A look at four different weight loss surgeries

Bariatric surgeon Dr. Alen C. Wittgrove describes gastric bypass surgery in Boston on Thursday, Feb. 15, 2007. (AP Photo/Ted Fitzgerald, Pool)

For those unable to lose weight through dieting, exercise or medication, bariatric surgery may be a viable option.

Generally speaking, bariatric (or, weight loss) surgery is only recommended for the morbidly obese -- that is, people with a body mass index of at least 40. While all of the below surgeries are performed laparoscopically, only the latter three are generally covered by provincial healthcare plans. In essence, each of these procedures aims to create a smaller stomach that will give a patient a sensation of fullness from eating less food.

GASTRIC BAND SURGERY

In this procedure, a silicone band is fitted like a bracelet around the top of a patient’s stomach. The golf ball-sized pouch that the band creates at the top of the stomach then helps restrict how much food can be eaten at one time. Recent research has shown that this procedure, which is generally not covered by provincial healthcare plans, can cause complications that require the band’s removal. It is, however, the only of the four procedures described here that is completely reversible.

GASTRIC BYPASS SURGERY

There are several forms of this surgery, but in Canada, the most common is known as Roux-en-Y gastric bypass surgery. In this procedure, a surgeon cuts a patient’s stomach and makes a small pouch at the end of the esophagus. The surgeon then cuts part of the small intestine and attaches it directly to the pouch, so that food bypasses most of the patient’s stomach when they eat. The part of the small intestine that is still attached to the posterior of stomach is then connected further down the small intestine to allow digestive juices to meet with food. Patients who undergo this procedure will need to take vitamin and mineral supplements for the rest of their lives.

SLEEVE GASTRECTOMY

A gastrectomy is essentially the partial or complete removal of the stomach. A common form of this is vertical sleeve gastrectomy surgery, in which the stomach is cut to create a long pouch or corridor that connects the esophagus with the small intestine. The pouch, or “sleeve,” is then stapled to size and the remainder of the stomach is removed. This surgery is generally performed on patients with pre-existing digestive conditions.

DUODENAL SWITCH

In this procedure, a surgeon removes part of the stomach and reroutes a long portion of the small intestine to create two different pathways as well as a single common channel. The shorter of the two pathways carries food while the longer pathway conveys bile from the liver. It all meets in the common channel before entering the large intestine. This procedure essentially reduces the amount of time the body has to capture calories and absorb fat.