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Getting the Facts Straight

Getting the Facts Straight
29 February 2020 Laura Eggerichs

Let’s Get the Facts Straight!

Answers to a few of your FAQs about weight loss surgery

Which operation produces the greatest weight loss?

The duodenal switch, which is less common than the gastric bypass or sleeve due to various unpleasant side effects,  results in the greatest weight loss of 85-100% of excess body weight (EBW) shed. The gastric bypass is next in line with an average EBW loss of around 60-80% Sleeve gastrectomy comes in third with patients losing around 50-70% of their EBW.  Regardless of the type of surgery, there’s always the fear of weight regain. But the good news is that 80-90% of patients keep at least 50% of the EBW off!

Which diseases tend to resolve or improve after surgery?

Bariatric surgery improves many different diseases and conditions and can also help prevent future ones from developing.  For example, at 5 years post-op, about 70% of patients with preexisting type 2 diabetes  are off their diabetes medications.  The gastric bypass tends to have a stronger effect on this than the sleeve, but both result in great improvement in diabetes.   Other conditions that tend to improve include high blood pressure, high cholesterol, sleep apnea, infertility, non-alcoholic fatty liver disease,  joint pain, and more.  Patients that receive the gastric bypass also see great improvement of acid reflux disease.  In addition to these benefits, the risk of heart disease, stroke, various types of cancers, and other conditions decreases significantly with weight loss after surgery.

Is the goal of bariatric surgery to lose weight as much as possible?

In general, no. Sure, some people might have that thought in their mind, but the overarching goal is health improvement.  Weight loss is actually a secondary goal in most cases.   In fact, when you are patients why they are having surgery, you often hear things like:  to keep up with my kids/grandkids, to live longer, to take fewer medications, to make getting around in everyday life easier, and so on.   What are some other things that losing weight could improve?

Which is the most common WLS worldwide?

While the gastric bypass has historically been the most common procedure, the vertical sleeve gastrectomy has recently become the most popular worldwide. The gastric bypass is still the most common among patients who have type 2 diabetes.

What are some of the reasons for choosing the bypass or the sleeve?

There are many reasons why people choose one procedure over the other.  The gastric bypass is still considered the gold standard. It results in greater weight loss and has better remission rates for type 2 diabetes than the sleeve. This is why patients with higher BMIs and more severe diabetes often choose the bypass.  It is also the procedure of choice for people that have acid reflux given that it improves the condition while the sleeve can make it worse.  While the bypass is great for some people, others do well to choose the sleeve.

The sleeve has grown in popularity in the past decade.  Many patients think of it as less invasive than the bypass which makes them feel more comfortable with it.  Aside from that feeling, there are many reasons one would choose the sleeve over the bypass.  The operation itself is better suited for people who have had multiple abdominal surgeries or who are higher risk surgical patients.   It is also preferable for people who are on certain psychiatric medications or immunosuppressant drugs.  Additionally, people that have intestinal conditions like Crohn’s disease are often advised to have the sleeve over the bypass.

The procedure you choose to have is ultimately up to you and your doctor.  Both the sleeve and the bypass have fantastic outcomes when it comes to weight loss and disease improvement.  If there’s no counterindication for one procedure or the other, then sometimes the best choice is the one that you feel in your gut (no pun intended) is right for you.

How many bariatric surgeries are performed in the UK each year?

Unfortunately, not enough.   In 2014/2015, the NHS performed 6384 bariatric surgeries, down 27% from 2011/2012, and these numbers are not improving despite the need continuing to go up.  To be on par with other European countries and to improve access to care for those who need it, the NHS should be performing closer to 50,000 surgeries per year according to a study published in the British Medical Journal in 2016.

How many people actually take their required vitamins post-op?

A large study published in 2010 found that only 5% of patients take their required vitamins and minerals after bariatric surgery.  Given the number of deficiencies that can develop, this isn’t good!  That’s why we at Baricol not only offer you easy-to-take supplements, but we also help you remember to take them with our subscription services and BariBuddy app.