Gastric Bypass and Gastric Band

Gastric Bypass vs Gastric Band
Gastric Bypass vs Gastric Band
The term bariatric surgery encompasses many forms of surgery available to assist with weight loss in obese patients. It should be noted that bariatric surgery is recommended only for those who are morbidly obese and suffer from health consequences caused by the obesity. Bariatric surgery is a serious undertaking and requires commitment to be successful. In addition, bariatric surgeries of any kind carry with them the risk of complications and death. This article will explain two forms of bariatric surgery: gastric bypass and gastric band.

People who qualify for either procedure have a body mass index (BMI) of over 40, or have a BMI of 35 and have one or more severe co-morbid conditions: high blood pressure, diabetes, spinal or joint problems, venous thromboembolic disease, obstructive sleep apnea, and other related issues.

Gastric Bypass Surgery

Gastric bypass is the blanket term used for the permanent surgical re-arrangement of the stomach and small intestine. Basically, the stomach is divided into two areas: an upper (small) pouch, about 10% of the size of the entire stomach, and the remaining portion of the stomach. The small intestine is then reattached. The purpose of this procedure is to reduce the amount of food required before the patient feels full, which limits the number of calories consumed each day. Weight is lost fairly quickly, and most patients will lose an average of 65 to 80% of excess weight in the first three and a half years following surgery.

Risks and complications of gastric bypass surgery include (but are not limited to):

  • adverse reaction to anaesthesia which causes death;
  • complications of abdominal surgery such as bowel obstruction, venous thromboembolism, infection, hemorrhage and hernia;
  • complications of gastric bypass such as dumping syndrome, anastomotic ulcer, anastomatic stricture, and anastomatic leakage; and
  • nutritional deficiencies.

Gastric Band Procedure

The gastric band procedure involves the laparoscopic installation of an inflatable silicone band to the upper portion of the patient’s stomach. The gastric band divides the stomach into two areas, one small pouch and a large pouch which includes the rest of the stomach. The patient eats a small amount of food and fills the small pouch, which causes the patient to feel full on less food. The resulting change in eating habits causes the patient to lose weight – an average of 60% of the excess weight. The difference between the gastric band and the gastric bypass is that with the gastric band there is not a permanent division of the stomach, as this procedure is reversible. There is less risk associated with the gastric band than with gastric bypass surgery. Patients tend to lose weight more slowly with the gastric band procedure during the first three and half years compared to the gastric bypass, but over the course of five years, patients from both types of procedures will lose about the same amount.

Risks and complications of the gastric band procedure include (but are not limited to):

  • adverse reaction to anesthesia which causes death;
  • productive burping;
  • slippage;
  • gastritis;
  • infection;
  • erosion;
  • slippage;
  • improper position of the band;
  • problems with the port or tube connecting to the band (used for inflation and deflation); and
  • infection.

Benefits of the gastric band compared to gastric bypass surgery include (but are not limited to):

  • lower mortality rate;
  • shorter recovery time;
  • no malabsorption issues (which cause nutritional deficiencies).

It must be noted that gastric bypass surgeries and gastric band procedures are life-altering and are not to be undertaken without commitment and full understanding of the risks, complications, and requirements. Patients must follow strict eating guidelines if they are to achieve success. Overall, patients achieve weight loss of up to 60% of excess weight averaged over the course of five years following the procedure. Personal choice and medical recommendations will determine if gastric bypass or gastric band is the preferred procedure for weight loss.

 

Comments, questions and stories of experiences with gastric bypass and gastric band procedures are welcomed and encouraged. Reply below.

Morbid Obesity BMI – What BMI is Considered Obese?

About a Morbid Obesity BMI

Morbid Obesity BMI to the Right
Body Mass Index Chart
What is morbid obesity BMI, and what are some of the dangers of morbid obesity?

The Body Mass Index (BMI) is a measure of whether you are under, normal weight, or obese. There are several calculators available online with which people can determine their Body Mass Index (BMI).

A body mass index (BMI) of 40-49.9 is a level of extreme obesity, which may be ground for considering bariatric surgery. Between 2000 and 2005, obesity (BMI ≥ 30) increased by 24%, morbid obesity (BMI ≥ 40) increased by 50% and super obesity (BMI ≥ 50) increased by 75%. Those with a body mass index, or BMI, above 40 are robbed of at least 6 1/2 years, on average, of expected life span, a study has found [5].

BMI and Obesity: What Role Do They Play in Longevity?

A high BMI and obesity have long been regarded as risk factors for a variety of health related problems such as hypertension, diabetes, cardiovascular disease, and certain forms of cancer. While this remains true, what affect does a high BMI and obesity play in overall mortality?

It was previously thought that a higher BMI was associated with an earlier, all-cause mortality. Several studies done in the past have supported this idea. Some recent studies have called this conventional thinking on high BMI and obesity into question.

A few studies conducted on weight gain and obesity show that carrying around a few extra pounds may actually decrease mortality, particularly in the elderly. This may be partially due to the fact that elderly patients with lower BMI’s may be more at risk for dying from a hip fracture due to their propensity towards osteoporosis and may be more susceptible to infectious disease due to their lower body weight.

It should be emphasized that this applies only to persons who are slightly overweight as opposed to those who are markedly obese. Being obese, particularly morbidly obese, seems to carry with it a higher all-cause mortality rate across the board.

