By Kaye Bailey
The advisory committee for the 2010 Dietary Guidelines for Americans reported grim news earlier this year when they confirmed that currently about two-thirds of American adults and one-third of American children are overweight or obese. The committee warned that Americans must slash their caloric intake and increase physical activity because the obesity epidemic is "the single greatest threat to public health in this century."
Given that discouraging news nearly 300,000 adult Americans will undergo bariatric surgery this year as a means to losing weight and treating chronic morbid obesity. There are at least 35 bariatric surgical procedures approved by the Food and Drug Administration (FDA) for the treatment of obesity. While each procedure is unique they are all generically referred to as Weight Loss Surgery (WLS). The American Society for Metabolic and Bariatric Surgery describes two basic approaches that weight loss surgery takes to achieve change:
Restrictive procedures that decrease food intake with the use of stapling or banding.
Malabsorptive procedures that alter digestion causing food to be poorly digested and incompletely absorbed so that it is eliminated in the stool.Patients seeking surgical help for obesity quickly learn the nomenclature of bariatric medicine and can readily list the names by which different surgical procedures are known. Bariatric procedures are all effective in the treatment of morbid obesity, but differ in degree of weight loss and range of complications. The choice of procedure, according to the European Association for Endoscopic Surgery, should be tailored to the individual situation. Here we look at the most commonly performed bariatric procedures in the United States and learn the names they go by:
Gastric Bypass Surgery: Since the early 1990s gastric bypass has been the most commonly performed surgical weight loss procedure and the laparoscopic gastric bypass is considered the "gold standard" of bariatric surgery. The public at large often mistakenly calls all bariatric procedures gastric bypass. Gastric bypass is both a restrictive and malabsorptive procedure. Patients refer to it as WLS, GBS, Roux-en-Y Gastric Bypass (RYGB) or simply gastric bypass.
Adjustable Gastric Banding: This procedure, most commonly called lap-band, is restrictive with the use of a prosthetic band placed around the upper part of the stomach, much like a belt. There is no cutting or stapling of the stomach. A tube is connected to the prosthetic band to a small access port that is fixed beneath the abdomen skin. The band is adjusted through this port to help control weight loss outcome. Patients call this procedure banding, lap-band, or gastric banding. They refer to themselves as "Bandsters" or "Bandits".
Sleeve Gastrectomy: This is a purely restrictive procedure meaning there is no intestinal bypass. The sleeve gastrectomy is rapidly emerging as a reasonable alternative to adjustable gastric banding and other stapling procedures with patients favoring it over the malabsorptive procedures. Among patients the procedure is often called "gastric sleeve" or "the sleeve" and patients of this procedure refer to themselves as "sleevesters".
Laparoscopic vs. Open Procedure: Laparoscopic procedures are used for a variety of general surgeries and in the last decade have become the predominant technique for many surgical procedures. When a laparoscopic operation is performed a small video camera is inserted into the abdomen through small incisions made in the abdominal wall. The surgeon views the procedure on a separate video monitor. Laparoscopic procedures are considered less invasive than open procedures that require one long incision to open the abdomen. Studies indicate patients having had laparoscopic weight loss surgery experience less pain after surgery resulting in easier breathing and lung function and higher overall oxygen levels. In addition laparoscopy patients have fewer wound complications such as infection or hernia, and they tend to return to quickly to pre-surgical levels of activity.
Kaye Bailey (c) 2010 - All Rights Reserved
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