The concept of surgery to control obesity grew out of the results of operations for cancer or severe ulcers that removed large portions of the stomach or small intestine. Because patients undergoing these procedures tended to lose weight after surgery, some physicians began to use such operations to treat severe obesity. The first operation that was widely used for severe obesity was the intestinal bypass.
This operation, first used more than 40 years ago, produced weight loss by causing something called “malabsorption” (failure of intestines to properly absorb nutrients from food). The idea was that patients could eat large amounts of food, which would be poorly digested or passed along too fast for the body to absorb many calories. Even though this surgery is no longer used in its original form, surgeons now use modified techniques that produce weight loss by limiting how much the stomach can hold. These restrictive procedures are often combined with modified malabsorbtive procedures that limit calorie and nutrient absorption and may lead to altered food choices.
Two ways that surgical procedures promote weight loss are:
- By decreasing food intake (restriction). Gastric banding, gastric bypass and vertical-banded gastroplasty are surgeries that limit the amount of food the stomach can hold by closing off part of the stomach. These operations also delay emptying of the stomach.
- By causing food to be poorly digested and absorbed (malabsortion). In the gastric bypass procedure, a surgeon makes a direct connection from the stomach to a lower section segment of the small intestine, bypassing the duodenum (the first part of the small intestine) and some of the jejunum (the second segment of the small intestine).
There are two “bariatric” or surgical weight-loss procedures that are offered at the MemorialCare Center for Obesity. The procedures are known as Gastric Bypass which is normally performed laparoscopically and the Adjustable Gastric–Band procedure. With your input, your MemorialCare Center for Obesity surgeon will select the medically-appropriate procedure for you. Each procedure is designed to limit the amount of food that can be eaten during a meal by reducing the size of the stomach. With a smaller stomach, you will feel full quickly and for a longer period of time, eliminating the need to eat larger quantities in more frequent intervals. The lower intake of calories will satisfy your appetite and will cause you to lose weight at the same time.