HEALTHY LIVING Which Weight Loss BY CHRIS ILIADES D


octors have been treating obesity with surgery for 70 years. They originally


rerouted the small intestines so that food digestion was bypassed and the stomach was left intact. This resulted in fewer calories


absorbed and weight loss, but also caused serious side eff ects including malnutrition, vitamin defi ciencies, dehydration, joint pain, and liver failure. Over time, surgeons tried


bypassing the stomach, called gastric bypass, and the term “bariatric” surgery was used for these procedures. Bariatric comes from the Greek word for weight. As these surgeries grew more common, it became apparent that they helped patients lose weight with fewer side eff ects, and helped prevent or reverse obesity-related diseases, especially Type 2 diabetes.


TODAY’S SURGERIES The Roux-en-Y. “Since the late 1960s, this has become the most tried and true,” says Jessica Folek, M.D., director of


bariatrics at Long Island Jewish


Forest Hills, Northwell


Health, in New York. This procedure divides the stomach,


creating an upper small pouch about the size of an egg. The larger part of the stomach is


84 NEWSMAX MAXLIFE | NOVEMBER 2022


Surgery Is Best for You? If you can’t shed pounds with diet and exercise, a bariatric bypass may be the answer. ::


bypassed and no longer stores food. This small pouch reduces how


much food you eat because you feel full quickly. The small intestine is also


divided. The lower end is pulled up and attached to the small stomach pouch. The upper end, which is still attached to the lower stomach, is pulled down and attached farther down on the intestine. This bypasses part of the


intestine, reducing the absorption of calories. Weight loss is due to less food intake and less absorption. Gastric sleeve. “While Roux-


en-Y is the most common bariatric surgery, it is being surpassed by the sleeve gastrectomy,” says Folek.


This procedure removes 80% of the stomach without any rerouting


of the small


intestine. You are left with a


stomach the size of a banana. Originally performed as the


fi rst stage of a procedure called the duodenal switch (DS), in which the intestines were divided and rerouted in the second stage of the surgery, doctors realized that patients waiting for the second stage were losing weight without the added complications. Now performed alone, the gastric sleeve works by limiting the amount of food your stomach can hold. Removing most of the stomach


reduces the hormone ghrelin, which increases hunger. As a result, the


gastric sleeve makes you feel full quickly and reduces appetite. Single anastomosis duodenal


switch (DS). This newer procedure includes a gastric sleeve and intestinal rerouting for malabsorption. There is only one intestinal connection point since the intestines being rerouted are not completely divided. Gastric band. This is a simple procedure that places an infl atable band around the top of the stomach to control how much food you eat. The gastric band was a highly popular procedure for a while but has fallen out of favor.


“The band is


simple to do but does not result in enough weight loss,


has a high rate of weight regain, high rate of reoperation, and often has to be removed. Almost all bariatric surgery centers have stopped off ering it,” says Folek.


ARE YOU A CANDIDATE? According to the American Society for Metabolic and Bariatric Surgery, weight loss surgery not only treats obesity, it is also eff ective against obesity-related diseases including Type 2 diabetes, high blood pressure, sleep apnea, and high cholesterol. It may also reduce heart disease,


stroke, and fatty liver disease. Bariatric surgery has also


been found to reduce the risk of numerous cancers linked to obesity. Bariatric surgery can be


performed with minimally invasive surgery using laparoscopic or robotic surgical techniques. These surgeries have become


so refi ned that they are now safer than having a hip replacement or gallbladder removal. You could be a candidate for weight loss surgery if your body


ROUX-EN-Y, GASTRIC SLEEVE, GASTRIC BAND/ALILA MEDICAL MEDIA/SHUTTERSTOCK


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