- With regard to obesity, some patients turn to invasive procedures such as bariatric surgical treatments including gastric bypass and gastric banding.
- Bariatric surgery is classified as a restrictive or a malabsorptive procedure or a combination of the two.
– Restrictive procedures, such as gastric banding and vertical sleeve gastrectomy, reduce the volume of the stomach dramatically to limit food intake while leaving the gastrointestinal tract alone.– Malabsorptive procedures, such as biliopancreatic diversion with a duodenal switch, shorten the small intestine to decrease nutrient absorption.– The combined procedure is the Roux-en-Y gastric bypass and it is considered the “gold standard”. In this procedure 95% of the stomach is bypassed and the small intestine is shortened. This is the most often performed procedure for extreme or morbid obesity.
- While these procedures do initially result in dramatic weight loss, they can be expensive and can have significant risks, including:
– gastric dumping syndrome– malnutrition (impaired absorption)– increased risk of bone fractures
- Comparing weight loss across the various procedures is difficult due to lack of standardization in result reporting and lack of long-term follow-up treatment.
- As a result, much attention today is focused on developing better treatment options for the overweight and the obese that are multi-disciplinary and include continued treatment/counseling for extended periods of time and nutrition assistance from a dietician.
See next page for referencesReferences
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- Blum K, Bailey J, Gonzalez AM, et al. Neuro-Genetics of Reward Deficiency Syndrome (RDS) as the Root Cause of “Addiction Transfer”: A New Phenomenon Common after Bariatric Surgery. Journal of genetic syndrome & gene therapy. 2011; 2012(1).
- Chevallier JM, Paita M, Rodde-Dunet MH, et al. Predictive factors of outcome after gastric banding: a nationwide survey on the role of center activity and patients’ behavior. Ann Surg. 2007; 246(6), 1034-1039.
- Maluenda F, Csendes A, DE Aretxabala X, et al. Alcohol absorption modification after a laparoscopic sleeve gastrectomy due to obesity. Obes Surg. 2010; 20(6), 744-748.
- Dunn JP, Cowan RL, Volkow ND, et al. Decreased dopamine type 2 receptor availability after bariatric surgery: preliminary findings. Brain Res. 2010; 1350, 123-130.
- Vetter ML, Faulconbridge LF, Williams NN, Wadden TA. Surgical Treatments for Obesity. In Brownell KD, Gold MS (eds.) Food and Addiction – A Comprehensive Handbook. New York: Oxford University Press; 2012 (pgs 310-317).
