Should I have bariatric surgery?

Bariatric surgery can help people in many ways.

  • The average weight loss of medical (no surgery) attempts is only 6% at 10 years.
  • Weight loss with surgery can be as high as 77% at 12 months. As high as 60% at 5 years.
  • Type 2 diabetes is resolved in 77% of patients. It is improved in 86%.
  • High blood pressure is improved in 79% of patients. Blood pressure goes back to normal in 62% of patients.
  • High cholesterol is lowered in 70% of patients.
  • Obstructive sleep apnea is resolved in more than 85% of patients.
  • The risk of this surgery is now lower than medical tries at weight loss. The risk of death is only 0.1%.

Who qualifies for bariatric surgery?

People with a BMI > 35 and high-risk weight-related health problems. This includes:

  • diabetes
  • sleep apnea
  • high blood pressure
  • fatty liver disease
  • GERD
  • high cholesterol

People with a BMI > 40

What is bariatric surgery?

There are two types of bariatric procedures performed at University of Iowa Hospitals & Clinics:

  • Restrictive – the stomach is made smaller. This limits food intake.
  • Malabsorptive – A part of the intestines are bypassed. This limits the number of calories the body can absorb.

    Restrictive

    Sleeve Gastrectomy

    • Up to 55% excess body weight loss at 5 years
    • Can help resolve some weight-related health problems

    Vertical Sleeve Gastrectomy

    Malabsorptive

    Roux-en-Y Gastric Bypass

    • Both malabsorptive and restrictive
    • Developed at UI Hospitals & Clinics. Has been done for over 50 years
    • Up to 77% excess body weight loss
    • Most helpful to resolve weight-related health problems

    Rouxeny Bypass

    Weight loss surgery can help resolve many related health problems.

    Which surgery is best for me?

    You and your surgeon will discuss the best procedure for you.

    Illustration of gastric bypass and sleeve gastrectomy surgeries

      Roux-en-Y gastric bypass (gastric bypass) Sleeve gastrectomy (sleeve)
    How does it work?
    • Lessens the amount of food you can eat
    • Lessens the amount of food absorbed
    • There are hormone changes that help you lose weight
    • Lessens the amount of food you can eat
    • Lessens the amount of food absorbed
    • There are hormone changes that help you lose weight
    Stomach
    • Your stomach is surgically separated into two parts
    • A new, smaller pouch is made
    • 75 to 85 percent of the stomach is surgically removed from your body
    • A new stomach "sleeve" is made
    Small intestine
    • Cut in the middle
    • Bottom section is brought up to make a new stomach pouch
    • Stays together (no intestinal rerouting)
    Pyloric valve
    • Bypassed
    • Stays intact
    Average operating time
    • 3 hours (5 hours total including recovery time)
    • 2 hours (4 hours total including recovery time)
    Average hospital stay
    • 1 to 2 nights
    • 1 to 2 nights
    Average time off work
    • 2 to 4 weeks
    • 2 weeks
    Average weight loss
    • 65 – 75% of your excess weight
    • 55 – 65% of your excess weight
    Surgery advantages
    • Has been the "gold standard" of bariatric surgery for more than 50 years
    • Slightly higher weight loss average
    • Slightly lower surgical risk
    • Fewer food intolerances
    Surgery disadvantages
    • Slightly higher surgical risks, such as:
      • Dumping syndrome
      • Nutritional deficiencies
    • You may develop gastroesophageal refulx (GERD)
    • If you have GERD it may get worse (a bypass may be recommended)
    • Cannot be changed or reversed
    • Standard risks of surgery and anesthesia
    Last reviewed: 
    June 2018

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