Stomach Folding vs. Gastric Bypass
Stomach folding, also known as gastric plication, is a relatively new procedure that is considered experimental and is performed laparoscopically. It is a minimally invasive surgery, and it usually takes just about an hour to complete. During the procedure, the surgeon makes five small incisions in the abdomen in order to reach the stomach. The surgeon then folds the stomach into a smaller, more compact size, typically reducing its volume by about 70 percent. Depending on the size of the stomach of the patient, the surgeon will do one or two folds, and the folds will be held with non-absorbable sutures. This surgery is potentially reversible, so if the stomach needs to be returned to its original size for any reason, that will most likely be possible. With a smaller stomach, patients typically feel fuller faster, and they often have a decrease in appetite as well. This surgery does not usually result in any severe food restrictions. With surgery and lifestyle changes, many patients are able to reduce or eliminate their need for blood pressure, diabetes, and depression medications.
In order to be eligible for this surgery, individuals must have a BMI of at least 27. The ideal candidate will have a BMI of 40 or more, or they will have a BMI over 35 with at least one weight-related health problem.
Average Weight Loss Results
Patients can typically lose 2 pounds per week after the completion of this procedure. In total, most patients lose between 40 and 60 percent of their excess body weight within a year.
Patients often must stay in the hospital for a day or two after the surgery, but within a week, they can usually return to work. Full recovery takes about 4 weeks. The first 2 weeks after surgery, the patient is required to consume an all liquid diet. The patient will then be able to add in thicker liquids, yogurt, and fruit. Eventually, regular foods can be consumed, but most people are only able to eat up to four spoonfuls of food per meal.
Common Side Effects
The most common side effects are nausea and vomiting, but oral medication can be given to minimize these effects. Even without medication, these side effects typically disappear within a week.
The average cost of stomach folding is approximately $10,000 to $15,000. Insurance does not typically cover this procedure.
Gastric Bypass (Roux-En-Y)
Gastric bypass surgery is sometimes completed laparoscopically. It typically takes several hours. During the procedure, the surgeon will staple off the upper section of the stomach so it is just a small pouch, about the size of an egg. This pouch is then attached to a part of the small intestine called the Roux limb. This forms a “Y” shape, which is why this procedure is often referred to as Roux-en-Y. This not only reduces the amount of food the patient can consume, it also forces the food to bypass the rest of the stomach and the upper part of the small intestine. After the procedure, the amount of fat and calories that is absorbed from food is reduced and so is the amount of vitamins and minerals. Dramatic weight loss is common after this procedure, and it can also help to reduce or eliminate other health-related problems, such as heartburn, reflux, and other conditions that are common in overweight individuals.
The ideal candidate will have a BMI over 40 or a BMI between 35 and 40 and a weight-related health condition, such as sleep apnea, high blood pressure, heart disease, or type 2 diabetes.
Average Weight Loss Results
The amount of weight loss depends upon the patient’s adherence to diet and lifestyle changes, but on average, people will lose about 100 pounds after gastric bypass surgery. Weight loss typically happens fairly quickly. One year after the surgery, weight loss stops and a patient’s weight stabilizes. At this time, it is very important to maintain healthy eating and exercise habits in order to not regain the weight that was lost.
Patients are often required to stay in the hospital for a day or two after surgery. An all-liquid diet is required during the first week or two; soft foods are then slowly added into the patient’s diet, and within a month of surgery, regular food can be consumed. Normal activities can also typically be resumed at this time.
Common Side Effects
Patients may experience body aches, dry skin, mood changes, temporary hair thinning, tiredness, and feeling cold during the first year following surgery. This is due to the rapid weight loss. Once the weight loss stops, these symptoms usually go away.
Some insurances will cover part of the cost of gastric bypass surgery. In the US costs range anywhere between $8,000 and $27,000 without insurance.