The 4 types of bariatric surgery you need to know about
Bariatric (weight loss) surgery is a permanent change to your body to help with weight loss. This blog post will go through the types of surgery, how much weight loss to expect, and what to consider.
I've got other posts about how bariatric surgery is not the easy way out, and you can read it here.
I'll be going through the:
- Sleeve gastrectomy (SG)
- Roux en y gastric bypass (RYGB)
- One anastomosis 'mini' gastric bypass (OAGB)
- Single anastomosis duodenal bypass with sleeve (SADI)
How much weight can you lose with surgery?
First, let's go through the concept of excess weight, as this helps to understand how much weight you can lose with weight loss surgery.
Excess body weight is any weight a person carriers that is above what their weight would be at a healthy BMI.
Most weight loss surgeries have an average excess weight loss of 50-70% meaning that you are likely to still have some excess weight after the procedure and will likely remain in the obese or overweight BMI range. This isn't to discount the weight you'll have lost, as it will come with lots of health benefits even if your BMI isn't 'healthy'.
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For example, if someone is 5ft 5in (1.65m) and weighs 111kg (17 stone 6lbs), their BMI would be 41kg/m2. This is in the obese range. Their weight at a healthy BMI of 25 would be 68kg. This makes their excess weight is 43kg.
If this person lost 50% of their excess weight, 21.5kg out of 43kg, they'll have an end weight of 89.5kg (14 stone 1 lbs) and a BMI of 32.8kg/m2. This is still in the obese range but they'll have dropped reduced their BMI by almost 10 points, which is a big improvement.
If they lost 70% of their excess weight, 30kg out of 43kg, their end weight would be 81kg (12 stone 11lbs). Their BMI would be 29.7kg/m2 which is the top of the overweight range.
Sleeve gastrectomy:
The SG is a procedure where 60-70% of your stomach is removed from your body. The remaining part of your stomach is similar to a banana shape, and is a narrow, slightly curved tube. This is a permanent procedure and can not be reversed.
The part of the stomach that is removed is where majority of the hunger hormone, ghrelin is released. By removing this part of the stomach, people won't feel as hungry and their appetite reduces. It also means you're not physically able to eat as much, as your stomach is a lot smaller so you can't consume as much as before.
With a SG, people typically lose 50-60% of their excess body weight.
Roux en y gastric bypass:
The RYGB starts with a small stomach pouch being created, this is then connected to a part of the small intestine that is further down. You skip the first part of the small intestine which is called the duodenum. The food you eat bypasses majority of the stomach and the duodenum.
This rerouting of your intestines leads to weight loss as you skip the first part of the small intestine which is where a lot of the digestion of food takes place. This means you'll not fully digest and absorb all the food you eat. It also means you're not able to eat as much as your new stomach pouch is now the size of an egg.
It's also likely that this surgery increases the GLP-1 hormone which makes you feel full and reduces appetite. You may have heard of GLP-1s in relation to the weight loss injections. We make the hormone in our intestines naturally but not in as high a dose as the medication.
People typically lose 60-70% of their excess weight with the RYGB.
One anastamosis gastric bypass:
The OAGB is sometimes called the 'mini' gastric bypass. It's a similar concept to the RYGB in that a smaller stomach pouch is created and the first part of the small intestine is skipped or bypassed. But with the OAGB, a slighter longer stomach pouch is created and there is one connection with the small intestine while the RYGB has two joins.
The OAGB leads to slightly higher potential excess weight loss with a range of 60-80% of excess weight lost.
Single anastomosis duodenal ileal bypass:
The SADI is a more extreme surgery. First, a sleeve created. Then a bypass is completed but this time a larger portion of the small bowel is bypassed and the new smaller stomach is attached to the last part of the small intestine. This leads to greater malabsorption of nutrients and less stomach volume which leads to weight loss.
It is sometimes done as 2 separate surgeries with a sleeve gastrectomy first and then if weight loss stalls, the bypass is done after.
By combining a SG and a bypass, you get a greater effect on the hunger hormones. There is less hunger hormone ghrelin produced, and the more of GLP-1 which makes you feel fuller and reduces appetite.
This is highly effective at weight loss and has around 70-90% excess weight loss.
All these surgeries have benefits of improving obesity related health conditions too. Such as type 2 diabetes, high blood pressure, sleep apnoea, and high cholesterol. A lot of people are able to come off their medications for these diseases.
Comparing the 4 types of bariatric surgery:
All of these surgeries require making changes to your diet and lifestyle. It's not as simple as having the surgery and carrying on as normal. You'll need to change your diet and eating habits, do regular exercise, and take vitamin and mineral supplementation lifelong.
If you don't feel that bariatric surgery is right for you, and you've tried every single diet but nothing works, my e-book How To Lose Weight for Good can help. It has tips on how to build a balanced plate, simplify meal prepping, and reframe your mindset to ditch the all or nothing thinking.
I hope you enjoyed this blog post.
Bye for now 👋
This blog post does not replace medical advice and if you're considering bariatric surgery please speak to your doctor.
References:
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