A Guide to Choose The Best Type of Weight Loss Surgery for You

Last Modified: December 23, 2019  |   Created on: December 9, 2019
General Surgery, Weight Loss
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Weight loss surgery also known as Bariatric surgery can help you the extra kilos and prevent medical problems associated with obesity. The surgery is generally performed on morbidly obese people who are at risk of developing or already have morbidities like diabetes,  high blood pressure, joint pain, heart diseases, and others like sleep apnea, infertility issues etc. Several different types of surgeries are available for weight loss.

Choosing the best bariatric surgery for weight loss can be challenging and you need to consider multiple factors like how much weight will be decreased, what are the risks and complications of the procedure, success rate and also the cost of weight loss surgery.

Following are the main types of bariatric surgery that are commonly done:

  • Gastric Bypass
  • Sleeve Gastrectomy
  • Adjustable Gastric Banding
  • Bilio-pancreatic diversion with a duodenal switch

Each of these procedures has its own advantages and limitations.

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Things you should know before selecting bariatric surgery procedure for your weight loss.

Choosing a safe and successful weight loss surgery for yourself that will keep off those extra kilos for a longer time is an important decision. According to experts, the best way to decide is after careful consideration and discussion with a specialist. A number of factors play an important role while selecting the best weight loss surgery option and some of these we have enlisted here:

  • The current BMI. To qualify for any type of bariatric surgery, your body mass index (BMI) must fall within a certain range (at least 30). The limited acceptable range is different for different surgeries. For gastric band procedure, BMI between 30-40 is acceptable while more complex procedures like gastric bypass and duodenal switch works best for patients with higher BMI range (35 – 50).
  • Weight loss goals, i.e the amount of weight you want to lose
  • History of previous weight loss attempts and ability to commit to a program
  • Medical history – some surgeries like Duodenal switch can lead to health improvement in cases of medical conditions such as Diabetes and morbid obesity.
  • Risk tolerance – It is important to know all about the risks and complications associated with the chosen surgery.
  • The support system: Some surgeries may take a longer recovery time, especially the more invasive ones. So, it is important to know you well you family and office life will adjust to the procedure.

Another thing you should know is that all types of bariatric surgery affect the digestive system. Before you make your decision, you must understand how a bariatric surgeries work. There are two main ways in which bariatric procedures causes weight loss:

  • Restriction: In this, the aim is to physically limit the amount of food that the stomach can hold, thus limiting the amount of calories consumed. Basically, the stomach is shrunk to contain less amount of food and the less one eats, the more weight they lose.
  • Malabsorption: This is used to reduce the number of calories and nutrients the body absorbs by shortening or bypassing part of the small intestine.

Some bariatric procedures are based on the combination of both gastric restriction and malabsorption. These procedures are often associated with hormonal changes.

Now a days, most of the weight loss surgeries are performed using minimally invasive methods, i.e. laparoscopic surgery. This technique limits the size of incision made during surgery and has many benefits, including reduced hospital stay, decreased risk of complications and faster recovery.

What are the benefits of choosing to have your weight loss surgery in India?

Weight loss surgery in India is a highly successful procedure. All the top-tier hospitals in Delhi, Gurgaon, Mumbai, Bangalore and Chennai offer different types of weight loss surgeries. Every year, numerous international patients arrive in India to get their surgery done at the best bariatric surgery hospitals in India at an affordable price range. There are many factors that attribute to India’s popularity as the best destination for bariatric surgery.

Some important reasons to choose Indian hospitals for weight loss surgery are:

  • Expert surgeons: Bariatric surgeons in India are highly skilled and trained professionals with rich experience of performing all kinds of surgeries.
  • Latest techniques for bariatric procedures: minimally invasive techniques like laparoscopy, endoscopic surgery, Robotic bariatric surgery are offered by the experienced surgeons.
  • Excellent clinical care: First-class medical facilities with high standard of quality
  • Economical packages: India is renowned for offering cost-effective treatment options. Bariatric surgery cost in India is reasonably lower than several other countries.
  • International patient services: The top bariatric hospitals in India have dedicated International Patient Services team that caters to a large number of patients travelling to India for medical treatment. Overseas patients have access to many special facilities and amenities at these hospitals including multilingual interpreters/translators, global cuisine, money exchange services, and multiple payment modalities, to name a few. The hospitals also offer assistance with visa procedure, pick up/drop from the airport, help in arranging accommodation and many other services.

According to American Society for Metabolic and Bariatric Surgery, each type of weight loss procedure has its pros and cons.

On this page, we have enlisted the 4 types of bariatric surgeries that are commonly performed with their risks and benefits to help you decide the best bariatric surgery option for yourself.

1. Gastric Bypass Surgery

Type: Combination of both Restrictive and Malabsorptive Approaches

What happens in this surgery?

