Weight loss in America in the past decade has seen some remarkable advancement. No longer is the general public limited to diet and exercise but a plethora of options to help them reach their goal, although not always maintaining it. From Nutri-System and Weight Watchers, pills of all kinds and the most drastic of measures Lap Band and Gastric Bypass.
Lap Band is the least invasive and reversible procedure done surgically for weight loss. Incisions are made in the abdomen and a small plastic band is placed around a pouch created by the surgeon, typically 110 to 220 grams of food. The stomach fill quickly, allowing the patient a sense of feeling full, sending a message to the brain as well that the patient is full and no more should be consumed, Thus, allowing them to control their intake and promoting weight loss. The procedure is adjustable as well as reversible, as a small access port is placed just under the skin. This port allows access to a syringe that can either add saline to decrease size of the banded are or remove saline to make the pouch a bit larger. As with all surgical procedures there are the standard lists of possible complications, including ulceration, gastritis, erosion and possible problems with band placement. Also the psychological effects of drastic and speedy weight loss are an issue that can pose problems without proper guidance. The average band patient loses one to two pounds a week in the beginning, although in heavier patients the numbers are higher. This procedure, though not as drastic as Gastric Bypass, has a higher maintenance average as it encourages better eating habits overall in the long run.
Gastric Bypass, the Roux-en-Y procedure, is a more invasive, surgical approach to weight loss. It is a permanent, nonreversible procedure that can be done one of two ways. Done the laparoscopic way it involves four to six incisions to allow access to the abdominal cavity with a surgical telescope connected to a camera to guide the instrumentation. The actual procedure is the creation of a small pouch that holds between fifteen and thirty milliliters from the upper stomach, this pouch, separated from the rest of the stomach, is then connected directly to a section of the small bowel, adjusting the degree of which food is absorbed but not adversely effecting nutritional absorption. Gastric Bypass is also done surgically with an incision made down the center of the abdomen. This surgery has a much longer recovery rate as well as other complications. Complications can include infection, hemorrhage, hernia, bowel obstruction, venous thrombosis as well as anastigmatic leakage or stricture. The worst side effect after this procedure is 'dumping syndrome'. This happens when a patient overeats or eats an amount of sugar that proceeds to bypass the stomach and go directly into the intestine. The end result is a period of nausea, sweating and an overall feeling of illness.
Over the years people have tried everything, from the cabbage diet, the grapefruit diet, countless dietary supplements, laxatives, water pills and even starvation. We've been introduced to new psychological disorders dealing with body image such as bulimia and anorexia. All of these weight loss methods have pros and cons; patients should have a discussion with their doctor as to what method would be best for them, and decide from there.
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