I wouldn't say losing weight is an easy task, or at least, not as easy as gaining weight. Your fat loss "journey" might feel like a never-ending trip. With time, it can get boring and mentally tiring to witness the slow progress and minimal results. This could also lead to stress levels skyrocketing, but, unfortunately, the quick-result drugs aren't really good, either. So, many, struggling with morbid obesity, take assistance in the form of weight loss surgery, also known as bariatric surgery.
Though diet and exercise help to lose weight, sometimes, due to underlying health conditions, losing weight becomes next to impossible. When diet and exercise become ineffective, the role of fat loss surgery becomes crucial. However, the purpose of such surgical interventions is not only weight loss but also improvement of an individual’s metabolic health and resolution of the co-morbidities associated with obesity, such as type 2 diabetes, hypertension, and heart disease.
While many have a surface understanding of what a weight loss surgery does, there are different types of surgeries catering to different needs. So, we turn to an expert, who helps us understand all things about weight loss surgery better and in detail.
- The most commonly performed bariatric surgeries include:
Gastric sleeve or laparoscopic sleeve gastrectomy (LSG): According to Dr. Arush Sabharwal, bariatric and metabolic surgeon at Scod Clinic, gastric sleeve is a type of bariatric surgery that removes 75-80 percent of the stomach surgically, giving it the shape of a banana or a sleeve. "Lower stomach size implies reduction in hunger due to lower levels of the ghrelin hormone (the ‘hunger’ hormone). The reduction in food intake aids in considerable weight loss," he adds.
Laparoscopic Roux-en-Y Gastric Bypass (RYGB): Earlier standard treatment of bariatric surgery, RYGB makes a small pouch of the stomach and also reroutes a portion of the small intestine. However, Dr. Sabharwal says it is no longer a treatment of choice, owing to complications such as candy cane deformity and internal hernia. "This reduces food consumption, and even the calorie absorption from the food also declines. Excess body weight gets significantly reduced, making it a great option for those ailing with type 2 diabetes," he explains.
Laparoscopic mini gastric bypass/one-anastomosis gastric bypass (MGB-OAGB): "This newer but widely accepted procedure creates a small stomach pouch and connects it to a loop of the small intestine. It offers excellent weight loss results—comparable to traditional bypass—with reduced operative time and fewer complications," Dr. Sabharwal says.
As bariatric science advances, several innovative procedures are gaining attention for their potential benefits in select patient populations. These include:
Intragastric Balloon: A non-surgical option where a saline-filled silicone balloon is temporarily placed inside the stomach to create a feeling of fullness. "It’s suitable for individuals who are not candidates for surgery but need short-term weight loss support. Results are modest, and the balloon must be removed within 12 months," he says.
SADI (Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy): According to Dr. Sabharwal, it is a simplified version of the traditional duodenal switch. "It combines a sleeve gastrectomy with a single small intestinal bypass, offering strong weight loss and metabolic outcomes with fewer complications compared to the classic BPD/DS," he explains.
SASI (Single Anastomosis Sleeve Ileal Bypass): A newer hybrid procedure combining restrictive (sleeve) and malabsorptive components through a single connection between the sleeve and the ileum. It aims to preserve pyloric function and reduce nutrient deficiencies.
Sleeve with Transit Bipartition (Bi-partition): This surgery, he says, keeps the pylorus intact and adds a bypass route from the sleeve stomach to the lower small intestine, allowing food to travel via two pathways. It enhances early nutrient delivery and gut hormone stimulation for improved metabolic outcomes.
Sleeve-Plus Procedures: "These are customised combinations of sleeve gastrectomy with partial intestinal bypasses (like loop duodenojejunal bypass or sleeve+jejunojejunal bypass)," Dr. Sabharwal says, adding that they are tailored to improve outcomes in cases of severe obesity or weight regain after sleeve alone.
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