Weight loss surgery

For many people losing weight is a long-term struggle.  Diets and exercise can be helpful but often fails to help achieve and maintain long lasting weight loss.  If this is true for you, surgery may have an important role in your weight loss journey.  Although surgery may seem like a dramatic step the health benefits can be lifechanging!

If you are considering weight loss surgery it is important to know what you are signing up for.  Weight loss surgery is lifechanging and involves making healthy lifestyle choices.  As part of the process you will see our weight loss dietitian and psychologist, who will help you identify what changes you need to make to optimise your weight loss goals.  This is an important part of moving towards an operation as if you allow both our dietician and psychologist to help you, your weight loss will be greater and more sustained.  Depending on your individual circumstances and your initial assessments, it may be valuable to continue to see them longer term as they can provide helpful guidance for you.  After your operation your weight will be monitored to ensure you continue to lose weight and then maintain your weight loss.

There are now four good operations for weight loss which can be performed.  All of them provide excellent weight loss outcomes but as they all differ slightly it is important to consider which of them is best for you.  If you are having trouble deciding which operation you would like, Dr Hamer is happy to discuss which will suit you best during your initial consultation.

Sleeve gastrectomy is the most commonly performed weight loss operation in Australia and will generally be the first choice for most patients.  Sleeve gastrectomy is performed using laparoscopy (key hole surgery), requires a general anaesthetic and a one to two night stay in hospital.  During the operation Dr Hamer will remove the 'greater curve' of your stomach, a process which turns your stomach shape from a larger kidney bean shape to a narrow tube.  Making your stomach into a tube limits the amount of food you can eat in one sitting, as well as speeding up the time food stays in your stomach.  Sleeve gastrectomy has excellent weight loss outcomes.  It has the added advantage that if you decide later that it is the wrong operation for you it can be easily changed to one of the bypass operations.

Gastric bypass is the most established weight loss operation world wide, with the best track record.  It helps you lose weight in two ways.  Firstly, a small pouch is made at the top part of your stomach to limit the amount of food you can eat.  Secondly your small bowel is joined to this pouch in a 'y' shape meaning that food bypasses the rest of your stomach and the first section of your small bowel.  This means that food spends less time in contact with your bowel and the digestive juices from your pancreas and liver making it harder for your body to absorb calories.  Gastric bypass is performed using key hole surgery, usually requires a 2 night stay in hospital and is an excellent alternative to sleeve gastrectomy.

Single anastomosis gastric bypass is the newest of the four good weight loss operations.  It combines the advantages of both sleeve gastrectomy and roux-en-y gastric bypass by fashioning the stomach into a tube similar to a sleeve gastrectomy, and then joining the small bowel onto this tube.  It is a simpler operation than roux-en-y gastric bypass with only one join (anastomosis) between stomach and bowel being required instead of the two joins that need to be made with the traditional bypass.  Results with single anastomosis bypass are excellent, but as it is a much newer procedure than sleeve or roux-en-y bypass, we cannot be quite so confident about its long term outcomes as with the other operations.  It involves a 1-2 night stay in hospital.

Laparoscopic adjustable banding has been one of the main weight loss operations performed in Australia over the last 10-20 years.  It is safe and has produced good results in a lot of people but has been replaced gradually by the other operations as they produce better weight loss over a longer period, and are less likely to require revisional operations.

Metabolic surgery is another name for weight loss surgery.  The operations are the same as weight loss surgery, but some people prefer the name 'metabolic surgery' as it emphasises the health benefits of sleeve gastrectomy or bypass rather than just the weight loss you will achieve.  This may be important for you particularly if you have diabetes, obstructive sleep apnoea, high blood pressure or high cholesterol.  For example, some people with type II diabetes who have metabolic surgery find that they can come off their medications, incredibly this often occurs within a few days of their operation before they have even begun to lose weight!

Weight loss surgery is assoicated with many health benefits.  In general most people will feel an increase in the energy levels and feel much better and healthier overall.  It increases life-expectancy and decreases the chance of developing many medical problems.  

Specific medical conditions such as diabetes, obstructive sleep apnoea (feeling tired in the mornings even after a full nights sleep), high blood pressure, high cholesterol, aches and pains in joints particularly knees and hips, polycytic ovary disease and fatty liver disease, all have been shown to improve after weight loss surgery.  If you have specific questions about whether or not weight loss surgery will help you with any of these please ask your GP or Dr Hamer.

Long term: For the first year after your surgery you will lose significant amounts of weight.  After this your weight will plateau, and no matter which operation you have had, some people find their weight starts to slowly drift back up again.  Although this can be disconcerting, it is at this stage that it is most important to put into practice and reconcentrate on the lessons you have learnt from your dietician and psychologist.  As you have had a weight loss operation your weight will be much easier to control than it was before, and if you maintain a healthy lifestyle you can keep your weight off long term.  

Exercise: Exercise, as you probably know from experience, is not the quick fix solution to weight loss that a lot of people think it is.  However, it does still have a very important role.  After your operation you will find it a lot easier to exercise than you have before.  Regular exercise, although it doesn't work well for losing weight is an excellent way to keep weight off.  We recommend trying different types of exercise to find something that you enjoy.  If you find something you enjoy doing you are much more likely to be able to do it regularly for the rest of your life.  Try lots of different things!  Whatever exercise you do, it needs to be done at least 3 times a week and it needs to be vigerous enough to raise a sweat.