The oldest form of weight loss surgery is the most familiar, stomach stapling. In this 30-year-old procedure, most of the stomach is sliced and then stapled shut.
After the procedure, only a small pouch remains. Shrinking the stomach so it can only hold half a cup of food makes it easier to feel full.
In fact, most people who have weight loss surgery feel full after eating the amount of food that you could put on a coffee saucer. It becomes impossible to eat more than two quarter-cup servings (about 50 grams altogether) of anything at a single meal. Weight loss follows calorie restriction.
The newer and now more common form of weight loss surgery, the Roux-en-Y gastric bypass, also makes the stomach surgically smaller. In this procedure, however, the stomach is not dissected and stapled shut.
In this newer form of weight loss surgery, the stomach is cut and sutured, or sewn, and the intestines are moved so that the end of the stomach is connected farther down the intestine.
This procedure leaves a smaller stomach that fills more quickly. It also leaves a shorter length of intestine to absorb fats (and other nutrients) from the smaller amounts of food that are eaten.
With this form of weight loss surgery, you don't just eat less. Your intestines absorb less of the food you do eat. Roux-en-Y bariatric surgery produces quicker and more significant weight loss than just stapling or banding the stomach.
There's also a third approach to weight loss surgery, the lap band.
The benefit of the lap band is that the weight loss surgery to install it can be laparoscopic, that is, done through an incision as little as one inch (25 mm) wide.
Lap band surgery can even be an outpatient procedure, with the patient going home the same day. After lap band surgery, many patients go back to work in three to four days and resume all normal activities (except eating) within a week. The other gastric bypass procedures require a minimum of four days in the hospital and six to eight weeks before resuming an active lifestyle.
Another advantage of lap band surgery is a much lower risk of infection. Lap band surgery goes around the stomach, not into 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 surgery is much less painful than the other procedures. And since pain in the muscles is so much less, patients are very unlikely to develop pneumonia or other breathing problems.
The disadvantage of lap band bariatric surgery is that not everyone can have it. The FDA at one time required that recipients of lap band bariatric procedures be at least 18 and no more than 50 years of age. It's also utterly essential not to be allergic to the material used to make the 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. Lap band surgery is easier, but requires more discipline.
There is no form of weight loss surgery that is a complete cure for obesity all by itself. Lifetime attention to diet and exercise are still necessary. But successful weight loss surgery can give you the boost you need to regain control of your life and become truly, lastingly, healthily thin.