Weight loss surgery 101: Different types, side effects and alternatives

If you've struggled to lose weight or are navigating weight-related health issues, you might have started searching for ways to lose weight. Chances are that bariatric surgeries have probably come up in your Google searches as a straightforward way to treat weight gain.

And, it's understandable if you're deliberating on whether or not this may be the right step for you. When making this decision, it's important to know the ins and outs of bariatric procedures (including lap band surgery, sleeve gastrectomy and gastric bypass surgery) as well as the hefty list of associated risks and side effects.

If you're weighing up your options and thinking about whether bariatric surgery might be right for you, we want to help you make an informed decision and give you all the options.

We're diving deep into everything to do with bariatric surgery and the most common side effects and long-term risks associated with this type of weight loss surgery.

What is bariatric surgery?

Bariatric surgery (a.k.a weight loss surgery) refers to a range of medical procedures that change the way food is digested by your body [1]. In almost all cases, bariatric surgeries make the stomach smaller. The aim is to help you reduce your stomach size and your portion sizes as a way to support weight loss.

Bariatric procedures are typically used to treat obesity and diabetes, however, they can also be used for a range of other health problems such as high blood pressure, thyroid disease, sleep apnoea and high cholesterol.

Weight loss surgeries are typically performed laparoscopically, meaning they only require smaller cuts into the stomach area [2]. These incisions give surgeons the ability to insert small tools with a camera attached to perform the procedure.

However, depending on the procedure and other medical complexities, such as severe obesity, open surgery may be needed.

Different types of weight loss surgery

In the UK, there are 3 types of metabolic and bariatric surgery including sleeve gastrectomy (a.k.a gastric sleeve), gastric band surgical procedures and gastric bypass surgery [3]. Each surgery varies in its procedures, however, its main aim is to help people lose weight and in turn, improve their health.

Each surgery has different advantages and disadvantages. And, there are a range of factors that doctors use to assess one's eligibility for these surgeries, such as the body mass index (BMI) and whether they're navigating any other weight-related health conditions.

Let's run you through these three types of weight loss surgery as well as what you need to know about these options.

Sleeve gastrectomy

A sleeve gastrectomy uses a stapling device to create a 'sleeve' in your stomach and removes the rest of your stomach [4].

This shrinks the capacity of your stomach from 2.5L to 200ml. After a gastric sleeve, you'll feel fuller after eating reduced portion sizes, therefore making it easier to lose weight.

Gastric band surgery

Gastric band surgery divides the stomach into two sections; a smaller upper portion and a larger lower portion. Gastric band surgery is sometimes referred to as lap band surgery because an inflatable and adjustable band is placed around the stomach [3].

Gastric band surgery slows down the entry of food into the main portion of the stomach, which makes you feel full after a smaller food intake.

Gastric bypass surgery

Gastric bypass surgery is a major surgical procedure, reconstructing the digestive system by decreasing the size of the stomach [4]. This changes the way the small intestine absorbs food.

In this procedure, a surgeon staples the top part of the stomach which creates a small pouch and attaches it to the lower end of the small intestine. Essentially, gastric bypass surgery limits the amount of food you can consume because the food bypasses most of your stomach.

All in all, weight loss surgeries can be pretty invasive with some major risks associated because they are essentially altering your stomach and digestive system to help you lose weight.

Who is eligible for weight loss surgery?

Eligibility for weight loss surgery is measured by your BMI (which is a metric used to measure obesity). People who are categorised with a high BMI typically find losing weight difficult with diet and exercise alone, so weight loss surgeries are used to decrease the risks of other health concerns such as obesity and diabetes.

In the UK, the requirements for weight loss surgery to be available on the NHS are based on BMI and other health concerns associated with obesity and diabetes. Here are the cases in which you can be considered for weight loss surgery [3]:

• If you have a BMI of 40 or higher
• If you have a BMI between 35-40 plus one or more obesity-related health problems
• If you have tried all other weight loss methods without much success
• If you agree to long term follow-ups such as lifestyle changes post-surgery

What are the most common side effects of weight loss surgery?

