With two surgeries option most commonly resorted to by obese, over-weight patients to lose weight. Dr. Nancy Puzziferri and colleagues at The University of Texas, South-western Medical Centre, Dallas report that gastric bypass surgery wins over gastric banding, both in the short and long term. Evidence shows patients undergoing gastric bypass not only lose more weight, they consistently do so over a period of time, however, three years down the road, they show the same results.
However, before opting for either, it is imperative to weigh the pros and cons, and while, bypass may be the riskier and more complicated surgery of the two, yet, a more intensive follow-up is required for gastric banding. What counts when deciding between the two, is the risk-benefit ratio and patient’s ability to return to the clinic.
Between 1997 and 2006, 1,102 gastric bypass patients against 631 who underwent gastric banding, were evaluated by Puzziferri’s team in order to compare the results of these two weight loss procedures. They found results of bypass surgery to be consistent across patients, who lost weight faster and kept it off longer, than those who went in for banding.
While, 53.2 gastric bypass patients lost 75% of their excess body weight at the end of the study, only 9.8% of banding patients had comparable weight loss. Bypass patients were 18-times more likely, than banding patients, to successfully lose weight within 6-months of the surgery, showing a success rate more than 9-times, two years down the line.
Researchers found gradual weight loss in banding patients rather akin to what one sees in those on low-calorie diets, which indicates behavioural practices are critical for losing weight in gastric banding, more so than in gastric bypass. However, the higher operative risk of the latter makes it a better choice for only a selected group of patients. A larger study with at least 5-years of follow-up is recommended for comparing the risks, benefits and costs of the two procedures.
But, even gastric bypass surgery does not mean that you do not have to monitor your food intake or give up exercise completely. Ms. Sloan, despite having gastric bypass surgery still disciplines her eating habits, keeping a food diary for each day to be scrutinized by the nutritionist she sees once a month. While, eating a wide variety of foods, she avoids high-sugar foods like ice cream and candy, having them only occasionally. And, exercises regularly by walking, swimming and lifting weights in order to keep lean and maintain muscle health.
With over 15-million morbidly obese Americans, 205,000 of which underwent surgery last year, going on to lose 100 or more pounds according to American Society of Metabolic and Bariatric Surgery estimates. Gastric surgeries help create a smaller stomach, bypassing a part of the small intestine to help lose weight, which means the amount people can consume at a given time is reduced, including the amount of digested food they can absorb.
While, weight-loss surgery is a major operation and carries a risk of complications, it does help to lose weight, thereby improving overall health, reducing the risk of premature death and heart disease by lowering blood lipids and blood pressure. Type 2 diabetes and obstructive sleep apnea also disappear with weight loss, while the risk of some cancers is also reduced.
But, surgery is not an instant cure for obesity; one also has to maintain weight loss through diet and exercise. Gastric bypass surgery makes you throw up if you eat too much, while eating sugary foods results in diarrohea. However, it does cure underlying psychological factors that prompt overweight people to overeat or eat fattening foods. Before going in for gastric surgery, it is best to find out first why one is overeating. It could be more of a psychological problem that needs psychiatric help than anything else.
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