“Gastric Balloon or Gastric Bypass? Two Patients Share Their Weight Loss Journey with Different Methods”

2023-05-22 14:36:44

Gastric balloon or gastric bypass? Two patients report how they lost weight using different methods.

22.05.2023 | 05:26 min

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Change diet, reduce calories and move a lot: These are the basic building blocks for shedding excess pounds. But many severely overweight people are unable to lose weight permanently in this way. You can find help in obesity centers. There they will determine which treatment is best for you.

A variant: reduce the size of the stomach with a balloon

An important starting point in the therapy of obesity is the reduction of the stomach. You don’t always need a scalpel for this. There is a balloon made of soft silicone that can be inserted into the stomach with an endoscope using a mirror. This balloon is then filled with saline.

The stomach is filled to a large extent and the patients are hardly hungry. The feeling of fullness is then the most important effect and side effect at the same time. Nausea, abdominal cramps or heartburn can occur, especially in the beginning.

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Up to 20 percent weight loss with gastric balloon

The balloon must be removed after a year at the latest – again via a reflection. Otherwise there is a risk that the soft silicone skin will become porous and tear due to constant contact with the strong acid in the stomach.

The gastric balloon is suitable for people with moderate obesity (BMI up to around 40). In the case of extreme obesity, it can be used to prepare for a later surgical stomach reduction. In these cases, surgery is technically less difficult and risky if weight reduction with the balloon has been performed beforehand. The method can achieve weight loss of up to 20 percent.

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Second variant: Operations to reduce the size of the stomach

There are several ways to surgically shrink the stomach. An important point is not only to reduce the absorption capacity of the stomach, but also to switch off hormones from the gastrointestinal tract that regulate appetite and metabolism.

The two most important procedures with the best evidence from studies are the construction of a gastric sleeve and gastric bypass (Roux-en-Y gastric bypass). Both operations are minimally invasive, i.e. they are performed using small incisions and a laparoscopy.

First, the surgeons cut a small pocket out of the stomach, which is then used for food intake, and sew up the rest. Then they divide the small intestine into two sections. They connect the lower part with the formed stomach pocket. This diversion (bypass) allows food to reach the lower small intestine much faster and absorbs far fewer nutrients and calories. The upper part of the small intestine, which receives important digestive secretions from the gallbladder and pancreas, reconnects to the lower part of the small intestine about a meter below. Thus, these secretions can further contribute to digestion.

With the gastric sleeve, the largest part of the stomach is removed, in which the production of hunger hormones also takes place. This gives the stomach a tubular appearance. After that, the feeling of hunger decreases permanently, and due to the smaller stomach, the patients are full much faster than before.

Reflux and heartburn as risks after surgery

Both surgical procedures have the general risks of every operation (e.g. wound healing disorders, post-bleeding, infection). After a gastric sleeve, around 20 to 30 percent of patients experience a backflow of gastric acid into the esophagus (reflux) due to the changed anatomy, which can lead to heartburn. A gastric bypass can also lead to what is known as early or late dumping syndrome.

At the early dumping syndrome, which is observed more frequently after eating foods with a lot of sugar, a large amount of undigested food quickly reaches the small intestine. To dilute them, the body pours water out of the vessels. In doing so, however, it withdraws it from the circulation, which causes the blood pressure to drop. Symptoms may include drowsiness, sweating, or nausea.

That’s rarer late dumping syndrome after eating a lot of carbohydrates. Due to the lack of pre-digestion, these cause the release of a lot of insulin in the small intestine. This can cause hypoglycaemia with dizziness, sweating and a feeling of weakness.

Selection of the procedure depends on individual factors

The surgical procedure is selected individually and depends on criteria such as BMI, gender, age, concomitant diseases and, last but not least, the patient’s wishes. The results are about the same for both methods. You can expect a weight reduction of 60 to 70 percent.

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After surgery: Vitamin intake and dietary changes necessary

After obesity surgery, also known as bariatric surgery, patients have to take nutritional supplements, especially vitamins, on a permanent basis. Which these are in detail is determined by the treating obesity specialist. In addition, it is essential for lasting success to change your diet and lifestyle.

“After obesity surgery you have to take vitamins for life,” explains Sylvia Weiner from the obesity center at Sana Klinikum Offenbach.

There are now special multivitamin preparations for this because you have to take in a lot of additional vitamins. Calcium is always added, and usually vitamin D as well.

dr Sylvia Weiner, obesity center Sana Klinikum Offenbach

From a BMI over 40 or over 35 with obesity-related comorbidities, there is an indication for bariatric surgery. The Costs can be covered by health insurance companies upon request. This only applies to the gastric balloon if it is used in preparation for a later operation. Anyone who decides to use it as the sole procedure must bear the costs of around 3,000 to 4,000 euros themselves.

Risks of gastric surgery abroad

There are a number of companies on the Internet that offer the balloon and the various operations quickly – and cheaply, especially abroad. Sylvia Weiner takes a critical view of this.

I’m a bit worried that a lot of people just want to go abroad quickly to quickly become beautiful.

Sylvia Weiner, obesity center Sana Klinikum Offenbach

According to Weiner, obesity not only requires a high level of expertise from the attending physicians, but also lengthy pre- and post-treatment.

Around half (53.5 percent) of the German population is overweight: 46.6 percent of women and 60.5 percent of men. Almost 20 percent of both sexes are obese, i.e. obese.

The classification of the weight classes is usually based on the Body Mass Iindex, short BMI. It is calculated from the weight in kilograms divided by the height in meters squared (kg/m2). overweight starts from one BMI out of 25, obesity (Obesity) starts at one BMI out of 30.

Severe obesity harbors the risk of serious secondary diseases such as diabetes, high blood pressure, cardiac insufficiency or dyslipidemia. Obesity is recognized as a chronic disease in its own right.