What are my options?

What are my options?

Making the decision to lose weight and lead a healthier lifestyle is an important one and so it is important that you first consider all the options available to you. There are many factors to consider before choosing a weight loss option and we’ve outlined a number of those options below:

Non-surgical options

What is it?

The most common approach to weight loss:

1. Eating less and eating sensibly

2. Exercising more

How does it work?

Small lifestyle changes to diet and exercise can translate to great health benefits.

Is it reversible?

Yes

Adjustability

Not applicable.

Outcomes

Unfortunately, diet, fitness and medication to treat obesity offer only short-term results. Studies show that obese patients on diets, exercise programmes or weight loss medications lose approximately 10% of their body weight, but tend to regain two-thirds within one year – and most of the weight within 5 years.

What are the risks?

While temporary weight loss can help,
‘yo-yo effect’ can make it harder to lose weight in the future.

Gastric Banding Procedure

What is it?

Laparoscopic Gastric Banding is the placement of a band around the top of the stomach through keyhole surgery. The Gastric Band is made of silicone and a balloon lines the inside. An access port, connected to the Gastric Band by tubing, is placed in the abdomen wall, which allows saline solution to be added or removed to change the size of the band.

How does it work?

The Gastric Band is designed to induce weight loss by applying a constant, gentle pressure to the top part of the stomach, encouraging satiety (a sense of fullness) even without food. By sending this signal of satiety to the brain, it limits the amount a person can eat.

Is it reversible?

Yes: As the procedure is done laparoscopically, there is no major opening of the abdomen required, no cutting or potentially permanent alteration to the stomach or intestines.

Adjustability

Can be quickly, easily and non-surgically adjusted to affect weight loss results, during a brief doctor’s office visit.

Outcomes

Patients can lose up to an average of 27kg of their excess weight in 12 months, and a recent study shows that the Gastric Band is a
long-term option with sustained weight loss at 17 years. It is now the most common form of weight control surgery in Australia, with over 100,000 Gastric Banding Procedures being performed in Australia since 1994.

What are the risks

Complications can include:

  • Acid reflux and vomiting
  • Band slippage
  • Stomach obstruction.

Gastric Sleeve Surgery (Sleeve Gastrectomy)

What is it?

Sleeve Gastrectomy (also known as Gastric Sleeve surgery) is a relatively new approach to weight loss surgery. Originally, it was the first stage of a far more complicated Gastric Bypass operation, but is now becoming more popular as a stand-alone procedure.

How does it work?

With Gastric Sleeve surgery, using a small stapling device, around two thirds of the stomach is removed laparoscopically, via a small tube. The residual stomach capacity is around 200 mls.

Is it reversible?

No Due to stomach cutting and removal, this procedure is considered permanent and cannot be reversed.

Adjustability

Since such a large part of the stomach is removed during the procedure, there are not really any "adjustments" to be made.

Outcomes

Gastric Sleeve surgery is believed to work by two main mechanisms:

1. Decreasing the stomach size and thus increasing the sensation of fullness.

2. Decreasing appetite. Appetite reduction apparently occurs because the level of the
so-called ‘hunger hormone’ is reduced.

What are the risks

Complications can include:

  • Risk of possible staple-line leakage.
  • Gastric remnant dilation
  • Suture line bleeding
  • Leakage and gastric strictures
  • Risk of gastric reflux.

Gastric Bypass

What is it?

Gastric Bypass has been available for more than 35 years and is still a commonly used surgery in the United States. Gastric Bypass is traditionally done with a long incision in the abdomen, but can also be performed laparoscopically. It involves cutting the stomach off near the top so that a smaller pouch may be made, which is reconnected to the small intestine.

How does it work?

Two commonly used gastric bypass techniques are:

1. Roux-En-Y Bypass

2. Sleeve Gastrectomy

Roux-En-Y Bypass involves creating a small stomach pouch that is then attached to a
Y-shaped section of the small intestine. With this method, most of the stomach and top portions of the small intestine are bypassed. This procedure reduces the absorption of nutrients and therefore calorie intake. It is done through a major opening of the abdomen, requires staples and is irreversible.

Sleeve Gastrectomy is a newer method of Gastric Bypass, which removes two- thirds of the lateral stomach to form a new tube-shaped stomach. Sleeve Gastrectomy is often used as a primary operation to further bypass procedures for super obese (BMI of 60+) people who may need more radical bypass in the future.

Is it reversible?

No

Adjustability

To make any "adjustments" or to improve weight loss results, additional surgery may be necessary.

Outcomes

May offer more rapid initial weight loss but some patients with Gastric Bypass will regain some weight over time. After about three years, weight loss is comparable to Gastric Banding Procedure.

What are the risks

Complications can include:

  • Nausea and vomiting
  • Separation of staples (major revisional surgery)
  • Leaks from staple lines (major revisional surgery
  • Higher risk of short term death following surgery when compared to Gastric Banding Procedure.

Gastric Plication

What is it?

Laparoscopic Gastric Plication, also known as Laparoscopic Greater Curvature Plication, is similar to Sleeve Gastrectomy surgery, but without the need for removing part of the stomach.

How does it work?

In this procedure, the stomach is reduced by cutting the greater omentum, part of the lining of the abdominal cavity and the short blood vessels supplying the stomach. Then the greater curvature of the stomach is folded inward using multiple rows of sutures. This creates a tube, similar to that seen in Sleeve Gastrectomy.

Is it reversible?

Yes

Adjustability

To make any "adjustments" or to improve weight loss results, additional surgery may be necessary.

Outcomes

The percentile of excess weight lost appears similar to that seen with other restrictive methods. However, this technique requires greater expertise and is more time consuming.

What are the risks

Not enough published data exists on this new procedure.