Weight loss surgery cures and improves many obesity related diseases and other health problems. In a report from the Journal of the American Medical Association it was reported that diabetes is cured in 80% of patients and resolved or improved in 90% of patients. As a pre-diabetic prior to surgery and a widower who lost their wife to diabetes I understand just how important this single benefit is. Having previously suffered from high blood pressure I can also appreciate the fact that hypertension (high blood pressure) is cured in 62% of patients and resolved or cured in 78.5% of weight loss surgery patients. It was reported that nearly all patients are able to reduce their blood pressure medication to a single medication within a few months. High cholesterol and high triglycerides is improved in more than 70% of bariatric surgery patients. As a person that was diagnosed with sleep apnea and placed on a CPAP machine something that I was never able to get used to, I became one of the 86% of bariatric surgery patients that is cured of sleep apnea. And to top all of this off the same journal reported that the risk of death is decreased by 89%.

Does your private or public health plan cover weight loss surgery. The chances are that it does. If you are significantly overweight you should talk to your doctor about it. First though be honest with yourself and ask if you have faithfully tried to loose and maintain your weight through traditional exercise and diet. If you haven’t tried traditional dieting and exercise first you are not ready for bariatric surgery. While I am a supporter of weight loss surgery you need to realize that weight loss surgery is not a magic cure it is a tool. While weight loss surgery is an exceptional tool you need training and the ability to maintain life long discipline or the tool will not work.

In this video Dr. Alan Whitgrove is interviewed on Health Matters and discusses how morbid obesity often leads to early death, the benefits of bariatric surgery, the difficulty for morbidly obese individuals to loose and maintain an acceptable weight through dieting and related subjects. This is a good video that will give you a better understanding of bariatric weight loss surgery. You should watch it if you are considering the surgery or know someone else that is.

One of the requirements of Medicare and my insurance company was for prospective candidates for bariatric surgery to attend a seminar. I attended an excellent seminar that was hosted by a local Bariatric Center that was approved by my insurance company. At the seminar both experts and patients spoke and all gave me a feeling of confidence in the procedures and the Center.

The following day as I started to review the information I was overwhelmed. While I really liked what I heard I needed to absorb what I had learned and perform a bit of research on my own.

During the seminar and as I begin my research, I learned that there are many types of weight-loss surgery. Reviewing the Medicare information I observed that they do not cover every type of weight loss surgery. The bariatric center that I was referred to by my insurance company performs Restrictive procedures where the amount of food and calories ingested is restricted. They also perform Malabsorptive where the absorption of the food is reduced. Their procedures include Roux-en-Y Gastric Bypass (RYGB) and Adjustable Silicone Gastric Banding. They perform both of the surgeries laparoscopically.

I knew that I wanted the surgery to be performed laparoscopically meaning that only a small incision is made. Heck, I want to look good in that bathing suit when I loose all that weight.

I was also quite pleased to learn that with most surgeries hospitalization is usually just a day or two. They even said that with the lap band surgery many of the patient go home the same day.

I do not have an extra $25,000 to spend on a surgery that is not covered by insurance or Medicare. After the seminar I also felt comfortable with the local Bariatric Center and therefore have limited most of my research to the approved surgeries they offer. For those of you that are interested in other types of surgeries I have placed some links that you may find helpful.

Roux-en-Y Gastric Bypass (RYGB)

Roux-en-Y Gastric Bypass (RYGB) surgery, was referred to as the gold standard treatment for the morbidly obese. This method combines a gastric restrictive operation with a small amount of malabsorption.

How the RYGB is performed

The stomach is divided into two parts. The upper part will receive food from the esophagus. The lower part of the stomach will not receive any food but it does deliver stomach acid into the duodenum. The surgeon also divides the small intestine in the upper jejunum and connects it to the small stomach pouch leaving an opening about the size of a dime. The joining of the stomach pouch and jejunum is called an anastamosis. Now if you are still with me and don’t understand the difference between halitosis and anastamosis, don’t worry about memorizing all these things. You might be an inquisitive person though and wondering what the surgeon does with the other end of the jejunum. Wonder no more for that end is reconnected creating a “Y” shape. Absorption will now begin at the point where the two pieces of jejunum come together. Now if you are a visual person like me and all of these fancy words have confused you perhaps the diagram will help you out! The American Society for Bariatric Surgery – ASBS has a lot of good information and you also might want to check out.

Advantages of RYGB

• Appetite reduction.
• Low complication rate
• Low rates of mortality, complications and failures.
• Highest long term success at achieving weight loss.
• Effective loss of 50 to 75 percent of excess weight.
• Weight loss is better that the totally restrictive methods.
• Low incidence of protein-calorie malnutrition and diarrhea.
• Weight-related comorbidities are rapidly improved or resolved.
  Appetite reduction

Complications of RYGB, Early

• Wound infection
• Pulmonary embolism
• Gastrointestinal hemorrhage
• Repertory insufficiency
• Slight risk of death

Complications of RYGB, Late

• Internal hernia
• Incisional hernia
• Bowel obstruction
• Stomal stenosis
• Marginal ulcer
• Micronutrient deficiencies

Adjustable Silicone Gastric Band

The adjustable silicone gastric banding surgery is a technology that was first approved by the FDA in June of 2001. During surgery an adjustable silicone elastomer band is placed around the upper part of the stomach to create a small pouch that will only hold a small amount of food. Food passes from the small pouch through a small outlet that has been created by dividing the stomach with the band. Food will now pass slowly through the outlet resulting in the patient feeling full.

The gastric band sounded pretty straight forward but as I read about it I learned it has many advantages and disadvantages as does the gastric bypass. The American Society for Bariatric Surgery – ASBS also has a lot of good information on the various gastric band surgeries.

Advantages of Adjustable Gastric Band

• Absence of anemia
• Absence of dumping
• Lack of malabsorption
• Short hospital stay
• Very low mortality rate
• Adjustability of the band
• Reversibility (by band removal)
• Laparoscopic placement

Complications of Adjustable Gastric Band, During Surgery

• Hemorrhage
• Injury to the spleen, stomach, or esophagus
• Conversion to open procedure

Complications of Adjustable Gastric Band, Following Surgery

• Band slippage (stomach prolapsed)
• Leakage of the balloon or tubing
• Port Infection
• Band infection
• Obstruction
• Nausea and vomiting

Late complications

• Band erosion into the stomach
• Esophageal dilatation
• Failure to lose weight