The main goals of weight-loss surgery are to: 

• Help the patient achieve a more normal weight
• Reduce comorbidities and improve overall health
• Extend life expectancy and quality of life
• Improve the patient’s self-image and psychological health
• Modify behavior

Once it is determined that you are a potential candidate for surgical weight loss, and the appropriate tests have been performed, you and your surgeon will discuss surgical options. Two types of weight-loss surgery are performed at Lahey Clinic—laparoscopic adjustable gastric band and Roux-en-Y gastric bypass.

Ninety-five percent of the weight-loss surgeries performed at Lahey Clinic are done laparoscopically. Laparoscopic surgery is performed through a small incision, as opposed to the large surgical opening used in traditional surgeries. Performing surgery this way cuts down on possible complications and speeds up the patient’s recovery time. For various reasons, some patients are not candidates for laparoscopic surgery. For these people, the procedure is done through a traditional open surgery.
 

Laparoscopic Adjustable Gastric Band

Laparoscopic adjustable gastric band surgery involves an adjustable band placed around the upper stomach. To the band is attached an access tube, which is laid across the abdominal wall under the skin. By inserting saline into this tube through a port—a process known as "filling"—the band can be tightened and loosened depending on your weight-loss progress.

This surgery is reversible and also safer and less invasive than the Roux-en-Y gastric bypass procedure, but is also slightly less effective for weight loss.

Laparoscopic adjustable gastric band surgery is often better for someone who is older or for whom surgery would be a greater risk. It is also well suited for someone who has comorbidities related to obesity but whose weight places him or her only just within the range of morbid obesity.

Over two years, the average laparoscopic adjustable gastric band surgery patient will lose about 55 percent of his or her excess weight. The weight loss is typically slower than that seen with other procedures—about a pound or two a week.

Roux-en-Y Gastric Bypass

The most common weight-loss surgery performed at Lahey Clinic is the Roux-en-Y gastric bypass procedure. It involves surgically separating the stomach so that a small pouch is created at the top. The small bowel is connected to this pouch, completely bypassing the larger, portioned-off section of the stomach and about 150 centimeters of the small intestine. The pouch can hold 30 cubic centimeters of volume, which is the equivalent of about one ounce of food or liquid, or a serving the size of a golf ball.

The Roux-en-Y surgery works in two ways: First, it creates a very small receptacle for food, preventing the patient from overeating. Second, it creates a small degree of malabsorption by reducing the intestinal area that absorbs nutrients and calories.

Weight loss is rapid following a Roux-en-Y procedure; the average person loses about two-thirds of excess body weight in the first six months. After that, weight loss slows down until, after about two years, the person ends up losing an average of 75 percent of excess body weight.