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Which bariatric operation is best for you?

Bariatric Surgery - DoctorWeight.com – 2008

Unfortunately the answer to this question is not easy, being determined not only by medical reasons. Very often financial and social variables must be taken into account; most bariatric operations are quite expensive as the price of surgery reflects the cost of expensive disposable surgical instruments or implanted devices. Leaving such other factors momentarily aside, you should first determine your BMI (Body Mass Index).

If your BMI is below 35, it is too early to consider any bariatric surgery. Try to lose weight by conservative treatment (diet, physical activity, behavior therapy). If previous attempts have failed, you can try a balloon installation (not strictly a form of surgery; for details see here).

If your BMI is 35-40 and you have such problems with your health as varicose veins, II-type diabetes, arterial hypertension, and joint or back problems, then you can think about surgical treatment. We now believe that the best option in such a case is gastric banding.

If your BMI is 40-60, then both types of operation (gastric banding and gastric bypass) are feasible. Surgeons able to perform both kinds of procedures never force a preference on these patients, but merely provide them with the facts to make an informed choice. Some patients choose a gastric bypass from aversion to having a foreign body implanted in their organism.

Others favor gastric banding as being less risky. Still others do not wish to come to the clinic for adjustments of the band (5 times during the first year), and so choose gastric bypass or ASG. If the weight of a patient exceeds 180 kg, and he/she has a very high surgical and anesthesia risk, we believe that most rational approach would be a gastric banding as a very fast operation (30-40 minutes) of low risk which nevertheless gives very good results in these super-obese patients.

Even major long-term weight loss does not ensue, this procedure can later be easily converted into a gastric bypass. In this case the latter would be performed under more favorable conditions, since primary weight loss of at least 50 kilograms is achieved.

Of course, all this is a generalization. In reality many additional circumstances must be considered, such as the food preferences of a patient, his/her general health, level of discipline, and the possibility of coming to a clinic for adjustments.

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