Two new options are available for patients looking to lose weight with the help of surgery.
Weight loss drugs have been occupying headlines for the past few years, and with good reason. They’re helping a lot of people lose weight and reduce their risks of chronic health problems. But weight loss surgery remains the most effective form of weight loss in the long-term for people living with obesity. And now, there are additional options in this field as well.
Since the first gastric bypass back in the 1960s, surgeons have been altering the procedure to be even more effective and produce fewer side effects. And now, two of those enhanced procedures are available at Vanderbilt Health.
Gastric bypass explained
Gastric bypass is a surgical weight loss procedure in which the stomach is significantly reduced in size, making patients feel satiated sooner and restricting the amount of food they can eat at any given time. During the procedure, the surgeon creates a small pouch at the top of the stomach and then connects the new pouch directly to the small intestine, bypassing a large portion of the stomach and the first part of the small intestine. The bypass action has the effect of reducing the amount of nutrients and calories that are absorbed into the body through the small intestine.
Patients can expect to lose, on average, 50% to 60% of their excess weight with gastric bypass. It also is effective at reversing such obesity-related conditions as type 2 diabetes, hypertension and sleep apnea.
New weight loss procedures
Vanderbilt Health’s weight loss program recently expanded its surgical weight loss offerings to include the single anastomosis duodenal ileostomy, often referred to as SADI, and the duodenal switch. But don’t mistake them for being experimental or even new.
“Both the SADI and the duodenal switch have been performed for about 10 years in good volumes in the United States,” said Dr. Joseph R. Broucek, a bariatric surgeon with Vanderbilt Surgical Weight Loss. “There’s good data from other bariatric programs for both procedures, but we wanted to spend a little more time evaluating the long-term outcomes of these procedures to make sure they’re safe and effective before bringing them to our patient population.”
The SADI procedure combines aspects of gastric bypass with the sleeve gastrectomy, which is another weight loss surgery that removes about 80% of the stomach, reshaping it into a banana-like organ (sleeve). During the SADI, the stomach is reshaped to create the sleeve and then part of the small intestine is bypassed, resulting in less absorption of calories.
The SADI procedure is particularly effective for patients with a body mass index over 50, or those with a BMI over 45 who have type 2 diabetes.
“SADI patients can expect to lose around 75% or more of their excess body weight in the long term, which is more than what is typically achieved with gastric bypass or sleeve gastrectomy alone,” Broucek said. “Additionally, the SADI procedure has shown very good glucose control, potentially even better than gastric bypass, making it an excellent option for diabetic patients.”
However, the SADI is not suitable for everyone. Patients with severe acid reflux are not good candidates for this procedure. It’s also important to monitor patients for potential vitamin deficiencies, though current data suggests that the risk of malabsorption is comparable to that of gastric bypass.
The duodenal switch is a more complex and aggressive weight loss surgery. Like the SADI, it starts with a sleeve gastrectomy. The duodenal switch then involves rerouting a significant portion of the small intestine to reduce the amount of time food and digestive juices mix, thereby limiting the absorption of calories and nutrients even further. This results in a higher potential for weight loss.
The duodental switch procedure is especially effective for patients with extremely high BMIs, often over 60, who need to lose a significant amount of weight. On average, patients lose 90% or more of their excess body weight. However, the procedure carries a higher risk of vitamin and nutrient deficiencies, requiring lifelong vitamin supplementation and regular medical follow-ups to ensure proper nutrition.
Advanced care for weight loss
The Vanderbilt Surgical Weight Loss program offers advanced care to help you lose weight and improve your overall health. If you’ve been unable to reach a healthy weight with nutritional and lifestyle improvements alone, surgery might be a better and safer option for achieving your weight loss goals. The team will work with you to develop a personalized care plan combining surgery, nutrition, exercise and psychological support.
