risen above 35 has less than a 1% chance of achieving a healthy body weight and maintaining it on their own without medical intervention.
To learn more about the benefits of bariatric weight loss, and what the best weight loss surgery for you may be, join our free online bariatric seminar.
Weight Loss Surgery Options
There are different types of weight loss surgeries available and most are done laparoscopically. Despite the technique, all offer individuals the opportunity to achieve significant weight loss. But what is the best weight loss surgery? Let’s take a look at the different options available.
Laparoscopic Sleeve Gastrectomy, Gastric Sleeve or VSG/LSG
- The surgeon permanently removes between 75% to 80% of the patient’s stomach, reshapes the remainder into a sleeve-like pouch that is stapled along the edge.
- The reduced stomach size aids in portion control as well as greatly reduced the production of the hormone ghrelin (this is the hormone that stimulates hunger)
- Sleeve gastrectomy surgery helps a patient lose weight through restrictive techniques but does not make alterations to the digestive system that affect the absorption of nutrients.
- The procedure is not reversible and is often used as the first step of other forms of bariatric surgery.
Is Gastric Sleeve Safe?
Laparoscopic gastric sleeve surgery has been around for more than two decades and many studies have been done, and historical data collected regarding the safety and efficacy of the procedure.
A study conducted in Spain followed patients for five years after having a laparoscopic sleeve gastrectomy procedure. Eight patients experienced side effects that were controlled and some patients experienced acid reflux or gallstones. Despite the few side effects, 75% of the patients in the study experienced remission from type 2 diabetes and 72% remission from high blood pressure.
Any surgical procedure involves risks, but gastric sleeve surgery is known as one of the safest bariatric surgical procedures to undergo. It is considered safe or safer than other forms of surgery.
Gastric Bypass or Roux-en-Y Surgery
- As in sleeve gastrectomy, about 70% of the patient’s stomach is permanently removed, shaped into a small pouch, and secured along the cut edge with staples.
- Next, the small intestine is cut and rerouted to attach to the lower part of the pouch, skipping much of the small intestine and then connecting further down. This alteration makes changes to the way food is ingested and restricts the absorption of calories.
- Gastric bypass surgery uses both restrictive and malabsorptive techniques. Portions of gastric bypass can be reversed but the surgery is highly risky and is not advised. Gastric bypass surgery can be revised if needed.
Duodenal Switch Surgery
- Similar to gastric bypass surgery, the duodenal switch combines both restrictive and malabsorptive properties to help patients lose weight.
- The patient’s stomach is made smaller through a sleeve gastrectomy and then similar to gastric bypass the digestive system is altered but in two different locations which creates a more malabsorptive environment than in gastric bypass surgery.
- Duodenal switch is not reversible but is considered the best weight loss surgery when measuring the most significant weight loss in patients.
Laparoscopic Adjustable Gastric Band
- Gastric band surgery uses the restrictive technique to help patients lose weight.
- An inflatable band is cinched around the top part of the stomach which divides it into two sections.
- The smaller section becomes the main stomach and the opening between the two sections causes the ingested food to flow very slowly from the top section to the bottom section.
- The patient feels “full” quicker and can not eat as much food due to the smaller stomach size. There is a port implanted under the patient’s skin that will allow the opening between the two sections to be adjusted by inflating or deflating the ring that is positioned around the stomach.
- While considered the safest form of bariatric surgery for several years, it is not widely used by bariatric surgeons today because it yielded inadequate weight loss results and a high rate of long-term complications. By 2015 gastric lap band usage was down to approximately 5.7% compared to the other bariatric surgery choices.
- Gastric band surgery is fully reversible.
Non-Surgical Weight Loss Options
With the advancements in the industry medically assisted weight loss has come a long way.
There are now a few non-surgical choices for obese patients who do not desire surgery or would be unable to physically withstand a long surgical procedure due to their health. Also, some lower BMI patients can benefit from these procedures as it offers them the ability to be proactive and avoid obesity by safely and effectively helping them lose weight.
Sometimes super obese patients will use one of these procedures as a stepping stone to help them lose some initial weight so they can safely proceed with another form of bariatric surgery.
Gastric Balloon – Orbera
- An Orbera gastric balloon is a tool used to help patients lose weight by using a silicone balloon to take up space in the stomach creating only enough room for them to eat a small amount of food during a meal.
