People who carry several extra pounds of body weight are well aware of the impact weight has on every aspect of their lives.
Hard on the body, excess weight shortens lifespans and fosters a host of chronic conditions. Day to day, it disrupts everything from breathing to mental and emotional states to sexual performance. It affects every step someone takes, the ease of getting dressed in the morning, and their comfort level in a car or on a plane.
For many, obesity’s not just a lifestyle issue; it’s a metabolic disorder — a constant, genetic hunger urge. Dieting and calorie restriction are ten times harder for these patients than for the average person. Their struggle can lead to despair or depression, especially if the pounds continue to multiply.
And although many American adults face this struggle, it’s often a taboo topic, considered rude or unkind to discuss.
So, patients struggling to shed pounds often turn to surgical treatment, asking, “What is the safest form of weight loss surgery?” Until recently, surgeries were considered the “quick, easy fix.” But they’re neither quick nor easy, and they’re not always safe.
Surgical Options for Weight Loss
Gastric Bypass
Most people are familiar with Roux-en-Y gastric bypass (RYGB), a common type of bariatric surgery. The first time I observed a Roux-en-Y surgery, I was struck by its complexity. It involves complete rearrangement of the digestive tract — the stomach, intestines, and colon — to encourage malabsorption.
In other words, this intricate procedure reduces food intake by limiting gastric volume, diverting digestive liquids, and shortening a portion of the bowel.
And it can have significant lifelong consequences for patients. Since they can no longer absorb certain vitamins through the stomach, they may need to receive certain vitamins differently. They may also experience dumping syndrome — the too-quick movement of sugary foods from stomach to bowel.
Gastric Sleeve
Gastric sleeve surgery is a less drastic, but nevertheless serious, procedure. The surgeon uses staples to reduce a patient’s stomach to half its original size, so the patient feels fuller faster. The procedure helps regulate hormones, and because the intestines and colon remain in their normal functioning state, nutrient absorption isn’t as affected as it is by gastric bypass.
However, gastric sleeve surgery has long-term complications and consequences for the patient, including the fact that the small stomach sleeve the patient receives may re-stretch and enlarge over time.
Gastric Balloon
As demand grew for effective procedures that wouldn’t involve cutting into patients, the gastric balloon was introduced. A bariatric surgeon inserts a saline-filled silicone balloon into a patient’s stomach.
The inflated balloon stays in place for six months, playing the same role as the gastric sleeve — it limits space within the stomach, so patients feel full longer. The Orbera balloon, currently the most highly recommended, has the most research to back its effectiveness.
Each of these procedures is effective in its own way. However, any time a patient receives anesthesia, an incision, or a foreign object within the body, there’s both short- and long-term risk of infection, bleeding, clotting, heart attack, or other cardiac strain. Plus, surgery-induced malabsorption can cause vitamin deficiency or pernicious anemia, and reduced stomach size can make food race through the digestive system too quickly.
Yet these long-term complications are typical side effects of a successful weight loss surgery or procedure!
A Change in Lifestyle
As a relatively lower risk alternative to surgery, the new generation of GLP-1 agonist medications — Ozempic, Mounjaro, and Zepbound — represent excellent options for losing excess weight
Of course, these unprecedentedly effective drugs still call for a patient to inject a substance into their body. And they’re so new that long-term effects are unknown. But GLP-1s are the most encouraging development we’ve seen on the weight-loss landscape in decades.
Whether choosing a promising medication or a long-established surgical procedure, the initial step may feel like hitting the “easy button,” since weight loss will come quickly. But keeping weight off always requires work.
The most effective change any weight-loss patient makes must happen within their own personal lifestyle.
For instance, gastric and bariatric surgeons traditionally require patients to modify their eating and fitness behaviors before surgery. In this way, the patient comprehends that lifestyle modifications are the true foundation of weight loss.
A patient with a gastric bypass may lose 100 pounds, but if they fail to make lifestyle changes, they could gain it all back two years later. Likewise, a patient who receives a gastric sleeve procedure but continues to eat heavily will eventually re-stretch their stomach.
You must be open to permanently changing your mindset, diet, and activity level. If you don’t, the weight will return.
Keeping Weight Loss Safe and Effective
So, let’s tie off that question: “What’s the safest form of weight loss surgery?”
In my professional opinion, the safest form of weight loss surgery — or weight loss, period — is no surgery at all. The best approach is to change your lifestyle, try to lose weight naturally. If that doesn’t work, then consider options like surgery or medications to augment your weight loss attempts.
Your Priority Physicians can advise you on some of today’s newer, better options for successful weight loss and help you with lifestyle changes and informed strategies tailored to your needs. Take the first step — reach out to discuss.
