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Bariatric Surgery
Origin and types

Bariatric Surgery
Many people hear the term bariatric surgery used loosely to describe a surgery specific to weight loss; however, most people are not familiar with all that Bariatric surgery encompasses.

The word bariatric stems from the Greek word ‘baros’ meaning “weight”, and refers to weight loss surgery, specifically, different types of surgery designed to foster weight loss through various methods including reduction of stomach capacity, and malabsorption through reduced small intestinal length. Bariatric surgery got its start following radical surgeries performed on cancer patients to remove the portion of stomach or intestine in which the cancer had invaded. Consequently, doctors noticed the dramatic weight loss following these surgeries and began directing this principle towards morbidly obese individuals as an interventional method of weight reduction. This proved a much more effective method of treating obesity than the non surgical options available and has benefitted a wide range of individuals suffering uncontrolled weight gain and the associated comorbidities.

Bariatric surgery involves different methods of altering the digestive system to restrict portions and reduce caloric intake, as well as absorption of caloric sources. There are two main types of bariatric surgeries with different methods of achieving the respective goals; restrictive surgery and malabsorptive surgery.

Restrictive surgery includes adjustable gastric banding (gastroplasty), accomplished through the lap-band, stomach stapling, or vertical banded gastroplasty. This method is strictly a restrictive method to reduce intake by decreasing the stomach from a typical melon sized capacity to an egg sized capacity using staples, or a silicone band. These particulars methods of reducing intake do not drastically alter the digestive system in any respect other than size and thus have their drawbacks because they are reversible and can potentially be rendered ineffective with frequent overeating.

Malabsorptive surgery includes a number of procedures referenced by the term gastric bypass. Roux-en-Y, biliopancreatic diversion, duodenal switch, and fobi pouch all fall under this category where the objective is accomplished through two parts; reduce stomach size, and bypass the first part of the small intestinal tract (duodenum). Food then courses rapidly through the digestive process allowing for a drastically reduced amount of absorption to take place which effectively counters an individual’s propensity to overeat since very little will be absorbed. This approach has proven much more effective at producing weight loss in obese individuals for this reason.