Reviewed by Dr. Jaroslav Tvaruzek
Weighing up the pros and cons of weight-loss surgery
Bariatric surgery is an effective treatment for those who are unable to lose weight through diet and exercise alone and can also lead to an improvement in obesity-related disorders such as heart disease and type 2 diabetes.
Gastric sleeve (Sleeve Gastrectomy)
Around 85% of the stomach is removed laparoscopically, leaving only a banana-shaped tube. This restricts the amount of food which can be eaten and decreases levels of the hunger hormone ghrelin, so appetite is reduced. It's a permanent procedure and cannot be reversed. However, it is a safe procedure if performed correctly by an experienced surgeon. An appropriate evaluation of the condition of the patient and thorough examination must be performed prior to surgery including a gastroscopy.
Benefits
- Around 21% TBWL (total body weight loss) by year 3
- Avoids the intestines, so there is less risk of malabsorbtion
- No need to avoid certain foods
- Comparatively safe procedure with shorter recovery time than bypass
- Can be converted to gastric bypass
Risks
- Newer surgical procedure so less data available about long-term weight loss or complications
- May cause dyspepsia/GERD/peptic ulcers
- Sleeve dilation may occur over time due to stretching and can result in more food being tolerated and renewed weight gain
- Potential leaks along suture line
Gastric Balloon
A silicone balloon is inserted into the stomach orally via endoscope and then inflated with saline, partially filling the stomach and making you feel full. The balloon should be replaced every 6 months to prevent deterioration and perforation.
Benefits
- Non- surgical procedure - no anaesthetic required, just a mild sedative
- Quick procedure and recovery - only takes 15 minutes to insert
- Available to those with lower BMIs who do not qualify for surgical interventions
- 10 to 15% TBWL during first 6 months
Risks
- Nausea and vomiting
- Reflux
- Heavy feeling in abdomen
- Balloon rupture/deflation
- Injury during insertion/removal
Other bariatric surgery procedures available on the market include gastric bypass, gastric wrap, and gastric band. These procedures are not ideal for undergoing abroad as they are considered more complex or not the most advanced procedures available today.
There is no one-size-fits-all approach and it's important to find the right treatment for you. It's also essential to note that bariatric surgery is not a quick fix and that lifestyle changes, diet and exercise are a key component of success and sustained weight loss.
Contributing writer: Natasha Robinson