The number of Australian’s undergoing weight loss (bariatric) surgery is increasing each year. The number of surgeries performed more than doubled from 2005-06 to 2014-15. And according to the Monash University Bariatric Surgery Registry there were around 28000 hospital admissions for weight loss surgery in Australia in 2018-19. The majority (70-80%) were for an initial procedure while the remainder were adjustments, revisions or removals. Women are more likely to undergo weight loss surgery, making up almost 80% of surgeries. And the majority are done in private hospitals as there is limited access to weight loss surgery in the public system.
There are three main types of weight loss surgery performed in Australia – gastric banding, gastric sleeve and gastric bypass surgery. Gastric sleeve surgery is currently the most common, making up around 70% of total surgeries.
Gastric banding involves placing an adjustable silicon band around the top of the stomach by keyhole surgery. The band is filled with saline to cause it to tighten which reduces the amount of food you need to feel full and prevents you from overeating. It requires major changes to your eating – you will need to eat much smaller amounts, eat slowly, chew food well and some foods may not be tolerated.
Gastric sleeve surgery, also called sleeve gastrectomy, involves permanent removal of a portion of stomach. This reduces the capacity of your stomach by about 80% and also reduces levels of appetite hormones, which helps to reduce hunger. Following this surgery, you need to change your eating habits to include small frequent meals across the day and be careful to stop eating as soon as you feel full.
Gastric bypass surgery also known as Roux-en-Y, involves creating a small stomach pouch (to reduce the volume of the stomach) which is then joined to part of the small intestine (called the jejunum). The food you eat then bypasses most of your stomach and the first section of your small intestine that normally absorb food. Gastric bypass surgery usually leads to more weight loss than other types of surgery. However, there is a high risk of developing nutritional deficiencies due to malabsorption and you need to take nutritional supplements for the rest of your life.
Weight loss surgery is generally only recommended in those who are carrying significant amounts of excess weight and who have been unable to lose weight despite lifestyle changes. It carries several risks including the risk of infection, slippage and erosion of the band (with gastric banding), nutritional deficiencies, worsening of reflux (with gastric sleeve surgery) and the possibility of developing a condition called ‘dumping syndrome’ (with gastric bypass) where undigested food moves too rapidly into the small intestine and causes symptoms such as abdominal pain, diarrhoea, nausea, flushing, palpitations, sweating and feeling faint after meals. You will also need to make permanent changes to the way you eat, including the quantity, frequency and types of foods you eat.
If you are considering weight loss surgery, speak with your GP, who can help you to determine whether this is the right option for you, and refer you to a specialist bariatric surgeon for more information. You can also find our more by visiting https://www.healthdirect.gov.au/guide-to-bariatric-surgery
References:
AIHW. Weight loss surgery in Australia 2014–15: Australian hospital statistics. https://www.aihw.gov.au/reports/overweight-obesity/ahs-2014-15-weight-loss-surgery/contents/table-of-contents
Monash University. Bariatric Surgery Registry 2018-2019 Report. https://www.monash.edu/medicine/sphpm/registries/bariatric
Lee et al. RACCGP – Bariatric–Metabolic Surgery: A Guide for the Primary Care Physician. Australian Family Physician 2017; 46 (7): 465–71.
