Until recently, bariatric surgery -- also known as weight-loss surgery -- has been an option only for the severely obese, especially those who also have obesity-related conditions such as type 2 diabetes or sleep apnea (both of which increase the risk for heart disease complications). But now that has changed.
One of the most common bariatric surgeries is adjustable gastric banding, which places a modifiable band around the stomach to curb food intake. In January 2011, the U.S. Food and Drug Administration (FDA) approved gastric banding for those who are less than severely obese.
How gastric banding works. During gastric banding, an adjustable silicon band is placed around the top part of your stomach. It forms a thumb-sized pouch that can hold only a small amount of food.
"The band's purpose is to prevent overeating," says Michael Schweitzer, M.D., a surgeon at the Johns Hopkins Center for Bariatric Surgery at Johns Hopkins Bayview Medical Center.
How? The band is adjusted at a doctor's office to control the rate at which food passes from the pouch to the lower part of the stomach. Slowing the passage of food to the lower part of the stomach makes you feel fuller longer, so you consume fewer calories.
Gastric banding is attractive for many reasons. It's a minimally invasive outpatient procedure -- the surgery itself takes less than an hour. It is also more easily reversed than other bariatric surgeries and has low complication rates.
For example, another common bariatric surgery, gastric bypass, requires that part of your stomach be stapled shut and the digestive tract rerouted. It also includes a two-day hospital stay.
Cons and caveats of gastric banding. There are good reasons not to rush into gastric banding, including:
Recovery from gastric banding includes a month-long diet of pureed foods and about six trips to the doctor's office for band adjustments in the first year.
After gastric banding you must also permanently go on a strict low-fat diet to achieve and maintain a normal weight. Eating too much or too fast can cause you to regurgitate swallowed food from the upper pouch after meals.
Finally, if you're a candidate for gastric banding surgery, you'll have to prove that you are ready for both the procedure and challenging lifestyle changes. You must undergo psychological counseling and show that you have tried diet and exercise for at least six months.