What you should know about different types of weight loss surgery

Once you've decided to pursue bariatric care, choosing which weight loss surgery procedure to undergo is an important and personal next step.

Before you make that decision, it's crucial to understand the different types of weight loss surgery available, along with how each will impact your health.

At Main Line Health, we offer several leading-edge bariatric surgery procedures, all of which are minimally invasive and designed to help your body have a healthier relationship with food.

The principles behind weight loss surgery

There are three overarching principles behind each bariatric surgical procedure: restriction, malabsorption, and hormonal change, says Richard D. Ing, MD, medical director of the Bariatric Surgery Program at Main Line Health.

Restriction entails physically reducing the size of the stomach and, therefore, its ability to take in food.

Malabsorption, on the other hand, involves limiting how much of the intestines absorb food. Typically, when patients first come to see us, their intestines are absorbing 100 percent of the food they eat. After surgery, their intestines only absorb about 50 to 70 percent of the fat and calories consumed.

Hormonal change is the third mechanism at play. The human brain controls about five or six different hormones that tell us whether we're hungry or full. While each form of bariatric surgery impacts "hunger hormones" in various ways, hormones work differently after surgery so that you have more control over how hungry you feel and how much you eat.

Types of weight loss surgery procedures at Main Line Health

Perhaps the most well-known weight loss surgery procedure is the gastric bypass operation.

How does a gastric bypass operation work?

During this restrictive and malabsorptive procedure, the surgeon creates a small, "new" stomach that is separate from the current stomach. This new stomach is then connected to a downstream part of the intestinal tract, so that when you eat, your food bypasses your "old stomach" and the first part of your intestinal tract, causing you to feel fuller from smaller amounts of food.

Additionally, since part of the digestive system is being bypassed, your body won't absorb as many calories, which helps you lose weight.

According to Dr. Ing, the most common bariatric operation in the U.S. is the laparoscopic sleeve gastrectomy, which is a restrictive surgery.

How does a laparoscopic sleeve gastrectomy work?

The procedure is relatively easy for a surgeon to perform, and it is much quicker than most others. During this procedure, the surgeon removes about 75 percent of your stomach, leaving the remaining stomach as a long tube or "sleeve" that remains connected to the small intestine. After this surgery, your stomach will be much smaller and you'll feel fuller with smaller portions of food.

The duodenal switch is a more restrictive and malabsorptive procedure.

How does the duodenal switch work?

The duodenal switch does two things:

• First, it removes part of the stomach so you'll eat less food.
• Second, it bypasses half of the intestines so your body absorbs significantly less fat and calories.

This is the most drastic of all procedures, Ing says, and it usually helps people lose the most weight, keep the weight off for longer amounts of time, and resolve health problems to the greatest degree.

Additional types of weight loss surgery

Main Line Health's bariatric program also offers intragastric balloon procedures, in which a device is temporarily placed into the stomach to reduce its capacity, along with an endoscopic sleeve and an endoscopic revision.

The endoscopic sleeve creates a smaller stomach by folding the stomach in on itself. The endoscopic revision reduces the size of the gastric pouch and can reduce the opening of the stomach to the intestine, which limits the amount of food the stomach can take in. All of these techniques are done through the mouth without incisions on the abdomen.

Patients are under general anesthesia for all of these procedures, which take anywhere from one to three hours.

Ing stresses that recovery time is relatively quick. For example, if you get the laparoscopic sleeve, you'll be home in 24 hours. If you and your doctor opt for a bypass procedure, you'll be on your way within two to three days. After that, most patients can get back to their normal lives within a couple of weeks.

All in all, there is no one bariatric surgery procedure that is best for everyone. By taking the time to understand what each procedure involves and how your body processes and digests food, you and your medical team here at Main Line Health can identify the type of weight loss surgery that will bring you the most success.

Main Line Health serves patients at hospitals and health centers throughout the western suburbs of Philadelphia. For more information or to schedule a consultation, call 484.476.6230.