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Types of obesity surgery

Summary

Types of obesity surgery

What types of obesity surgery are there?

The surgical treatment of obesity has been transformed during the last decade or so, largely due to developments in laparoscopic (keyhole) techniques and anaesthetics. Two types of surgical procedures used to promote weight loss are:

Restrictive surgery 

During these procedures the stomach is made smaller so that it holds less food, making you feel full with smaller portions.  Because you can only eat small quantities, your calorie intake falls and you lose weight.  Restrictive procedures do not interfere with normal digestion and absorption of nutrients.  

Malabsorptive surgery

This approach changes the body’s ability to absorb calories from food.  By re-routing food in such a way as to exclude (bypass) a section of the small bowel (intestine), much of the calories and nutrients pass through without being absorbed.  Again, fewer absorbed calories means weight loss.  

 Most modern surgical treatments for obesity involve pure restriction or a combination of restriction and malabsorption. The two most commonly performed operations for obesity are:

1. Laparoscopic adjustable gastric banding (LAGB) also known as lap banding/gastric banding

 and

2. Gastric bypass ( combining both restrictive and malabsorptive elements) 

Gastric banding is a purely restrictive procedure whilst gastric bypass combines restriction with a small malabsorptive component.  Other less commonly performed procedures include biliopancreatic diversion (BPD), duodenal switch (BPD/DS) and variants. 

A summary of the main benefits and risks of these two procedures is shown below:

TABLE 1

Laparoscopic Adjustable Gastric Banding versus Gastric Bypass

Laparoscopic adjustable gastric banding (LAGB)

Gastric bypass

100% restrictive procedure

70% restrictive, 30% malabsorptive

Takes around 45 minutes

Takes around 1.5 – 2 hours

Hospital stay 1 night

Hospital stay 3 nights

Recovery time 10-14 days

Recovery time up to 6 weeks

Fully reversible procedure

Not easily reversible

50-60% excess weight loss

60-70% excess weight loss

<5% early complication rate

5-10% early complication rate (haemorrhage, staple-line leakage etc)

Mortality 1: 1000 (0.1%)

Mortality 1:200 (0.5%)

No risk of metabolic complications

Risk of metabolic complications including vitamin and mineral deficiency

Vitamin and mineral supplementation recommended but not essential

Lifelong vitamin and mineral supplementation essential

Regular band adjustments required to achieve desired weight loss

Regular blood tests required to prevent anaemia, protein deficiency etc

 

Healthier Weight's expert team will advise you regarding which of these procedures – or other alternatives – is the most appropriate for you.

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Types of obesity surgery
FREE Guide
FREE Guide

Obesity surgery and weight loss surgery guide

  • Types of obesity surgery
  • Risks of surgery
  • Benefits of surgery

 

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