Gastric Bypass - What are other weight loss surgery options?

The most common alternative to gastric bypass surgery is laparoscopic banding (lap band surgery). In this procedure, a surgeon places a donut-shaped device, with an inflatable balloon on the inside, around the upper part of the stomach. The intent is similar to gastric bypass surgery: the upper part of your stomach is turned into a small pouch that can handle much smaller quantities of food.

Why dieting fails

1. The more muscle mass your body has, the more efficiently you burn calories. Muscle uses a lot of energy. Initially, weight loss inevitably implies muscle loss. The greater the restriction or the more unbalanced the diet, the greater this loss will be.

2. Less muscle mass means a slower basal metabolism. Food is more efficiently absorbed to keep the body in its natural weight zone. The weight put back on after a diet is mainly fat and not muscle, which can lower energy needs, making further weight gain easier.

3. Ending a diet or suddenly relaxing strict dieting rules can lead people to eat compulsively and to overeat.

4. The self-esteem and confidence that comes with successfully controlling weight diminishes as the weight returns, and people become increasingly obsessed by weight and food.

5. A balanced diet coupled with exercise remains your best option for weight management.

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• The major difference is that there is no bypass to the second section of the small intestine. The device can be tightened or loosened by a saline injection.

The surgery takes less time and recovery is quicker than for gastric bypass, which can involve a hospital stay of a few days and weeks of recovery at home before resuming a normal lifestyle.

Weight loss with the lap band is more gradual than with gastric bypass surgery. Because it is adjustable and more easily reversible, lap band surgery is safer and easier to accommodate life changes like pregnancy.

Lap band surgery involves fewer possible complications during surgery but does present other potential problems afterwards. There have been cases of band erosion, where the band goes through the gastric wall and into the stomach's cavity. There have also been complaints that the band can sometimes slip out of place.

Not every province covers the cost of lap band surgery and some provinces that do won't cover the cost of the band, which can mean an out-of-pocket expense of about $5,000 for the patient.

A less used option is biliopancreatic diversion with duodenal switch. In that, the surgeon removes about 80 per cent of the stomach. Most of the intestine is bypassed by connecting the end of the intestine to the duodenum near the stomach.

This type of surgery offers substantial weight loss but an increased risk of malnutrition and vitamin deficiencies. It is generally recommended only for people with a BMI of over 50. Patients who undergo this procedure require close monitoring.

FAQ's regarding bypass