Improvement in Health
Bariatric surgery achieves excellent long term weight-loss for most morbidly obese patients who follow recommended guidelines.
A recent report from the Journal of the American Medical Association has detailed other health benefits of weight loss surgery.
- Diabetes was resolved in 80% of patients and improved in 90% of patients. Most patients are off all of their diabetes medications or have significantly reduced doses in the first three months after surgery. Blood sugar glucose levels and Hemoglobin A1c levels usually return to normal or near normal.
- Hypertension (high blood pressure) was resolved in 62% of patients and improved in 78.5%. Most patients are able to reduce their blood pressure medications to a single medication within a few months.
- Hyperlipidemia (high cholesterol and high triglycerides) improved in more than 70% of patients.
- Obstructive sleep apnea was resolved in 86% of patients.
- Risk of death is decreased by 89%.
Other potential benefits:
- Improvement in arthritis with reduction in pain and increased mobility.
- Resolution or improvement of other medical conditions such as: Acid reflux, ankle swelling, obesity related heart failure, asthma, urinary stress incontinence, infertility and other menstrual problems.
- Potentially reduced risk of developing cancer.
- Improved ability to participate in physical and recreational activities.
- Improved lifestyle and outlook toward the future.
Weight Loss Results
Adjustable Gastric Banding:
The Lap Band® or REALIZE™ Band affords weight-loss without dividing the stomach or rearranging the intestinal tract. Based on studies conducted in Europe and Australia, 8 year results for Lap Band patients show an average loss of 50-60% total excess body weight. Weight loss results with the Lap Band® or REALIZE™ Band occur gradually over a period of 18 months to 2 years. The need for adjustments of the Lap Band® or REALIZE™ Band are determined by the patient’s progress with weight loss as well as level of restriction patient feels. Patients who lose a significant amount of weight can get resolution of type 2 Diabetes, high blood pressure and obstructive sleep apnea following the gastric band surgery.
Roux-en-Y Gastric Bypass:
The laparoscopic Roux en Y procedure or gastric bypass, has shown excellent long-term weight loss. Weight loss 5-10 years after laparoscopic or open Roux en Y averages between 62-75% of total excess body weight. Gastric bypass is the most common bariatric surgery performed in the US and has excellent weight loss results in several long term studies. A significant advantage of the gastric bypass is the excellent resolution rate of type 2 diabetes of about 87%. Majority of the patients get the resolution within the first few weeks prior to significant weight loss. Patients who lose a significant amount of weight can get resolution of type 2 Diabetes, high blood pressure, obstructive sleep apnea, high cholesterol and experience an improvement in overall quality of life. Super morbidly obese patients (BMI >50) experience less dramatic weight loss results with Roux en Y surgery. Ten year post-op results for super morbidly obese patients show an average of 40-50% total excess body weight loss. These individuals may want to consider other weight loss procedures.
Gastric Sleeve / Vertical Sleeve Gastrectomy:
Long term weight loss results are still limited since this procedure has only been done since 2002. Currently 3-year results show that the weight loss is excellent and close to the gastric bypass results. Average excess weight loss with this procedure is more than the average for Lap Band® procedure. Gastric Sleeve appears to have the least chance for major long term complications related to bariatric surgery. Patients who lose a significant amount of weight can get resolution of type 2 Diabetes, high blood pressure and obstructive sleep apnea following the gastric sleeve.
The duodenal switch procedure achieves superior weight loss results for super morbidly obese patients in comparison to the Roux en Y gastric bypass. 10 year post-op results for the open duodenal switch show an average of 75-80% total excess body weight loss. Duodenal switch patients need a close follow up with the surgeon because of the risk of nutritional deficiencies secondary to malabsorption. Patients who lose a significant amount of weight has the best chance to get resolution of type 2 diabetes, high blood pressure, high cholesterol, high triglycerides and obstructive sleep apnea following this procedure. The duodenal switch procedure has the highest cure rate for diabetes.
Stomaphyx is a new procedure performed as a revision for gastric pouch reduction following Roux-en-y gastric bypass in patients who had significant weight gain. The results of this procedure in terms of weight loss are unknown. It is a simple endoscopic procedure.
Many types of revisions can be performed for either complications or to achieve better weight loss. Generally, revision patients have a higher complication rate and a slower and lower overall weight loss compared with patients who had the same procedure as the primary procedure.