In Roux-en-Y gastric bypass, the stomach is divided into two parts - upper and lower. The surgeon seals off the lower section using surgical staples and directly connects the upper stomach part to the intestine. This creates a shortcut for the food flow, bypassing the rest of the stomach. As only a small part of the stomach is now used, the amount of food intake will be drastically reduced and the body will absorb lesser amount of calories.

Benefits

  • The weight loss is fast and you can lose around 70% of excess weight
  • Improves obesity related medical conditions, such as diabetes, cholesterol, heartburn
  • Good long term results - the reduced weight can be maintained for 10 years or more.

Disadvantages

  • If you don't follow a strict balanced diet after gastric bypass, there is a risk of developing nutrient deficiency and dumping syndrome.
  • Dumping syndrome in the condition in which the food is dumped from the stomach to intestines before being properly digested. Side-effects of this syndrome is nausea, weakness, bloating, diarrhea and other symptoms.
  • Chances of developing surgery related complications like infection and blood clots can also occur.

2. Adjustable Gastric Banding Surgery

Type: Restrictive weight loss surgery

What happens in this surgery?

In gastric banding surgery, an inflatable silicone device known as Lap-band or Gastric band is placed on the outside of the stomach. This creates a small upper pouch in the stomach which is connected to the lower section via a small channel. The upper pouch can only contain a small amount of food as the band slows down the emptying of the pouch. This will give you a feeling of a full stomach sooner, thus limiting the amount of food intake.

Benefits

  • It is a reversible procedure
  • Less invasive - no cutting or rerouting of the intestines is involved
  • Low rate of serious complications
  • Fast recovery
  • Low risk of vitamin deficiency
  • Band can be adjusted to tighten further and restrict stomach size even further
  • Short hospital stay - 24 hours or less
If you can commit to a gradual weight loss program and keep patience with the amount of weight reduction, gastric band could be the best choice for you.

Disadvantages

  • Gastric band often show slower and less dramatic weight loss than other surgeries, there are chances of regaining weight over the years.
  • The complication with gastric banding is that the band may become loose or leak or even slip out. Risk of requiring another surgery or re-operation is high.
  • Requires placement of a foreign object in the body
  • In a small percentage of patients, there is a possibility of band slippage or band erosion into the stomach and also for possible mechanical problems with the band, or tube
  • If the patient overeats, it may result in dilation of the esophagus
  • Necessary to strictly adhere to the postoperative diet and follow-up visits

3. Sleeve Gastrectomy Surgery

Type: Restrictive weight loss surgery

What happens in this surgery?

In a vertical sleeve gastrectomy surgery, a large portion of the stomach (approximately 75%-80%) is removed, leaving a narrow tube-like ‘sleeve’ in its place. This procedure restricts the amount of food intake as the stomach size is much smaller now and you will feel fuller without eating too much. Sleeve gastrectomy reduces the production of hormone called ghrelin which triggers hunger when the stomach is empty. So, this will also prevent you from eating more.

Laparoscopic sleeve gastrectomy in India is a popular weight loss procedure. In this minimally invasive technique, the surgeon makes a small cut and uses laparoscope is to remove the part of stomach.

Benefits

  • Sleeve gastrectomy is a recommended procedure for people who are too obese or sick and it is risky to undergo other weight loss surgeries for them.
  • It is a simpler operation with lower risk factors and requires no foreign objects to be placed .
  • No bypass or re-routing of the food stream is required
  • A relatively shorter hospital stay, approximately 2 days, is needed

Disadvantages

  • It is an irreversible procedure
  • The long-term benefits and risks are still under evaluation as it is a relatively new procedure.
  • Potential for long-term vitamin deficiency

4. Biliopancreatic diversion with duodenal switch

Type: Restrictive weight loss surgery

What happens in this surgery?

The Biliopancreatic Diversion with Duodenal Switch (BPD/DS) involves two steps. First step is similar to the sleeve gastrectomy and includes creation of a small, tubular stomach pouch by removing a portion of the stomach. In the next step, a large portion of the small intestine is bypassed. The valve that releases food into the small intestine is left, along with the duodenum, the first part of the small intestine. The middle section of the intestine is closed off and attached to the last part, then directly to the duodenum. This is known as the duodenal switch. The separated section of the intestine is reattached to the end of the intestine to allow the flow of bile and pancreatic digestive juices into this part of the intestine. This is known as the biliopancreatic diversion. These changes causes food to bypass most of the small intestine, thereby limiting the absorption of nutrients and calories. The reduction in the size of the stomach along with these changes leads to weight loss.

