{"id":8725,"date":"2020-05-04T03:49:00","date_gmt":"2020-05-04T03:49:00","guid":{"rendered":"https:\/\/www.caresurgeryclinic.com\/beta2024\/?p=8725"},"modified":"2024-10-25T03:52:24","modified_gmt":"2024-10-25T03:52:24","slug":"how-do-you-know-what-type-of-bariatric-surgery-is-right-for-you","status":"publish","type":"post","link":"https:\/\/www.caresurgeryclinic.com\/beta2024\/how-do-you-know-what-type-of-bariatric-surgery-is-right-for-you\/","title":{"rendered":"How Do You Know What Type of Bariatric Surgery Is Right for You?"},"content":{"rendered":"<p>Get to know the benefits and risks of 3 popular options<\/p>\n<p>You\u2019ve tried every diet and exercised yourself into submission \u2014 but you\u2019re still not losing any weight. If you\u2019re among the one-third of Americans considered obese, bariatric surgery just maybe what the doctor ordered.<\/p>\n<p>The two most common weight loss procedures are Roux-en-Y gastric bypass and sleeve gastrectomy.<\/p>\n<p>\u201cFor an average patient with severe obesity, both procedures are good options since they are relatively similar,\u201d says bariatric surgeon\u00a0<a href=\"https:\/\/my.clevelandclinic.org\/staff\/18077-ali-aminian\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Ali Aminian, MD (opens in a new tab)\">Ali Aminian, MD<\/a>. But there are some considerations that might tip the scales (pun intended) in favor of one over another.<\/p>\n<p>How can you decide which\u00a0<a href=\"https:\/\/health.clevelandclinic.org\/13-surprising-facts-about-bariatric-surgery\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"weight loss surgery (opens in a new tab)\">weight loss surgery<\/a>\u00a0is best for you? Dr. Aminian breaks down the options.<\/p>\n<h3>Bariatric surgery options<\/h3>\n<p>You are eligible for bariatric surgery if your body mass index (BMI) is:<\/p>\n<ul>\n<li>40 or higher.<\/li>\n<li>\u00a0Between 35 and 40, and you have diabetes, high blood pressure, high cholesterol, fatty liver disease or sleep apnea.<\/li>\n<li>Between 30 and 35, and you have uncontrolled\u00a0<a href=\"https:\/\/health.clevelandclinic.org\/type-2-diabetes-can-bariatric-surgery-control-it\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"diabetes (opens in a new tab)\">diabetes<\/a>.<\/li>\n<\/ul>\n<p>But finding the right procedure requires a discussion between you and your bariatric surgeon. \u201cWe consider the patient\u2019s history, conditions and expectations. Then we come up with a plan together,\u201d says Dr. Aminian.<\/p>\n<p>Today, doctors perform almost all bariatric surgical procedures using minimally invasive techniques. That means smaller incisions (usually five or six in the abdomen) and faster recoveries. Most patients go home the day after surgery and recover in two to three weeks.<\/p>\n<h3>Gastric bypass surgery<\/h3>\n<p><strong>The basics:<\/strong>\u00a0Roux-en-Y gastric bypass surgery is an operation that shrinks your stomach, along with the amount of calories and fat your body absorbs.<\/p>\n<p><strong>\u201c<\/strong>We disconnect the stomach on the top part and make a small pouch there. We then bring a loop of a small intestine up and connect it to that pouch, rerouting the GI (gastrointestinal) tract,\u201d explains Dr. Aminian. \u201cWhen the patient eats food, it enters the small intestine directly. We bypass 90 to 95% of the stomach.\u201d<\/p>\n<p><strong>The benefits:<\/strong>\u00a0\u201cGastric bypass is a more powerful tool than sleeve gastrectomy. Patients usually lose 10 to 20 pounds more with it. Rerouting the GI tract leads to some favorable hormonal changes, so the chance for diabetes improvement is higher as well.\u201d<\/p>\n<p><strong>Who it\u2019s good for:<\/strong><\/p>\n<ul>\n<li><strong>People with severe reflux disease:<\/strong>\u00a0Acid reflux often improves after gastric bypass surgery.<\/li>\n<li><strong>People with high BMIs:<\/strong>\u00a0People lose more weight with gastric bypass.<\/li>\n<li><strong>People with diabetes:<\/strong>\u00a0While gastric bypass is generally better for these patients, Dr. Aminian notes: \u201cIn patients with severe diabetes, it doesn\u2019t matter whether we do a bypass or a sleeve. Both procedures are similarly effective.\u201d<\/li>\n<\/ul>\n<h3>Sleeve gastrectomy surgery<\/h3>\n<p><strong>The basics:<\/strong>\u00a0Also known as the gastric sleeve, sleeve gastrectomy surgery involves operating only on the stomach. Surgeons remove around 80 to 85% of it, leaving a smaller \u201csleeve\u201d in its place.<\/p>\n<p><strong>The benefits:<\/strong>\u00a0Dr. Aminian says the sleeve is a bit safer than gastric bypass: The risk of all complications is 3% after sleeve vs. 5% with Roux-en-Y gastric bypass.<\/p>\n<p><strong>Who it\u2019s good for:<\/strong><\/p>\n<ul>\n<li><strong>People who have had multiple abdominal surgeries:<\/strong>\u00a0\u201cRerouting the GI tract and operating on the small intestine would be impossible when there is severe scar tissue around it,\u201d notes Dr. Aminian. \u201cIn sleeve gastrectomy, we only operate on the upper part of the abdomen, which is usually less affected by the scar tissues.