UCHealth - Weight loss surgery
UCHealth - Weight loss surgery

Weight loss surgery

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Weight loss surgery (bariatric surgery) reduces the size of the stomach and the amount of food it can hold, often enabling significant weight loss. Bariatric procedures include Roux-en-Y gastric bypass, sleeve gastrectomy, LAP-BAND® adjustable gastric banding and Biliopancreatic Diversion with Duodenal Switch (BPD/DS).

Bariatric surgeries can induce metabolic changes in your body, affecting hormone production and the nerve signals regulating appetite and fullness. These can help to lower your weight level. In addition, weight loss surgery requires you to change your diet to reduce the calories you consume.

Significant health benefits from weight loss surgery can include normalizing blood glucose levels, lowering blood pressure and cholesterol, and improving obstructive sleep apnea and diabetes-related vascular complications.

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Weight loss surgery procedures

Weight loss surgery can lead to successful outcomes. Each procedure has different benefits and requirements. Learn more about these bariatric surgeries at UCHealth:

Roux-en-Y gastric bypass

The Roux-en-Y gastric bypass is done using a laparoscopic technique, with a camera and small incisions.

The surgery reduces the size of the stomach from the size of a cantaloupe to the size of an egg, creating a 1- to 2-ounce stomach pouch. The small intestine is cut and reattached to the new stomach pouch.

By bypassing a portion of the small intestine, food passes faster and fewer calories are absorbed.

Advantages of Roux-en-Y gastric bypass

  • On average, patients will lose 70-75% of their excess body weight after surgery. Weight loss usually plateaus between 18 and 24 months.
  • Maintained weight loss is most common after this surgery.
  • This is the most effective long-term treatment for type 2 diabetes mellitus.
  • This is the most appropriate weight loss surgery for patients with acid reflux.
  • Most patients see improvements in other medical problems associated with obesity, including high blood pressure, high cholesterol, acid reflux, sleep apnea and osteoarthritis after successful surgical weight loss.

Sleeve gastrectomy

A sleeve gastrectomy is done using a camera and small incisions to reduce the size of the stomach and create a small “sleeve” that looks like a tube or banana. This surgery removes about 80% of the stomach.

Not only does it help you lose weight by reducing the amount of food you can eat, it also removes the part of the stomach that affects the hormones that control hunger.

Advantages of sleeve gastrectomy

  • On average, patients will lose 65-70% of their excess body weight.
  • This surgery does not require reconstruction of the GI tract.
  • There is no dumping syndrome as seen with gastric bypass.
  • There is no malabsorption as seen with gastric bypass.
  • Most patients see improvements in other medical problems associated with obesity including high blood pressure, high cholesterol, acid reflux, sleep apnea and osteoarthritis after successful surgical weight loss.

LAP-BAND®

The LAP-BAND® wraps an inflatable band around the upper portion of the stomach to create a small pouch, allowing for adjustments as you lose weight. While gastric bypass and sleeve gastrectomy are the more common weight loss surgeries, this procedure is at times the best option for patients that need something less invasive.

Placement of lap bands is currently offered at University of Colorado Hospital. UCH offers revisions of previous LAP-BAND surgeries, as well as ongoing maintenance and management of patients with the LAP-BAND.

Advantages of the LAP-BAND®

  • Patients can expect to lose 50% of their excess weight over the first 3 years (average weight loss). Patients can maintain that loss long term.
  • The LAP-BAND is less invasive than other bariatric surgeries. There is no cutting or stapling of the stomach or intestines.
  • The LAP-BAND decreases hunger and makes you feel full longer.
  • There is no malabsorption of nutrients. However, a daily multivitamin is recommended since food intake is decreased.
  • Illnesses associated with obesity such as heart disease, high blood pressure, diabetes, arthritis and asthma may improve or resolve with weight loss.
  • The LAP-BAND is removable, although it is meant to stay in place permanently.

Biliopancreatic Diversion with Duodenal Switch

Biliopancreatic Diversion with Duodenal Switch (BPD/DS) is performed at University of Colorado Hospital and Poudre Valley Hospital.

Biliopancreatic Diversion with Duodenal Switch (BPD/DS) is a less common weight loss procedure in which a smaller stomach pouch is created and most of the small bowel is bypassed. This surgery is reserved for those with BMIs over 50 or as a back-up procedure for those who have failed a bypass or sleeve.

Although BPD/DS produces the greatest amount of weight loss, it has the greatest number of side effects. Strict adherence to guidelines after surgery is critical to avoid malnutrition and vitamin deficiencies that can cause serious complications.

Advantages of Biliopancreatic Diversion with Duodenal Switch

  • Can result in greater weight loss than gastric bypass surgery, sleeve gastrectomy and the LAP-BAND®.
  • Like other bariatric procedures, it decreases hunger and makes you feel full longer.
  • Illnesses associated with obesity such as heart disease, high blood pressure, diabetes, arthritis and asthma may improve or resolve with weight loss.

