Once you have decided that weight loss surgery is for you, the next major step is which operation is best for you. This can sometimes be straight forward but commonly requires deciding between the "pros and cons" of each. For instance, smoking and acid reflux would generally mean that a Gastric Sleeve and Gastric Bypass respectively would be best for you.
The operation that you choose should take into account your motivating factors. If comorbidity resolution (such as diabetes), solely weight loss or combination are your reasons for choosing surgery then this may reflect which operation is best for you. In broad terms the operations are either RESTRICTIVE (Sleeve gastrectomy), MALABSORPTIVE (Duodenal switch) or combination of the two (Roux en Y and Omega-loop Gastric bypass). A restrictive operation reduces the size of your stomach (85%) and limits the volume you can physically eat at any one time. A malabsorptive operation delays the mixing of eaten food with the enzymes required for digestion to further down the gastrointestinal tract ('the gut " or small bowel) and thus less calories absorbed by the body. After an operation that has a malabsorptive component, one must strictly adhere to the post-operative prescribed multivitamins to avoid nutritional and mineral deficiencies. Each operation has excellent weight loss results however weight regains and ability to 'eat around' the surgery is higher in some.
Any weight loss surgery is a major operation but generally considered safe. Major complications are seen in <4%. The Duodenal switch operation is not commonly performed in New Zealand (<1%), and if you are interested I will refer you to the surgeon who performs them.
A BMI >40 is equivalent to smoking in shortening one's life expectancy.