All procedures come with their risks, which need to be properly considered before making a decision to undergo surgery. Weight loss surgery is no different and comes with a long list of side effects and risks.

There are some common side effects that can occur as a result of weight loss procedures including:

• Nausea and vomiting
• Diarrhoea
• Acid reflux
• Wound infection
• Associated risks of anesthesia
• Bleeding
• Leaking from the stomach and small intestine
• Blood clots

These short-term side effects can be quite serious and will factor into your decision regarding weight loss surgery.

What are the long-term weight loss surgery side effects and risks?

Long-term risks associated with bariatric surgery can be more serious as a result of significant weight loss and cause other health problems including:

• Dumping syndrome, which is caused by rapid gastric emptying. Symptoms include diarrhoea, nausea, light-headedness and tiredness after eating a meal [5]
• Consistent low blood sugar
• Malnutrition. Bariatric surgery can make it more difficult for your gut to absorb essential vitamins and minerals from food [6]
• Ulcers
• Hernias
• Bowel obstruction
• Gastric band slipping out of place, causing heartburn and vomiting [6]
• Excess skin

In some cases, weight gain after bariatric surgery can happen, too. While a weight loss procedure can stop your body from being able to consume high quantities of food, it doesn't get to the root cause of what has caused you to gain weight.

Plus, these weight loss treatments often aren't supported by diet, exercise and lifestyle changes, which is where weight regain can occur.

In fact, one study found that 50% of patients receiving gastric bypass surgery regained weight 24 months after surgery [7]. Additionally, for patients in the very obese group, weight regains and surgical failure was even higher.

Sometimes, further surgeries are required to make repairs, however, more than one bariatric procedure comes with even greater risks and potential health problems.

Non-surgical weight loss options

Although bariatric surgery may be an option for some people, it's certainly not the only option you can consider. There are plenty of non-surgical and less invasive weight loss pathways out there designed to assist you with weight loss.

Holistic weight loss programmes

Here at Juniper, we’ve made it our mission to change the way we treat weight management. A big part of that plan is our Weight Reset Programme which combines medication with health coaching and a supportive community.

You can kickstart your weight loss journey with Wegovy or Mounjaro, two groundbreaking weight loss medications that mimic the GLP-1 and GIP hormone respectively to help control cravings, delay stomach emptying, and keep you feeling fuller for longer.

Plus, we have a team of expert dietitians and health coaches you can consult with, to help you work through any challenges you're experiencing during your weight management journey.

We help you make lifestyle and habit changes to help increase your fitness levels and promote eating a balanced diet by providing you with one-on-one health tracking and weekly check-ins with your clinician to track your biometric, mental and physical health, continuously making adjustments to your programme to suit your individual needs.

We’re in it with you for the long run; having helped thousands of women achieve 15-20% weight loss over one year. Once in the programme, you’ll have regular access to a team of health professionals who are here to listen, guide and help unlock a healthier you.

Endoscopic sleeve gastroplasty

Endoscopic sleeve gastroplasty (ESG) is a new non-surgical procedure, where a surgeon places an instrument with a camera at the tip through your oesophagus (food pipe) and a device used to make stitches [8].

This device is tucked inside the stomach wall, reducing the amount of food held in your stomach and can be removed at any time.

Intragastric balloon

An intragastric balloon is a non-surgical procedure, where a doctor inserts a balloon inside your stomach through a tube from your mouth [8]. The balloon is then filled with salt water, taking up space in your stomach which in turn, makes you feel fuller and decreases your food intake.

How do weight loss injections work?

Weight loss injections work by inserting a pen (a tiny needle) in the upper thigh or abdomen. The injection works to regulate your digestion and reduce your appetite, while health coaching helps you make behavioural changes for long-term weight loss.

While a regular injection might sound intimidating, it is a quick process and the results speak for themselves.

This is why Juniper's Weight Reset Programme was created — to provide women with another weight loss option. While weight loss surgery may be an option for you, depending on your health concerns, it's definitely not the only option out there.

Bariatric surgery comes with a lot of risks and side effects that may cause other medical problems in the long term. There are plenty of non-surgical options on the market that come with fewer risks and help you achieve long-term, sustainable weight loss.