In the oldest form of gastric bypass surgery, stomach stapling, most of the stomach is cut and then stapled shut so that only a small pouch remains. After the stomach is made smaller, the person is not able to eat as much food - at least in terms of volume of food.
With a smaller stomach, it takes far less food to feel full. How much less food to feel full? Usually the amount of food that you could put on a coffee saucer is all a gastric bypass patient will be able to eat.
It becomes impossible to eat more than two quarter-cup servings of anything at a single meal. A quarter-cup of steamed squash and a one-ounce serving of turkey become as filling as three Whoppers and a shake. Since calories are restricted, weight loss follows.
A newer form of the same operation, Roux-en-Y gastric bypass, even moves the stomach to empty into the middle of small intestine. Less of the intestine is exposed to food, and less fat, sugar, and vitamins are absorbed.
Both of these procedures are major surgery. They require several days of hospitalization. They cut through muscles that take six to eight weeks to heal, and they carry a real risk of blood clotting and infection.
The stomach is home to harmless and infectious bacteria. Anytime the stomach is cut open, there is always a chance these microorganisms could infect other organs in the body. But lap band bariatric surgery avoids many of these risks.
Lap band bariatric surgery was perfected in the 1990's at LSU Medical Center in New Orleans. Surgeons have had the option of inserting a band around the stomach for over 30 years, but interest in the procedure really took off when a way was found to loop the band around the stomach without major surgery.
The advantage of the lap band is that the gastric bypass surgery to install it can be laparoscopic, that is, done through an incision as little as one inch (2.5 cm) wide.
Lap band bariatric surgery can even be an outpatient procedure, with the patient going home the same day, going back to work in three to four days, and going about all normal activities - except eating - all within a week. Other forms of surgery require a minimum of four or five days in the hospital and six to eight weeks to resume normal activities.
In lap band bariatric surgery, the surgeon is placing something around the outside of the stomach. The bacteria in the stomach do not leak into other parts of the body, and the risk of infection is greatly reduced.
Lap band bariatric surgery is much less painful than stomach stapling or the Roux-en-Y bypass. Because the pain in the muscles is so much less, patients are very unlikely to develop pneumonia.
Another New Orleans medical center, St. Charles Hospital, even developed a robot to hold a camera that guides the surgeon to place the band around the stomach with a minimum of bleeding and risk of infection.
The disadvantage of lap band bariatric surgery is that not everyone can have it. At one time the FDA required that recipients of lap band bariatric surgery be between 18 and 51 years of age. They must not have any autoimmune diseases that would cause their bodies to reject the plastic band.
And if you overeat after you have a lap band in place, the effect is a little like pulling a napkin through a napkin ring. Too much food can stretch the band so that it damages the stomach.
Also, recipients of lap band bariatric surgery are at special risk for a phenomenon known as dumping. When the entire half-cup meal consists of a very sweet food, sugar rushes directly to the small intestine.
The resulting load of sugar doesn't result in a sugar high. It results in a "sugar low." There can be dizziness, nausea, and fainting. If you have lap band bariatric surgery, you may have to restrict your consumption of sweets for life - but you will not have that source of weight gain.
No form of bariatric bypass surgery is a complete cure for obesity. Lifetime diet and exercise are still necessary. But successful lap band bariatric bypass surgery can give you the boost you need to regain control of your life and become truly, lastingly, healthily thin.