Gastric surgery for weight loss is a growing field, with modern surgical techniques presenting a realistic alternative for obese patients. Research shows that gastric surgery can help patients lose approximately 50% of their excess body weight, compared to 5% to 10% using traditional weight-loss diet and exercise programmes. Another major benefit of gastric surgery is that it is associated with longer periods of sustained weight loss than other methods. Specifically, research findings show that 60% of surgery patients continued to maintain the 50% level of weight loss over 5 to10 years.

In addition to weight loss, gastric surgery can improve several co-morbid conditions such as glucose intolerance, diabetes mellitus, sleep apnoea, obesity-associated hypoventilation, hypertension and serum lipid abnormalities. There is also some evidence of improved heart function with decreased ventricular wall thickness and decreased chamber size. Gastric surgery patients report improvements in mobility and stamina as well as mood, self-esteem, interpersonal effectiveness and quality of life.

Potential candidates for weight loss surgery must have made multiple attempts, in good faith, to achieve weight loss by dietary or pharmacological means. Although it is difficult for morbidly obese patients to lose significant amounts of weight by non-surgical means, candidates for surgery must be given the opportunity to try weight loss by conservative means before considering gastric surgery.

Who is eligible for gastric surgery?

The following conditions are applicable to patients who are to undergo gastric surgery:

• Repeated failed attempts at behavioural and medical therapy.
• A body mass index (BMI) score of 40 or higher, or 35 and higher if serious co-morbid conditions are present.
• Patients must be between 16 and 65 years of age.
• Patients must be capable of understanding the procedure and its implications.
• A commitment to prolonged lifestyle change.
• A commitment to long-term follow-ups.

The risks of gastric surgery

• Anastomosis leaks – vitamin and mineral deficiency
• Wound infection – dumping syndrome 
• Stomal stenosis – nausea
• Incisional hernia – vomiting

Information about gastric surgery

• The surgery takes between one and two hours.
• Patients are admitted on the morning of the surgery.
• There is no routine admission to the intensive care unit.
• Patients are usually discharged from the hospital on the third or fourth day after surgery.
• Recuperation time averages between four and six months. 
• Patients are required to follow a special post-operative diet and will require lifelong follow ups and vitamin replacement.
• Weight loss from the surgical intervention generally ranges between 40% and 70% of excess body weight over the course of 12 to 18 months, depending on the weight before surgery.