Compare weight loss surgeries and evaluate carefully to enjoy health (Part 2)

Exercise can strengthen the body's muscles and consume calories, but in comparison, the calories consumed account for a small proportion of the total calories consumed in a day, so the effect of exercise for weight loss is slow, and weight often returns because it cannot be sustained. Therefore, exercise mainly makes people healthier rather than reducing weight in the process of weight loss.

Exercise is slow to produce results for weight loss, so some people choose surgery to change the process of food digestion to achieve the goal of weight loss.

Dieting and exercise are the only way to lose weight, but some people still hope to achieve their goals through "external forces", such as seeking the help of drugs. Currently, there is only one weight loss drug approved by the Department of Health, "Luoshixian" (Nomedin has been withdrawn from the market because it can cause cardiovascular side effects). It can reduce about 5-10% of body weight, but it is not very effective in Taiwan. This is because Luoshixian can reduce the absorption of lipids, but most Taiwanese people mainly eat starchy foods such as rice and wheat, which is different from Westerners who mainly eat meat. As for using other weight-loss drugs of unknown origin, it may be ineffective at best and harmful to your body at worst, so you must be careful.

Compared with the weight loss methods described above, surgery is a more radical method. Through surgery, the process of food digestion is changed or the amount of food eaten is reduced, ultimately achieving the goal of weight loss.

Bariatric Surgery

Currently, it is roughly divided into the less invasive gastric balloon placement, or gastric banding surgery, sleeve gastrectomy, and gastric bypass surgery performed by laparoscopy. Basically, except for the gastric balloon which can only be used for a short period of time, the other three methods can be used for long-term control.

In terms of gastric balloon placement, a silicon ball is placed in the stomach of the patient under anesthesia through gastroscopy. The volume of the balloon itself slows down the time it takes for food to pass through the stomach, making the patient feel full, reducing the amount of food eaten, and ultimately achieving the goal of weight loss. However, the gastric balloon is a temporary treatment (about six months), and if it is left in place for too long, it is likely to cause sequelae.

Up to 25% of people who use gastric balloon placement to lose weight will gain the weight back, usually because they have not developed correct eating habits. If these people who have gained weight again have indications, it is recommended that they consider surgery. Therefore, the success of gastric balloon weight loss depends on whether you develop correct eating and exercise habits and persist in them.

Gastric banding is a type of restrictive weight loss surgery and is currently the most commonly used procedure in Australia and the fastest growing procedure in the world, mainly because the procedure is simple, safe and reversible. The gastric band is a silicone bag with a ribbon-shaped water balloon inside. The inner diameter can be adjusted by the water balloon to affect the time it takes for food to pass through.

This band is placed below the junction of the stomach and esophagus, forming a volume of about 15-30 cc. Food will accumulate here because of the band. Only after the food is ground and passes through the band can you eat again. When food accumulates in the upper part of the stomach, you will feel full, so you can reduce your food intake and achieve the goal of losing weight.

Gastric banding basically uses external force to slow down the time it takes for food to pass through the stomach. Although it is a laparoscopic surgery, it does not cut the organs, which means that the patient can return to his or her pre-surgery state if he or she changes his or her mind. Because gastric banding is a purely restrictive surgery, the rate of weight loss is slow in the early stages, and on average, it can reach about 50% in the second year.

Gastric banding is the safest surgery among all weight loss surgeries, with a mortality rate of approximately 5 in 100,000 and a complication rate of 3 in 1,000, including gastric torsion, perforation, obstruction, and band displacement. Although gastric banding surgery is safe, it is not suitable for some people who are addicted to sweets or liquid drinks, because these liquid foods can easily pass through the stenosis caused by the band and cannot achieve the restriction purpose, and there will be no ideal weight loss results.