Is Weight-Loss Surgery for You?

Find out the pros and cons of weight-loss surgery—gastric bypass, vertical sleeve gastrectomy and adjustable gastric banding—for people with type 2 diabetes.

By
Stephanie Guzowski
Vertical Sleeve Gastrectomy, Gastric Bypass, Adjustable Gastric Banding, Weight-Loss Surgery, pros and cons

The reports are in and they’re remarkable: After undergoing bariatric surgery, 8 in 10 obese patients experienced a significant improvement in type 2 diabetes, according to a study in the Archives of Surgery. And, that’s even before the weight loss had kicked in!

“I’ll have gastric bypass patients on high doses of insulin before surgery, and by the time they leave the hospital they can be off all their insulin—even before they’ve lost weight,” says Philip Schauer, MD, director of the Cleveland Clinic Bariatric and Metabolic Institute. Dr. Schauer says the procedure itself may increase release of hormones that trigger insulin production.

But, even with bariatric surgery, you still have a big part to play. True success means keeping the weight off—which means you’ll still have work to do once the procedure is done. Think surgery may be for you? Read on to learn more about the options. 

Gastric Bypass
Reduces the stomach by 95%, allowing food to bypass part of the small intestine, which limits calorie absorption.

Advantages:

  • Gastric bypass has the best success rate in improving diabetes: 83% of patients could stop taking their diabetes medications, according to the Archives of Surgery study.
  • Weight loss ranges from 60% to 80% of excess body weight within two years.

Disadvantages:

  • It can lead to complications, such as tearing, infection or bleeding.
  • Food bypasses areas of the small intestine responsible for absorbing vitamins and minerals, such as iron, so you will need to take supplements.

Vertical Sleeve Gastrectomy
This procedure reshapes your stomach, reducing its size anywhere from 60% up to 85%, which restricts the amount of food you’ll be able to eat in a sitting.

Advantages:

  • Weight loss is typically rapid, averaging about 65% of excess weight lost within the first two years after surgery.
  • You’ll be able to absorb nutrients normally, so it’s unlikely you’ll need supplements.
  • Fewer postoperative visits, compared to gastric bypass.

Disadvantages:

• Potential complications related to stapling, such as leaks and bleeding, may occur; but the risk is small, happening about 1% of the time.

Adjustable Gastric Banding
Restricts food intake via an adjustable silicone band that’s placed around the upper portion of the stomach.

Advantages:

  • Gastric banding is the least invasive weight-loss surgery—no cutting or reconnecting of stomach or intestines. It has a rapid recovery rate.
  • Since the band is an implantable device, its effect can be completely reversed just by taking it out. It’s also adjustable, without the need for more surgery.
  • Average weight loss is about 50% of excess body weight.

Disadvantages:

  • There’s a 70% chance of losing substantial weight. Success depends on commitment to eat healthier and follow-up visits.

Interested in weight-loss surgery?
Talk to your healthcare team. Here are a few questions to spark the dialogue.

  • Am I a good candidate for weight-loss surgery?
  • Should I try other ways of losing weight first? If so, what do you recommend?
  • If you think I’m ready for a procedure, which do you recommend for me and why?
  • What kind of weight loss should I expect?
  • How will my diet and lifestyle change after the surgery?
Published
November 2013