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Reducing obesity through new bariatric procedures

Mike Licht

Although obesity has been determined a disease of its own, there are also many other life-threatening diseases that can stem from it. This can include diabetes, heart disease, hypertension, cancer, high cholesterol, and many more.

This week on "Take Care," Dr. Steven Edmundowicz talks about new approaches to bariatric surgery with fewer side effects, and the different ways the procedure can reduce obesity. Edmundowicz is the medical director of the Digestive Health Center at the University of Colorado Hospital, and is a visiting professor at the University of Colorado School of Medicine.

So what exactly is bariatric surgery?

"Currently, bariatric surgery is an operative procedure," Edmundowicz said. "It's done under general anesthesia to some way alter the gastrointestinal (GI) tract to allow patients to lose weight."

But there's a variety of different kinds of procedures that can be done to perform bariatric surgery. The two most common ones are laparoscopic gastric bypass and bypass limb, says Edmundowicz.

A laparoscopic gastric bypass reduces the size of the stomach, while a bypass limb redirects food and makes a patient feel fuller after eating less food. The bypass limb procedure can also have metabolic affects, which can help improve other illnesses as well, such as diabetes, says Edmundowicz.

Laparoscopic gastric bypass and bypass limb may be the most common procedures when it comes to bariatric surgery, but currently, the most popular is the gastric sleeve procedure, according to Edmundowicz. This is a more simple surgery and can sometimes even be performed in an outpatient setting.

"[The] gastric sleeve procedure is where a laparoscopic procedure is done to essentially remove a significant portion of the stomach, which also allows patients to feel full at an earlier set-point," Edmundowicz said.

Another more recent popular procedure is a space-occupying balloon. Edmundowicz says this process can be done orally by placing the balloon at the end of a tube to then be blown up in the GI tract. Since the balloon takes up space it also gives the feeling of being fuller, and can help patients relearn the amount of calories they should be eating, says Edmundowicz. Once the patient has adjusted to new eating habits, the balloon is then removed.

But no matter the type of bariatric surgery, patients most eligible would be those whose weight has an impact on their health. Edmundowicz says the typical patient has a body mass index (BMI) over 35, and has usually developed some other disease such as diabetes or hypertension.

Candidates that would not be eligible for bariatric surgery would be those with an eating disorder, such as binge eating. To determine this, a psychological test is administered before surgery is considered, according to Edmundowicz.

However, for those that do receive bariatric surgery, the success rate is high. Edmundowicz says that 80 to 90 percent of patients are able to keep the weight off that they lose after surgery.

But as with any surgery there can be side effects to a bariatric procedure. In many cases, Edmundowicz says patients can have trouble absorbing certain vitamins and have to take supplements for some time after the surgery. However, the more recent procedures do result in fewer side effects than the standard gastric bypass, according to Edmundowicz.

“There are a significant number of complications that are eliminated, such as leaks after surgery where there’s actually a hole in the intestine causing contents to spill,” Edmundowicz said.

Along with this, Edmundowicz says overall recovery has also improved with newer procedures because they are less invasive.