Which Procedure Is Right For Me?
Bariatric surgery is the most effective and durable treatment for morbid obesity. Nowadays, there are many different surgical options we can offer a patient. All surgeries are effective. To determine which procedure is best suited for an individual, there are a number of medical factors that need to be taken into consideration.
One factor to consider is the complexity of the procedure. In general, the more complex a surgery, the more effective it is for weight loss. The Biliopancreatic Diversion with Duodenal Switch (BP-DS) is a technically demanding surgery and the most complex in bariatric surgery; however, compared to the Roux-en-Y gastric bypass (RNY) and gastric banding procedures, it produces the most weight loss. Although the BP-DS is the most effective in weight loss, not everyone is eligible for this procedure.
Bariatric surgery can be divided into two different categories, restrictive and malabsorptive. Restrictive procedures limit the amount of food the stomach can hold and malabsorptive procedures reduce fat absorption. Some surgeries are a combination of both. Therefore, another factor to consider is the type of procedure. Surgeries which affect both components are more effective. For example, the Lap-Band, which only restricts the amount of food that can be eaten, is less effective than the RNY, which decreases food intake and reduces the absorption of fat.
Another factor to consider is surgical risk. Less invasive operations, like the Lap-Band, are better suited for high risk patients who require shorter time in the operating room. Patients with medical issues like diabetes respond better to surgeries like the RNY and BP-DS, because they change the metabolism.
A patient’s preference is a very important factor that I take into consideration. Today, patients are well informed about the different bariatric surgeries. Many make their own decisions based on their research and their lifestyle and commitment.
Finally, the most important factor to consider is the patient’s commitment to making important lifestyle changes. All weight loss surgeries are effective as long as the patient fully understands that surgery is just a tool.