Are you a candidate?

There are many factors that can help determine if you should consider weight loss surgery. Your body mass index (BMI), your overall health and whether other weight loss methods have not worked are a few of those things. If extra weight is affecting your health or quality of life, you may want to consider surgery.

General guidelines to qualify for weight loss surgery:

  • You must have a BMI of 40 or more, or a BMI of 35 or more, plus a serious obesity-related health problem, such as type 2 diabetes, high blood pressure or sleep apnea.
  • You must be healthy enough to have surgery.
  • You will be required to have a psychological evaluation.
  • You must have tried to lose weight by other means, such as diet and exercise.

Your Body Mass Index (BMI) is a simple calculation that uses your height and weight to estimate whether you’re in a healthy weight range.

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BMI is a general screening tool and does not account for differences in muscle mass, age, sex, or overall body composition. A healthcare provider can help you interpret your result in the context of your overall health.

If you are not a candidate for weight loss surgery, there are other options available to you. The Metabolic and Bariatric Endoscopy Program at UCHealth University of Colorado Hospital specializes in treating patients who don’t qualify for, or don’t want to undergo, weight loss surgery.

UCHealth weight loss surgery locations

Working with both adults and adolescents considering weight loss surgery, UCHealth has been a longstanding leader throughout Colorado for bariatric procedures.

Is weight loss surgery effective?

Weight loss surgery is both a physical and psychological tool that people can use to lose weight and keep it off.

It is effective: when patients follow their physician’s plan to limit the amount of food they eat while choosing food that benefits the body, 50-70% experience permanent weight loss.  

Bariatric surgery has proven to be the most effective and long-lasting treatment for severe obesity. 

Preparing for bariatric surgery

Bariatric specialists evaluate your situation and help determine if weight loss surgery is right for you. If you are deemed a candidate, here are some helpful steps you can take to prepare:

Begin reading food labels

Pay special attention to calorie, fat and sugar content.

Start a food & activity diary

A food and activity diary will help you track what your food intake and activity levels. We recommend using a food and activity tracking app. Bring your diary with you to your appointments.

Remove beverages that contain calories from your diet

This includes soda, juice, flavored coffee and alcohol. Beverages should have less than 5 calories per serving.

Wean off of caffeine

If you drink a lot of caffeine, cut back before surgery. You will need to avoid caffeine for 6 weeks after surgery. We strongly recommend that you wean off caffeine before to avoid withdrawal symptoms.

Additional tips prior to surgery

Lower the amount of sugar & simple carbohydrates you eat. Limit candy, cake, cookies, deserts, breads, pastries, pasta, rice and potatoes.

Lower the amount of fat you eat. Limit fried foods, fast foods, high fat meats, high fat cheese, chips, butter, margarine, salad dressing and oil.

Lower the number of processed foods you eat. Avoid foods that are highly processed. Less processed foods are much healthier for you.

Exercise. Your goal should be to work up to at least 30 minutes of exercise every day or 3 hours per week. If you do not currently exercise, start slowly and increase your activity over time.

Drink 64 ounces of water every day. Carry a water bottle everywhere you go. Practice sipping very slowly. Avoid drinking fluids 30 minutes before and 30 minutes after eating solid foods.

Eat slowly & take dime sized bites. Take one bite every two minutes. Chew your food well. Food should be the consistency of applesauce before you swallow.

Evaluate your mental health. Are you an emotional eater? Do you eat when you are bored? Do you use food to cope with stress? If you answered yes, you will be more successful with long-term weight loss if you find new ways to cope before surgery. Consider talking to a mental health professional.

Attend weight loss surgery support groups. Studies show that people who participate in weight loss surgery support groups are more successful with long-term weight loss.

Support and care

Bariatric surgeons, nurses, dietitians and bariatric patient advocates are involved before, during and after weight loss surgery to help patients successfully adjust to this major life change. Specific resources are offered, including:

  • Support group meetings
  • Nutrition classes
  • Psychological consultations
  • Scheduled follow-ups

Weight loss surgery is highly effective, but it does not cure obesity. Obesity is a chronic disease for which there is no known cure. Bariatric surgery is a tool that helps produce weight loss. Maintaining a healthy diet and exercising regularly after bariatric surgery usually leads to a successful outcome.

According to the data, patients who participate in support groups have greater success after bariatric surgery. Spouses, partners or family members can come to support group meetings. It’s normal for them to be nervous and sometimes not completely supportive of weight loss surgery. Here, they can talk to other patients, spouses and support people, which can make them more comfortable with their loved one’s decision.

References

Long-term effectiveness, outcomes and complications of bariatric surgery

New Study Shows Long-term Effectiveness of Gastric Bypass in Treating Type 2 Diabetes and Obesity

The latest news in Weight loss surgery