\u201d<\/li>\n<li><strong>High-risk surgical patients:<\/strong>\u00a0Sleeve gastrectomy is easier on patients than gastric bypass: The anesthesia time is shorter, and the recovery is faster. High-risk patients include people with severe\u00a0<a href=\"https:\/\/health.clevelandclinic.org\/dieting-failing-heres-when-to-consider-bariatric-surgery-to-protect-your-heart\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"heart disease (opens in a new tab)\">heart disease<\/a>\u00a0or lung problems, plus transplant candidates or recipients.<\/li>\n<li><strong>People who weigh more than 450 to 500 pounds:<\/strong>\u00a0Too much fat can limit the amount of space inside the abdomen. Surgeons need room to reroute the GI tract. \u201cWithout space, gastric bypass isn\u2019t possible.\u201d<\/li>\n<li><strong>People on multiple medications to treat psychiatric illness:<\/strong>\u00a0Gastric bypass can affect how your body absorbs \u2014 and responds to \u2014 medications. \u201cIf a patient with severe depression or anxiety is stable on multiple psych medications, we don\u2019t want to give them a procedure that may alter their medication\u2019s absorption and effectiveness.\u201d<\/li>\n<\/ul>\n<h3>Duodenal switch<\/h3>\n<p><strong>The basics:<\/strong><em>\u00a0<\/em>Duodenal switch surgery is what would happen if sleeve gastrectomy and gastric bypass had a baby. During this procedure, bariatric surgeons remove part of the stomach to create the trademark sleeve. Then they do a more extensive version of gastric bypass surgery. The result? The potential for even more weight loss and greater metabolic effects.<\/p>\n<p>It may seem like the best of both worlds until you consider there\u2019s a higher risk for surgical complications because surgeons are doing more to alter your anatomy.\u00a0 That\u2019s why only 1 to 2% of bariatric surgeries done in the U.S. are duodenal switches. If you want to go this route, it\u2019s critical to find an experienced surgeon and center.<\/p>\n<p><strong>The benefits:<\/strong><em>\u00a0<\/em>Patients tend to lose even more weight than with Roux-en-Y gastric bypass surgery. It can conquer diabetes, too.<\/p>\n<p><strong>Who it\u2019s good for:<\/strong><\/p>\n<ul>\n<li><strong>People with severe obesity<\/strong>: Patients can lose a significant amount of weight.<\/li>\n<li><strong>People with severe metabolic disease<\/strong>: The duodenal switch procedure impacts hormonal balance in the GI tract. It\u2019s very effective for improving related metabolic conditions like diabetes and high blood pressure.<\/li>\n<li><strong>People who are very good at following their doctor\u2019s orders<\/strong>: \u201cIt\u2019s usually selected for patients who are very compliant to the vitamins, supplements and post-op follow up. It\u2019s not safe for everyone. Even in patients who follow postop recommendations, there is a small risk of malnutrition,\u201d Dr. Aminian says.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Get to know the benefits and risks of 3 popular options You\u2019ve tried every diet and exercised yourself into submission \u2014 but you\u2019re still not losing any weight. If you\u2019re among the one-third of Americans considered obese, bariatric surgery just maybe what the doctor ordered. The two most common weight loss procedures are Roux-en-Y gastric [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":8726,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[148],"tags":[163],"class_list":["post-8725","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-weight-loss","tag-weight-loss"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.caresurgeryclinic.com\/beta2024\/wp-json\/wp\/v2\/posts\/8725","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.caresurgeryclinic.com\/beta2024\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.caresurgeryclinic.com\/beta2024\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.caresurgeryclinic.com\/beta2024\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.caresurgeryclinic.com\/beta2024\/wp-json\/wp\/v2\/comments?post=8725"}],"version-history":[{"count":1,"href":"https:\/\/www.caresurgeryclinic.com\/beta2024\/wp-json\/wp\/v2\/posts\/8725\/revisions"}],"predecessor-version":[{"id":8727,"href":"https:\/\/www.caresurgeryclinic.com\/beta2024\/wp-json\/wp\/v2\/posts\/8725\/revisions\/8727"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.caresurgeryclinic.com\/beta2024\/wp-json\/wp\/v2\/media\/8726"}],"wp:attachment":[{"href":"https:\/\/www.caresurgeryclinic.com\/beta2024\/wp-json\/wp\/v2\/media?parent=8725"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.caresurgeryclinic.com\/beta2024\/wp-json\/wp\/v2\/categories?post=8725"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.caresurgeryclinic.com\/beta2024\/wp-json\/wp\/v2\/tags?post=8725"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}