There are several types of weight-loss surgeries collectively referred to as bariatric surgery. Essentially, the operations result in changes to the digestive system which result in weight loss by limiting food intake and reducing calorie absorption. Most patients lose 60 to 80 percent of their excess weight in the 12 to 18 months after surgery.

Who should get weight loss surgery?

Anyone who has tried dieting and portion control, committed to an exercise program but the weight just won’t come off may be a good candidate. The surgery may be an option for patients with a body mass index of 40 or more. Patients with a BMI between 35 and 40 and serious weight-related problems also may be considered good candidates.

What type of surgery is the best?

Either of two procedures offer certain advantages:

• Roux-en Y gastric bypass reduces the size of the stomach and allows food to bypass a large part of the stomach and small intestine. Due to their smaller stomach, patients feel fuller with less food.

• Sleeve gastrectomy results in weight loss through restriction. Two-thirds of the stomach is removed, leaving the stomach a narrow tube. The intestine isn’t bypassed, so patients are less likely to experience vitamin and mineral deficiencies.

How do patients benefit?

Besides looking and feeling better, losing weight improves quality of life. Patients experience increased mobility, improved body image and decreased risk of obesity-related illness. For patients with one or more health conditions before surgery, weight loss may lessen or eliminate symptoms as well as reduce or eliminate the need for certain medications.

What is the approval process?

Patients need a physical examination and testing as part of the approval process. The physician also may require patients to lose additional weight or quit smoking before surgery to make the surgery and recovery safer.

What else should someone know?

• Weight-loss surgery is not a cure-all. It requires a commitment from the patient to make permanent diet changes and exercise regularly to succeed long-term.

• Surgery is expensive and not covered by all insurance companies.

Bree Dewing is a weight-loss surgeon at Sanford Clinic in Bismarck. She earned her undergraduate degree at the University of Minnesota in Minneapolis and completed a medical degree at Saba University School of Medicine in Saba, Netherlands Antilles. She did her residency in general surgery at the University of North Dakota School of Medicine and Health Sciences in Grand Forks.

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