Benefits

  • Better and faster weight loss than a gastric bypass
  • Allows patients to eventually eat larger or more normal meals
  • Absorption of fat is reduced by 70 percent or more
  • Causes favorable changes in gut hormones to reduce appetite and improve satiety
  • It Is the most effective procedure for patients with diabetes, in comparison to other methods

Disadvantages

  • It is a less commonly used method as the risk of not getting enough nutrients or vitamin deficiency is more serious.
  • Higher risk of complications such as dumping syndrome, especially with surgeries without duodenal switch.
  • A longer hospital stay may be required.
  • Requires strict adherence to dietary and vitamin supplementation guidelines as well as regular follow-up visits to avoiding serious complications from protein and certain vitamin deficiencies.

Weight loss outcomes of these procedures, according to ASMBS:

Gastric bypassLong-term weight loss with 60 to 80 percent excess weight loss Typical maintenance of >50% excess weight loss
Sleeve GastrectomyExcess weight loss of >50% for 3-5 year data, a typical maintenance of >50% excess weight loss
Adjustable Gastric band40 – 50 % Excess weight loss
Biliopancreatic Diversion with Duodenal Switch60 – 70% excess weight loss or more for 5 year follow up

Lyfboat’s assistance

Lyfboat team of empanelled medical experts include the best bariatric surgeons in India working the top bariatric hospitals in Delhi, Mumbai, Bangalore, Chennai and other cities. We provide the most reliable and affordable bariatric surgery cost in India and negotiate for better prices on your behalf. Lyfboat is a NABH accredited medical travel facilitator, known for its high quality patient services and compassionate guidance to international patents.

You can send your medical reports and queries at care@lyfboat.com and we will get back to you at the earliest with a comprehensive comparative analysis of the cost from different doctors and hospitals.

Tips to help you choose the best bariatric doctor:

  • Research about the surgeon’s credentials
  • Consider the years of experience the doctor has
  • Get referrals and recommendations from other doctors and specialists or even family and friends
  • Consider the quality and accreditations of the hospital where the surgeon works
  • Review the feedback by the previous patients of the doctor
  • Go through the testimonial videos of patients treated by the doctor

To know more, you can read Top 13 Bariatric surgeons in India for detailed information about their professional career, experience and expertise.

FAQs

Q. What is the cost of weight loss surgery in India?

Bariatric surgery cost in India starts from USD 4,500 and may increase depending on the type of bariatric surgery opted by the patient. India is highly recognized all over the world for providing high quality clinical care at a highly affordable cost, when compared to other countries.

The overall cost of bariatric surgery in India vary depending on factors such as the quality/accreditations of the hospital, surgeon’s experience, room category, duration of hospital stay and several other factors.

Q. How is liposuction different from bariatric surgery?

Liposuction is a cosmetic surgery which involves removal (sucking out) of the localised fat from an area such as thighs or belly. It is not a type of weight loss surgery and provides no health benefits.

Bariatric surgery is a weight loss procedure in which the accumulated fat in the body gradually reduces over a period of 4 to 6 months after the surgery. The surgery provides many health benefits, including treatment or management of morbid obesity and related medical conditions.

Q. Who is a bariatric surgeon?

A Bariatric Surgeon is a specialist who performs operation on morbidly obese people to help them lose excess weight. Credentials of a bariatric surgeon in India include:

  • MBBS degree
  • Postgraduate degree (MS) in general surgery
  • Fellowship/Training in bariatric and laparoscopic procedures
  • Considerable experience of performing various types of weight loss surgeries

Q. What are the long term results of bariatric surgery?

Studies conducted at various bariatric surgical centers reports that bariatric surgery show long term results with excess weight loss of 50-70%, depending on the type of surgery. Most individuals suffering from morbid obesity can maintain more than 50 % of the excess weight loss as per 3-5 year follow-up data.

Q. When can I resume work after the surgery?

This depends on the type of job you do. With an office/desk job, you can start after 3 days of the surgery. But if your work involves lifting heavy weights, you will need more time, possibly a week, before resuming work. Recovery is different in different individuals and the doctor will advise a suitable time frame to resume activities as per the person’s recovery progress.

Q. What is a Minimal access Surgery?

Minimal access surgery or minimally invasive surgery is an advanced surgical technique that can be used for various types of operations. It is also known as ‘Keyhole Surgery’ or Laparoscopic Surgery. In this, the surgeon inserts a thin telescope called a laparoscope through small incisions. The laparoscope is attached to a small video camera that projects the view of the patient’s internal organs to a high resolution monitor during the operation. The surgery is performed using special surgical instruments that are inserted through one or more small (3-5mm) incisions. The incisions are closed with sutures or surgical glue after the surgery. This technique offers many advantages including, reduces postoperative pain and discomfort, less chances of complications such as infection, shorter hospital stay, faster recovery and less scarring of tissue.

Vanshika Rawat

Written By Vanshika Rawat

Vanshika Rawat is an experienced content developer. She is very knowledgeable in the field of science and healthcare and has worked under brilliant scientists during her higher education. Vanshika obtained her degrees in Masters in Science and Bachelors in Science (Microbiology with Hons.) from renowned institutions - Panjab University and University of Delhi.