Obesity: Surgery...

Increasingly, surgery is being used to combat obesity.

The most common weight loss surgery in Europe and Australia is the adjustable gastric band where a silicone ring is placed around the top of the stomach to help restrict the amount of food eaten in a sitting. This surgery has been FDA approved in the United States since 2001 but has been being used in other parts of the world since the early 1990s. It is considered the safest and least invasive of the available weight loss surgeries such as Roux-en-Y gastric bypass surgery (RNY), biliopancreatic diversion, and stomach stapling (also known as "vertical banded gastroplasty", VBG).

Unlike those more invasive techniques the band surgery does not cut into or reroute any of the digestive tract and is completely reversible. Removing the implant returns the stomach to its pre-surgical norm. All of these surgeries can be done laparoscopically. The more invasive of the surgeries usually bypass or remove some portion of the patient's intestines which causes malabsorption and dumping.

All of these surgeries come with risk to the patient.

For instance a recent study by the U.S. Department of Health and Human Service showed a 40% complication rate within 180 days of bariatric surgery.  Moreover these surgeries do not guarantee either successful weight loss or reduced morbidity and mortality. Patients are also required to make lifelong changes to their diet if they are to keep the lost weight off in the long term. Therefore, as with any major surgery, patients need to carefully evalute the long term ramifications of their choice.