What is Weight Loss Surgery?

Severe obesity is best treated by surgical intervention because time and time again perscriptions and dietary treatment has proven to be ineffective.

Dangers of severe obesity:
(1) complications such as an inability to breathe properly,
(2) including Sleep Apnea,
(3) failure of the heart to circulate enough blood to all the tissues,
(4) diabetes,
(5) hypertension,
(6) pain in weight bearing joints,
(7) and injury as a result of ineffective treatment (yo-yo dieting).

If a patient is below 100 pounds over weight, Weight Loss Surgery should only be considered if his/her physician determines there is sufficient medical need for weight reduction and an operation is the only way to accomplish this.

Here are the two ways WLS may control obesity:
(1) restriction of food intake,
(2) and malabsorption of ingested food.

The normal stomach can hold more than three pints of food at a single feeding. Through WLS the stomach can be reduced to a small pouch that only holds a few ounces.

Notes about organs of the Gastrointestinal Tract:
Stomach: receives and stores food we swallow, secrets a strong acid that assists digestion.
Duodenum: absorption of most the iron and calcium in the foods we eat, digestion of meat and other protein.
Small Intestines: average 20 feet in length where digestion continues and all absorption of digested foods occurs.
Colon (large bowel): receives residue that comprises the feces, remainder of water absorption occurs in the colon.
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The stomach and the colon are both considered storage sites. The stomach for food to be processed and the colon for the remainder of ingested material that could not be digested or absorbed.

Effective WLS is the result of energy balance related to the amount of food that is absorbed and the amount of energy that is used. All excess energy is stored as fat, and when there is an energy deficit energy is drawn from the stored fat cells. The need for the body to use the stored energy in fat cells can be achieved by reducing food intake and/or absorption (the function of WLS) and/or increase physical activity.

History of WLS:
The classic malabsorption surgery was originally an intestinal bypass used between 1954 and about 1974. The idea of intestinal bypass was that individuals could eat large amounts of food. The excess would be either poorly digested or passed along too rapidly for the body to absorb the excess calories. The draw back was that essential nutrients were also lost in the stool and the side-effects of intestinal bypass being too difficult to predict and manage. The original form of the operation is no longer used.

Near total removal of the stomach (gastric resection) for cancer or severe acid peptic ulcer disease caused many individuals to remain at a below normal weight. This was the original surgery that suggested gastric bypass for treatment of severe obesity. The draw back in some patients was the "Dumping Syndrome." The side effects include nausea, weakness, sweating, faintness and sometimes diarrhea after eating. This is caused when the pyloric sphincter muscle at the base of the stomach is no longer in the food path and concentrated fluid enters the small intestines too rapidly.


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