Understanding weight loss surgery

Weight loss surgery, sometimes called “bariatric surgery,” is surgery to help you lose weight.

Weight loss surgery is appropriate if 1) you have a body mass index (BMI) above 40 and have not responded to diet, exercise, or weight-loss medicines, or 2) have a BMI above 35 and also have a medical problem related to obesity, such as diabetes, heart disease, high blood pressure, etc. BMI is a value derived from a person’s mass (weight in kilograms) divided by the square of height in meters.

Several different types of weight loss surgeries are performed. The most common is the gastric sleeve, where a large portion of the stomach is removed, leaving behind a narrow tube. The second most common is gastric bypass, where a part of the stomach is closed off (leaving only a small pouch for food), then connecting the new stomach pouch to the middle part of the small intestine. This allows food to “bypass” or reroute around a part of the stomach and small intestine. Almost all gastric bypass and gastric sleeve procedures are done as “laparoscopic” surgery, utilizing small incisions.

How do the different procedures compare?

Each type of weight loss surgery is different, and each has different benefits and downsides. These include the following:

Sleeve gastrectomy, or gastric sleeve, is safer than gastric bypass because it does not involve rerouting or cutting and reattaching the intestines. Additionally, it is less likely to cause problems with how nutrients are absorbed.

Gastric bypass leads to the most weight loss and works the fastest, but it involves the most serious surgery with the highest risks. It can also cause problems in how the body absorbs nutrients. As a result, it can lead to “nutritional deficiencies,” meaning the body is missing important nutrients. This can sometimes cause sickness. If you have gastric bypass, your doctor will monitor your nutrient levels afterward.

More than helping you lose weight, surgery will improve, or even cure, certain health problems, including diabetes, high blood pressure, high cholesterol, sleep apnea, and more.

Drs. Yaniv Cozacov and Jihui Li, Cleveland Clinic trained general surgeons, perform the gastric sleeve procedure at Horizon Health. The program offers free consultations and a private-pay option. For more information, call 217-466-4033.