The Pros and Cons of Weight Loss Surgery
If you have been on and off the weight loss wagon and the amount you have to lose to reach a healthy weight is overwhelming, you may have considered bariatric surgery. However, it's not a decision that can be taken lightly. Here we break down the research to give you the pros and cons of getting weight loss surgery and what it may mean for you.
Who Can Have Weight Loss Surgery
Bariatric surgery is regulated by the U.S. Food and Drug Administration. According to their guidelines, gastric banding devices are approved for patients who are:
18 years and older (some youth are allowed who are adult height) WITH
BMI of 40 or higher OR
BMI between 30 and 40 with an additional obesity-related disease such as heart disease, diabetes, sleep apnea, or high blood pressure.
Here's a tool to calculate your BMI.
Four Types of Weight Loss Surgery
Each type of weight loss surgery restricts food intake through different mechanisms:
- Laproscopically Adjustable Gastric Band (AKA Lap-Band) Restricts the size of the opening of the top portion of the stomach with a small bracelet-like band.
- Roux-En-Y Gastric Bypass Creates small pouch likened to the lap-band, but then reroutes food directly to the small intestine.
- Vertical Sleeve Gastrectomy Removes a large portion of the stomach which lowers the hunger hormone ghrelin more so than purely restrictive procedures.
- Biliopancreatic Diversion with a Duodenal Switch Removes a large portion of the stomach, as well as reroutes food from much of the small intestine, and adds a third feature that changes how bile and other digestive juices absorbs food.
Pros of Weight Loss Surgery
Potential Long-Term Weight Loss and Reduced Risk For Disease A 15-year follow-up study showed an average 47% excess weight loss following 3,227 patients who have undergone lap-band surgery. Other research studies corroborate these findings. With weight loss typically follows reduced risk of complications associated with diabetes, heart disease, and other obesity related conditions. However, weight loss isn't guaranteed without diligent follow-up and studies point to reduction in conditions, like diabetes, may not be long term fixes.
Improved Management of Hunger and Cravings Hunger hormones are naturally-lowered either by the removal or restriction of the stomach. After surgery, the stomach requires much less food to satisfy hunger and also results in feeling full longer. However, this affect wanes over time if overeating becomes a consistent practice. There also seem to be alterations in brain activity following weight loss surgery. A small study in London’s Journal of Obesity found women who’d undergone weight loss surgery showed less reaction to visual food cues. A second study corroborates these findings indicating an increased ability to manage cravings.
Cons of Weight Loss Surgery
Medical Complications and Side Effects Weight loss surgery comes with similar side effects to other surgical procedures including:
- Gastro-intestinal distress such as gas, diarrhea, bloating, pain and discomfort.
- Complications requiring device removal like nerve damage, hernias, and strictures.
- Risk of nutrient deficiency from being unable to meet needs.
- Bleeding, infections, gallstones, ulcers, and blood clots.
Doesn’t Address Emotional Eating While some people report being more mindful following weight loss surgery, given the intense pre- and post-op counseling, if you’re an emotional eater, the surgery doesn’t address this aspect of eating. Some people call it "head hunger", or that need to find comfort in food. You may still be compelled to eat more even though you’ve medically made it harder to do so.
Increased Substance Use Susceptibility Even if weight loss surgery changes your use of food for comfort, it may increase your use of other substances to self-soothe. While the number of studies is limited, a group of 155 participants showed a marked increase in substance use following weight loss surgery. The frequency of their use of cigarettes, alcohol and drug use increased significantly.
How to Minimize Risks
If you go through with weight loss surgery there are ways you can increase your chances of having a successful recovery and weight loss.
- Follow nutritional and psychological advice including taking prescribed supplements and completing post-op therapy.
- Avoid certain foods as outlined in guidelines.
- Stay fit to help your body continually heal and maintain the weight lost due to surgery.
- Seek out counseling where needed to addresses changes in body image and personal relationships due to extreme weight loss.
Bottom Line: Despite the weight loss and reduced hunger you may experience after surgery, overtime your ingrained eating habits may take over. This is a major surgery and requires a lifetime of responsibility to watch what and how much you eat to minimize complications. Weigh the pros and cons with your physician to decide if it's right for you.
Would you or have you considered Weight Loss Surgery, why or why not?