How is BMI measured to make the diagnosis of obesity?

BMI or body-mass index is calculated by dividing your weight measured in kilograms by your height in meters squared. If your BMI is above 25, you are considered to be overweight. If above 30, you’re classified as obese. Some recent studies have shown that elderly women with BMI’s between 25 and 27 and elderly men with BMI’s between 27 and 29 have the best chance for survival when compared to those with higher or lower BMI’s.

Where does this conflicting information on BMI and obesity leave us as far as determining risk of mortality? This data would suggest that being very mildly overweight without any other underlying medical conditions probably doesn’t significantly shorten lifespan and may even prolong it in the elderly population. Being obese or severely underweight may confer an increased risk of death, particularly in the elderly who are at risk for falls with resulting hip fractures.

Do the results of these new BMI and obesity studies suggest you can let down your guard and ignore those few extra pounds? Probably not! It’s decidedly harder to take off those extra pounds as you age and your metabolic rate slows down. It’s best to practice healthy diet and exercise habits now in order to avoid having those few extra pounds turn into true obesity as you age. Plus, by practicing healthy lifestyle habits, you’ll significantly reduce your risk of developing age related chronic diseases.

Morbid Obesity BMI Conclusions

Both morbid obesity BMI and excessively low BMI’s can be dangerous to the health of an elderly person for several reasons. Statistically, at any age, a normal range BMI offers the best outcome for a long (and healthier) life span.

 

References

  1. https://stanfordhealthcare.org/medical-clinics/bariatric-surgery/bmi-calculator.html
  2. https://www.urmc.rochester.edu/highland/bariatric-surgery-center/questions/morbid-obesity.aspx
  3. https://www.tijuanabariatrics.com/blog/2016/05/30/bariatric-surgery-for-obesity-class-169993
  4. http://www.asmbs.org/Newsite07/media/asmbs_fs_obesity.pdf
  5. http://www.latimes.com/science/la-sci-sn-extreme-obesity-cuts-lifespan-20140708-story.html

Signs You May Need LapBand Surgery

Adjustable Gastric LapBand
The Adjustable Lapband
The LapBand procedure is a weight loss surgery that has increased in popularity since is introduction to the United States in 2001. So, what is it that sets LapBand surgery apart from other bariatric procedures? It has to do with risk and convenience. With a lower complication and death rate and a shorter recovery period, the LapBand is the preferred choice of treatment for most individuals and healthcare professionals.

If you are overweight, you may be ready to jump on the LapBand bandwagon. As previously stated, the LapBand surgery does have a number of benefits, but it is not right for everyone. So, how do you know? Please continue reading on for five signs that the LapBand surgery is something you should closely examine. In the event the signs apply to you, schedule a consultation appointment with a LapBand surgeon to determine your eligibility.

  1. – If Your Doctor Suggests It

    Those who suffer from obesity are likely to schedule more appointments with their primary care physician. Those suffering from obesity, deal with other health related complications, including asthma and diabetes. In most cases, primary care physicians recommend healthy eating and exercise. In extreme cases of obesity, the LapBand system may be mentioned.

    If your primary care physician suggests the LapBand surgery, take this suggestion to heart. Your doctor has your best interests in mind.

  2. – If You Are Severely Obese

    On average, those suffering from obesity have a Body Mass Index (BMI) of 30 or more. This usually translates to 30 pounds overweight. Although obesity has many risks and complications, LapBand surgeons are selective. In most cases, simply just being obese isn’t enough to warrant a LapBand procedure. Instead, most physicians recommend patients have a Body Mass Index (BMI) rating of 40 or more. This translates into severe and morbid obesity.

    If you are 100 pounds overweight or more, LapBand surgery may not only help you lose weight, but it may save your life.

  3. – If You Are Unable to Lose Weight

    In most cases, the LapBand surgery is used as a last resort. It is considered a relatively safe procedure, but there are always risks involved. That is why most professionals opt for natural weight loss methods. Before giving the okay for LapBand, most surgeons want to see proof that their patients have tried to lose weight with diet and exercise. If not, most will try natural approaches before opting for surgery.

    For those who have unsuccessfully tried to lose weight with diet and exercise multiple times, weight loss surgery may be the only option.

  4. – If Your Health is at Risk

    Health will play a huge role in one’s ability to undergo LapBand surgery. For many, it is a double sword. LapBand surgery and weight loss can lessen the symptoms of asthma, diabetes, and other obesity related conditions. In fact, symptoms may completely disappear. On that same note, those who are obese due to a medical condition, such as a thyroid problem or pregnancy, are not ideal candidates. In these instances, a reduced stomach size may not cure a weight problem.

    If you suffer from obesity related health problems, consider surgery. Not only will you lose weight, but your overall health and well-being will improve. You may feel as if you got a new lease on life with the LapBand surgery.

  5. – If You Cannot Complete Daily Activities

    Despite being obese, some men and women are able to lead normal and happy lives. This is often the case with slight obesity. On the other hand, there are those who cannot do daily activities or needed tasks. Those who find it impossible to play with their children, walk up a flight of stairs, or leave the house, are at a serious and dangerous stage. This is the point where LapBand surgery and other extreme methods of weight loss should be examined.

If your obesity restricts your ability to go about your day, now is the time to consider the LapBand system.