CHOOSING AMONGST WEIGHT LOSS SURGERY OPTIONS, WHY IS IT SO COMPLICATED?
You would think these surgeons and weight loss experts would simplify matters and devise one procedure and one standard diet program that worked the best. Plain and simple, here is the one that works the best, sign up and you can these are the results you can expect.
Unfortunately, it has not worked out to be nearly so simple. Instead, the surgical approaches have moved toward recognition of a few principals and have also shifted from the types of operations performed. However, there are still several operations that appear very viable as contenders for the “best” procedure and advocates of each one continue to point to data showing its success.
Over time, we have seen that the science tells us a few important principals:
- The surgery works best when combined with a comprehensive program.
- Protein or meal replacement shakes are appetite suppressing and probably represent the second best tool we have in the battle against excess weight.
- Going totally without surgery yields a very, very small percentage success rate when the BMI has crept over 30-35. (It doesn’t mean well shouldn’t try!)
The operations performed however have become perhaps somewhat more confusing for the consumer or the patient who is seeking medical help. Over time, the surgery has shifted largely away from more invasive, open surgery toward less invasive, laparoscopic or minimally invasive surgery through keyhole incisions. It has shifted from long hospital stays and intensive post-operative treatments and management of complications to outpatient surgery or very short hospital stays after a minimally invasive procedure. And finally, the operations themselves have changed. The surgery that was most successful forty years ago was an operation that involved bypassing a large percentage of the small intestine, the portion of the intestine that absorbs nutrients. Other “mal-absorptive” operations were also very successful, but lead to long term complications such as vitamin deficiencies and deficiencies of iron and other nutrients. So the most successful surgery has now shifted towards ones that focus most of the attention on the stomach and reduce our appetite, decrease our hunger, decrease portion sizes and may offer a small amount of mal-absorption.
Today, four operations deserve mention as being truly minimally invasive, involving minimal hospital stay and being highly successful with very few complications (especially relative to older procedures). The four procedures I consider viable today as highly successful weight loss surgical procedures are:
- Laparoscopic adjustable gastric band or LAP-BAND.
- Laparoscopic Roux-en-Y gastric bypass or gastric bypass.
- Laparoscopic sleeve gastrectomy.
- Laparoscopic “mini” gastric bypass or “loop” gastric bypass
Each of the procedures has its pros and cons, but the bottom line is that the properly motivated person who is engaged in a long term plan with a diet plan that emphasizes proper vitamins, minerals and proteins, the use of protein shakes and regular exercise (let’s hear it for the walking club!) is highly likely to result in terrific success with long term weight loss, better health and a greater sense of energy and wellbeing.