Bariatric Surgery

What is bariatric surgery?

Bariatrics is an English word that describes a field of medicine that deals with weight loss, weight control, and obesity treatment. Bariatrics is combined using three different root origins: bari- from Greek (also, baros), meaning heavyweight, burden, or load. The second root, iatr, comes from Greek iatrikos/iatros which describe physicians and treatment, and the suffix, ic, means pertaining to.

We like to call bariatric surgery “weight loss surgery” but because it definitely causes weight loss, but… it also profoundly affects metabolism and does much more than weight loss. Maybe the best term is “metabolic surgery”.

Bariatric surgery, in part, aids with weight loss by restricting the amount of food the stomach can hold. The great thing is that the patient feels FULL on a small amount of food. What may be more important is that Bariatric surgery changes a person’s METABOLISM, that is why it is often called “Metabolic Surgery”. Medical problems associated with obesity respond to this change in metabolism. A change in metabolism creates a number of changes in the way gastrointestinal hormones that also work to add to the satiety or “hunger satisfaction” from the food that is eaten.

Normal dieting causes a decrease in metabolism, but after metabolic surgery there is a paradoxical metabolic response that creates incredible weight loss that plateaus at the correct place, giving the patient a new metabolic “set point”.

There are several types of bariatric surgery available at Heartland Surgical Weight Loss, including:

• Gastric bypass
• Sleeve gastrectomy
• Adjustable gastric band

You need an expert like Dr. Fermelia to help you to decide between a gastric sleeve or a gastric bypass. Dr. Fermelia will help you determine the best surgical weight loss option for you based on your needs and medical history.

What is a gastric sleeve?

Gastric sleeve surgery offers effective long-term weight loss by restricting the amount of food your stomach can hold and by changing your metabolism. Dr. Fermelia makes a tube out of the stomach and removes about 2/3 of the stomach. The remaining stomach is about the size of a medium banana (100 to 150 ccs or 4-6 ounces). The new stomach is considerably smaller than your full stomach, allowing you to consume smaller meals and fewer calories, yet still, be satisfied. Long-lasting metabolic changes are created by changing the way gastrointestinal hormones respond to the food you eat.

What is gastric bypass? 

Gastric bypass surgery offers effective long-term weight loss by restricting the amount of food your stomach can hold and by changing your metabolism. Dr. Fermelia creates a small stomach pouch, dividing the top of your stomach from the rest of the stomach (this is why it is called a gastric bypass). The upper pouch is redirected to the small intestine. The new stomach is considerably smaller than your full stomach, allowing you to consume smaller meals and fewer calories, yet still, be satisfied. Long-lasting metabolic changes are created by changing the way gastrointestinal hormones respond to the food you eat.

How is sleeve gastrectomy different from a gastric band?

A sleeve gastrectomy is a laparoscopic procedure that involves removing 60 to 80% of the stomach. The remaining portion is banana-shaped and holds much less food than your full stomach. There is a definite metabolic change that occurs with the gastric sleeve that does not occur with the lap band. An adjustable gastric band doesn’t require the removal of your stomach. Instead, an inflatable band is placed around the upper part of your stomach to create a pouch. The new pouch can only hold a small amount of food, satisfying your hunger through restriction. With a sleeve or a band, you can’t consume a large number of calories, yet you are satisfied with a small meal, ensuring effective weight loss. Unlike the gastric band, with the sleeve, there is a durable metabolic change that continues to contribute to small meal satisfaction. This metabolic change and weight loss lead to improved management or the prevention of certain medical conditions like type 2 diabetes. The gastric band improves morbid obesity co-morbidities through weight loss alone.

How is a sleeve gastrectomy different from a gastric bypass?

A sleeve gastrectomy is a laparoscopic procedure that involves removing 60 to 80% of the stomach. The remaining portion is banana-shaped and holds much less food than your full stomach. The gastric bypass is the “gold standard” operation that has been around for a long time and is tried and true. The gastric bypass is a procedure that involves making a small pouch of the upper part of the stomach that “bypasses” the lower stomach. It reroutes the pouch to the intestines, which augments the metabolic effect of the surgery.

There is a definite metabolic change that occurs with BOTH gastric sleeve and gastric bypass. It is agreed by most weight loss surgeons that the metabolic change with the gastric bypass is more profound, the weight loss is a little more, and the resolution of morbid obesity comorbidities is a little better. A gastric bypass doesn’t require the removal of your stomach. The gastric bypass is an excellent choice in patients with bad GERD or heartburn. With both operations, the new pouch can only hold a small amount of food, satisfying your hunger with smaller meals. With both sleeve and bypass, there are metabolic changes (through changing the way that gastrointestinal hormones work) that continue to contribute to hunger satisfaction with small meals. This metabolic change and weight loss lead to improved management or the prevention of certain medical conditions like type 2 diabetes. The sleeve promotes weight loss and doesn’t require the rerouting of your intestines.