Obesity surgery, also known as bariatric surgery, refers to surgical procedures performed to help individuals lose excess weight and reduce obesity-related health complications. It is typically recommended for patients with severe obesity (BMI ≥ 40) or moderate obesity (BMI ≥ 35) with associated comorbidities like diabetes, hypertension, sleep apnea, or joint issues. The goal is to induce significant weight loss, improve metabolic health, and enhance quality of life.

Types of Obesity Surgery

Roux-en-Y Gastric Bypass (RYGB) This procedure involves creating a small pouch from the stomach and connecting it to the small intestine. The bypassed portion of the stomach and intestine reduces calorie absorption and limits food intake.

• Mechanism: Restrictive (reduces stomach size) and malabsorptive (limits nutrient absorption).
• Benefits: Rapid and substantial weight loss; improved diabetes and cardiovascular health.

Sleeve Gastrectomy: In this surgery, approximately 70-80% of the stomach is removed, leaving a tube-like structure (sleeve). This significantly reduces food intake and decreases levels of ghrelin, the hunger hormone.

• Mechanism: Restrictive.
• Benefits: Simpler than bypass surgery; effective weight loss with fewer complications.

Adjustable Gastric Banding (AGB): A silicone band is placed around the upper part of the stomach, creating a small pouch that limits the amount of food consumed. The band can be adjusted to control weight loss progress.

• Mechanism: Restrictive.
• Benefits: Reversible procedure; less invasive; slower but steady weight loss.

Biliopancreatic Diversion with Duodenal Switch (BPD/DS): This complex procedure combines sleeve gastrectomy with intestinal rerouting to significantly reduce nutrient absorption.

• Mechanism: Restrictive and malabsorptive.
• Benefits: Most effective for weight loss but carries a higher risk of nutritional deficiencies.

Intragastric Balloon: A saline-filled balloon is temporarily placed inside the stomach to occupy space and reduce hunger. It is a non-surgical, endoscopic intervention.

• Mechanism: Restrictive.
• Benefits: Short-term weight loss option for patients not ready for surgery.

Benefits and Risks

Obesity surgery can result in long-term weight loss, improved metabolic health (diabetes, lipid profile), and enhanced mobility. However, risks include infections, nutrient deficiencies, dumping syndrome, and the need for lifestyle modifications post-surgery.