Just like we do, many teens wish they could change something about themselves. In some cases — take hair, for example — that's pretty easy to do. Kids can grow it long, cut it short, and if they don't like it, a new look is just a quick snip or a few skipped haircuts away.
But certain things are not easy to change. For the 4%-6% of U.S. teens who are severely obese, losing those extra pounds can be one of them. For some, sticking to a doctor-approved diet and exercise plan will help them lose enough weight to improve related health problems, such as diabetes, heart disease, or sleep apnea.
But for others, even major lifestyle changes don't work. When regular weight loss attempts fail and medical problems persist, weight loss surgery (or bariatric) surgery might be an option.
Bariatric surgery had its start in the 1960s, when doctors first noticed that people who had portions of their stomach or intestines removed due to ulcers or cancer tended to lose a lot of weight after surgery, regardless of what they ate.
Doctors soon realized why: Not only could a smaller stomach hold less food, but a shorter intestine couldn't absorb as many calories and nutrients for the body to use.
The field of weight loss surgery has come a long way since then, but is still based on those same two principles:
Today, there are three main surgical techniques for weight loss: gastric bypass, gastric sleeve, and gastric banding.
Gastric bypass (also called "Roux-en-Y" gastric bypass) is the most commonly performed weight loss surgery. It involves creating a small pouch, about the size of an egg, at the top of the stomach using surgical staples or a plastic band. This pouch, which will serve as the "new" stomach, is then connected directly to the middle part of the small intestine (the jejunum).
So not only will the pouch hold a lot less food — just 1 cup as opposed to the 4 cups or more that a normal-sized stomach can hold — but the food will also bypass the larger part of the stomach and the upper part of the small intestine (the duodenum).
The pros of gastric bypass are that it has a high rate of success and a longer track record compared with the other options of gastric sleeve or gastric banding.
The cons are that even though it can often be done laparoscopically (using a few small incisions and a camera to guide the doctor's movements instead of opening up the abdomen), it still involves cutting the intestine — which makes it a more complex procedure than banding, and therefore has more potential for complications and a longer recovery time. The lack of intestinal absorption also tends to cause vitamin deficiencies and, unlike gastric banding, the procedure is not reversible.
Gastric sleeve (also called sleeve gastrectomy) is the second-most common weight loss procedure. With this operation, the surgeon removes part of the stomach and creates a tube or "sleeve" from the remaining portion. This new, banana-shaped stomach is much smaller than the original stomach.
After the operation, a person will eat less, feel full sooner, and be less hungry. Unlike gastric bypass, a gastric sleeve operation only changes the stomach. This kind of surgery doesn't divert food around part of the small intestine, so vitamin deficiencies are less likely.
Gastric sleeve surgery is less drastic and is easier to perform with fewer complications than gastric bypass. The gastric sleeve procedure is not reversible.
Gastric banding also works by decreasing the amount of food that can be comfortably eaten. An adjustable silicone ring is placed at the very top of the stomach to create a small pouch. Like gastric bypass and gastric sleeve, this band reduces the size of the stomach and makes people feel fuller sooner. Unlike bypass, though, banding does not interfere with food absorption in the small intestine.
The pros of gastric banding, which is done laparoscopically, are that it has a lower complication rate than the more invasive gastric bypass and gastric sleeve procedures, and vitamin deficiencies are less common because the intestine is not affected.
The band can be