Types of Obesity Surgery and Their Mechanisms

Obesity surgery, commonly known as bariatric surgery, comprises multiple procedures aimed at weight loss for those struggling with severe obesity. These surgeries work primarily by restricting the amount of food the stomach can hold, causing malabsorption of nutrients, or a combination of both.

Gastric Sleeve Surgery (Sleeve Gastrectomy)

This procedure involves removing approximately 80% of the stomach, leaving a tube-like portion of the stomach, or ‘sleeve’. This smaller stomach cannot hold as much food, thus reducing the amount consumed. This surgery also impacts hormone levels that influence hunger, satiety, and blood glucose control.

Gastric Bypass Surgery (Roux-en-Y Gastric Bypass)

Gastric bypass is a two-part surgery. Firstly, a small pouch is created in the stomach, which becomes the only part of the stomach that receives food. This drastically reduces the volume of the stomach. Secondly, a significant portion of the small intestine is bypassed, which limits the body’s ability to absorb calories from food.

Adjustable Gastric Band

This involves placing a band around the upper part of the stomach to create a small pouch to hold food. The size of the band can be adjusted to change the level of restriction. The advantage of this is that it is reversible and adjustable compared to other forms of surgery.

Biliopancreatic Diversion with Duodenal Switch (BPD/DS)

A more complex procedure, this involves removing a large part of the stomach to limit food intake and restrict the amount of calories and nutrients the body can absorb by bypassing a significant portion of the intestine.

The above surgeries all help reduce weight, improve or resolve comorbidities like diabetes, and enhance quality of life but they come with their own risks and requirements for permanent life changes.

As someone who had a gastric sleeve about two years ago, I’ll tell your straight up—this is not an easy way out. I had to go through a major shift in my eating habits, not just because my stomach was a lot smaller, but the food I could eat changed a lot. I can’t eat sugary stuff like I used to because it makes me feel sick now (that’s called ‘dumping syndrome’). But honestly, it saved my life. I lost about 60 kilos and importantly, got off my diabetes meds. It wasn’t easy, surgery is tough, recovery is tough, making life changes is tough, but so worth it!