For individuals who suffer from morbid obesity and have not found success with traditional diet and exercise models of weight loss, bariatric surgery may be a viable option to improve their long-term health prognosis. While there are various forms of bariatric surgery that patients can discuss with their health care providers, each is not without its benefits and drawbacks, as well as its potential health risks and complications. In the United States, the options for bariatric surgery include a laparoscopic adjustable gastric band, gastric sleeve surgery (or sleeve gastrectomy), and gastric bypass.
In a laparoscopic adjustable gastric band surgery, the size of the stomach is reduced through the use of a small ring with an inflatable band; this allows the patient to feel full after just a small amount of food. The size of the band can be increased or decreased based on patient needs during follow-up visits. Patients generally see less weight loss than with other forms of bariatric surgery, but this offers the least likelihood of vitamin or nutrient deficiency, a lower risk of complication, and a shorter hospital stay. In gastric sleeve surgery, a portion of the stomach is removed, and what remains is closed with surgical staples. The surgical stay is longer than with the gastric band surgery, and there are slightly higher chances for surgical complications. Patients can also experience acid reflux as a chronic condition after this surgery is performed. Gastric bypass is similar in that a portion of the stomach is closed off using surgical staples. While it would be removed in gastric sleeve surgery, it is not in gastric bypass. Instead, the small intestine is cut and attached directly to the new, smaller stomach pouch. Not only is the stomach smaller, but the small intestine is shorter as well, allowing for fewer calories to be absorbed. The negative corresponding consequence, though, is that there is a higher risk of vitamin or nutrient deficiency. Some research also links it to an increased risk for alcohol use disorder. While this procedure is very difficult to reverse, it can be done if a physician deems it necessary.