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Bariatric Surgery
Surgical operations for the control of severe obesity are based on one or both of two principles. The first is restriction, where the amount of calories or food ingested is controlled by limiting space available. The second principle is malabsorption, where the absorption of food is limited.

Since the advent of bariatric surgery in 1959, operations have been improved and modified again and again, undergoing many changes while overcoming a questionable early history. Early failures were associated with techniques that have since been abandoned. Surgeons have continued to modify and improve surgical procedures taking into consideration the ineffectiveness of most non-surgical methods. Further enhancements are in the process as new technologies and surgical methods become available.

Today, the two most common operations performed in the U.S. for the treatment of severe obesity include Roux-en-Y Gastric Bypass and Laparoscopic Adjustable Gastric Banding (LAGB).

Roux-en-Y Gastric Bypass
Considered the “gold standard” and recognized by the National Institutes of Health (NIH) for the treatment of severe obesity. This operation is performed using the laparoscopic or open techniques and combines gastric restriction with slow gastric emptying. It is one of the most frequently performed weight loss procedures in the U.S. with 70-80% of excess weight loss after 5 years. Additionally, 96% of certain associated health conditions or comorbidities (sleep apnea, high blood pressure, diabetes and depression) are typically improved or resolved following surgery.

With this procedure, the stomach is divided to form a new, smaller pouch for food. The small bowel is re-routed to empty the new, smaller pouch. As food enters the pouch it quickly fills and causes the patient to have a sensation of fullness after eating only a small portion of food. The remainder of the stomach is present, but no longer acts as a reservoir for food.

The first illustration depicts a normal stomach and bowel before surgery. The second illustration depicts the stomach and bowel after gastric bypass surgery. The small bowel is reattached to the new stomach pouch. Food intake is restricted.

Laparoscopic Adjustable Gastric Banding (LAGB) or the “Lap-Band” System
This is a relatively new gastric restrictive procedure offered in the U.S. The Lap-Band System was approved by the FDA in June of 2001 and limits the amount of food that may be consumed at one time. The Lap-Band System uses an implanted medical device designed to induce weight loss in severely obese patients by restricting food consumption.

When performing the operation using the laparoscopic technique, surgeons implant an inflatable silicone band into the patient’s abdomen. The band is then fastened around the upper stomach creating a new, small pouch and small outlet. This limits the amount of food intake and slows the emptying process into the stomach and intestine. After surgery, the diameter of the stoma outlet between the small upper stomach pouch and the rest of the stomach can be adjusted via a port passed through the skin.

LAGB is commonly performed in this country and is a suitable surgical procedure with a very acceptable rate of complications and operative risk. Studies show that patients can maintain 30-40% excess weight loss after 3 years with this procedure.

Why Do Gastric Bypass Surgery Patients Need Nutritional Supplements?

*These statements have not been evaluated by the Food and Drug Administration.
This product is not intended to diagnose, treat, cure or prevent any disease.

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