- The procedure takes between 20-30 minutes during which an endoscope is used to place a deflated Orbera balloon into the stomach and filled with saline to a pre-determined size.
- The balloon helps the patient feel “full” and limits the amount they can eat to help them lose weight.
- There is no hospital stay required and only about a 3 day recovery period.
- Gastric balloons are for temporary use only and are removed after six months.
- Patients receive continuous support throughout their time with the balloon as well as after it is removed. The objective is to jump-start the patient’s weight loss as well as acclimate the patient to a healthier diet, exercise profile, and overall lifestyle so they can continue to lose weight and maintain their weight loss results into the future.
What Is The Safest And Least Invasive Weight Loss Surgery?
What is the safest form of weight loss surgery? This is one of the most popular questions asked of most bariatric specialists today. The answer may surprise you but many bariatric doctors’ responses will not involve surgery at all but an endoscopic procedure called endoscopic sleeve gastroplasty or ESG. This fairly new procedure is taking the bariatric weight loss industry by storm with its significant weight-loss potential, low risk and complication rate, and non-surgical approach.
What Is Endoscopic Sleeve Gastroplasty (ESG)?
- ESG or endoscopic sleeve gastroplasty is a procedure that is performed through an endoscope that is lowered down the patient’s throat. The procedure is not surgery and does not require the use of any incisions.
- An endoscope is a very thin flexible tube that is equipped with a camera that also allows room for additional surgical tools to access the procedure site.
- A special suturing device is lowered through the endoscope and used to strategically place about 7-12 sutures in the stomach to reduce its size and reshape it into a sleeve-like pouch resembling a banana.
- The procedure takes about 30 to 45 minutes and does not require a hospital stay.
Endoscopic Sleeve Gastroplasty (ESG) or Accordion Procedure: Everything You Need to Know
Dr. Chris explains what Endoscopic Sleeve Gastroplasty (ESG) procedure is, how it is done, and what its benefits are.
How Does ESG Work To Help Patients Lose Weight?
During the ESG procedure, the patient’s stomach is reduced by 70-75% and the remaining 25% is what will be used as the stomach going forward.
Because the patient is working with a smaller stomach they will not be able to eat as much food during a meal and it will take longer for the food eaten to digest. This will also extend the length of time that the patient feels “full” which will help keep them from “grazing” between meals.
Endoscopic sleeve gastroplasty offers the alteration results that closely resemble the surgical gastric sleeve (VSG) but without the surgery, risks, associated complications or extended recovery time.
Patients follow a specified diet plan after the procedure starting with liquids and working their way back up to solid foods. This transition takes place much faster than after a surgical procedure and in total usually just lasts a few weeks.
Most patients can return to work after about a week as long as their job is not labor-intensive. The bariatric surgeon will determine when the patient can return to their normal routine but generally it is not longer than 3-4 weeks.
Studies Support Significant Weight Loss Potential Through ESG
Endoscopic sleeve gastroplasty not only offers the benefit of being one of the safest forms of weight loss surgery (it is not a surgical procedure) but also has been proven as effective as gastric sleeve surgery. The overall complication rate of ESG is less than 1% while offering the potential for significant weight loss.
ESG surpassed the expected target of 25% EWL (the percentage of expected excess weight loss) in clinical trials and reached almost twice that at 49% in a 12 month period.
- Only 3 out of 150 patients who took part in this trial had minor complications but all resolved without any surgical intervention;
- Patients in the study also showed significant improvements in their weight-related health issues and none developed GERD (severe acid reflux).
Another study highlighted by The National Center for Biotechnology Information reported excess weight loss statistics after 12 months undergoing both gastric sleeve and gastric bypass surgery as follows:
- Gastric Sleeve Surgery -43%;
- Gastric Bypass Surgery – 51%;
- ESG Non-Surgical Outpatient Procedure – 49%.
Comparing the surgical statistics above to that of the non-surgical endoscopic sleeve gastroplasty, you can understand why ESG is becoming the safest and least invasive weight loss choice for patients in the United States.
If you are interested in learning more about ESG and how it can help you lose weight, contact us today to set up a consultation.
At IBI Healthcare Institute, we know that losing weight is a process and requires many challenging lifestyle changes. We are here to partner with you for your entire weight loss journey to help you reach your weight loss goals and become healthier.
