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Diet and Nutrition

Bariatric Surgery: A Solution for the Obesity Epidemic?

Most Common Types of Bariatric Surgery

The most popular surgical approaches to weight loss are:

In addition to significant weight loss, bariatric surgery can result in improvement in diabetes, hyperlipidemia, hypertension, and sleep apnea.

Gastric Bypass Surgery

Gastric bypass surgery is a "combination surgery" that

  1. Reduces the size of the stomach by creating a smaller pouch with staples
  2. Connects a section of the small intestine to the pouch

Therefore, the patient eats less food and poorly absorbs calories, vitamins, and minerals in the small intestine, resulting in weight loss.

Lap-Band Surgery

Lap-band surgery, which was approved in 2001, reduces the size of the stomach by placing a silicone band around the top portion of the stomach. Post-operatively, a balloon inside the band can be inflated or deflated through a simple procedure to control the opening and the weight loss. Studies have shown that lap-band surgery results in about half the weight loss that accompanies gastric bypass surgery; therefore, it may not be an effective treatment for extremely obese persons.

Risks with Bariatric Surgery

Approximately 1 in every 200 gastric bypass surgeries results in death and about 20% of patients are re-hospitalized during the first year after surgery. Common complications include bleeding, infections, gastritis, gallstones, constipation, dumping syndrome (which is accompanied by dizziness, diarrhea, nausea, & vomiting), and vitamin/mineral deficiencies. Compared to gastric bypass surgery, lap-band surgery has a faster recovery time and lower risk of death; however, there are possible complications, such as infections, band slippage, esophageal reflux, and vomiting.

Is bariatric surgery an appropriate weight loss method for all obese persons?

Only persons with extreme obesity [Body Mass Index (BMI) = 40] or with a BMI of 35 plus a serious obesity-related health problem should be considered for surgery. Those who qualify are usually at least 100 pounds over their recommended weight. Surgery should be a "last resort", only after multiple attempts at weight loss through non-surgical methods. Patients should undergo a thorough physical and psychological evaluation by a multidisciplinary team, as well as an educational program that prepares them for the surgery and the post-surgical treatment. Patients must be committed to lifelong medical follow-up, vitamin/mineral supplementation, and improved diet and activity habits. So the surgery itself is not a solution to the problem of obesity, but it is a viable component of the treatment plan for some persons.

This article originally appeared in Nutri-bytes (April 2007), a service of the University of Cincinnati College of Nursing and was adapted for use on NetWellness with permission.

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Last Reviewed: Apr 03, 2007

Bonnie J Brehm, PhD, RD Bonnie J Brehm, PhD, RD
Professor of Nursing
College of Nursing
University of Cincinnati