Weight Loss Surgery: A Life-Saving Solution

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Weight Loss Surgery: A Life-Saving Solution

Center for Metabolic and Weight Loss Surgery at Columbia University Medical Center

Marc Bessler, MD
Director, Center for Metabolic and Weight Loss Surgery
Columbia University Medical Center
In Affiliation with NewYork-Presbyterian Hospital
Phone: 212.305.4000

The reasons why people become extremely overweight are not well understood, but there are most likely many factors involved, including low metabolism due to low energy expenditure and excessive calorie intake, as well as genetic, psychological, environmental, social and cultural influences. One thing is certain, however: people who are severely overweight are at increased risk for health problems that can be life-threatening.

About Weight Loss Surgery

Surgery has become an acceptable method of treatment because it appears to be the only option that can provide long-term maintained weight loss in the majority of patients with clinically severe obesity. Today, there are several surgical procedures used for achieving weight loss. The most common are gastric bypass and adjustable gastric banding.

Gastric Bypass

The surgeon divides the top of the stomach to create a small pouch, and attaches the pouch to the small intestine, bypassing the majority of the stomach and a short segment of the intestine. The procedure achieves weight loss by decreasing the amount of food that can be eaten at any one time and by causing the release of hormones that produce a sense of satiety or lack of hunger. Appropriate candidates for this surgery are those who are 80 pounds or more overweight. Almost everone can have a laparoscopic version of the procedure performed through 5-6 small incisions.

Gastric Banding

Laparoscopically placed around the upper part of the stomach, the saline-filled gastric band is removable and adjustable, and does not permanently alter the anatomy. The band divides the stomach into a smaller pouch above the band and a larger pouch below. The band is connected by a tube to a reservoir placed beneath the skin during surgery so that the surgeon or nurse practitioner can later inject saline to adjust it. The procedure limits the amount of solid food that a patient can eat at any one time.

Importance of a Comprehensive Approach to Weight Loss

Because of the multi-faceted nature of obesity, there is no single quick fix for the problem. Nor is there a single way to achieve permanent weight loss for every individual. If you or someone you know is considering weight loss surgery, our team recommends choosing a program that takes a comprehensive approach, including modifications of diet and exercise habits, as well as psychological support. The ideal weight loss program should have on-staff dietitians and psychologists as well as surgical and nursing clinicians. It should offer patients pre-operative evaluation and education, as well as extensive follow-up and support after surgery to help patients settle into new routines and habits.

Quality of Life Interventions from the Columbia University Department of Surgery