By Jennifer DeLeo

Weight loss has to be one of the most complicated health issues. We are pummeled with information on the health complications (heart disease, hypertension, Type 2 diabetes, sleep apnea and/or high cholesterol) that stem from obesity – just as we are pummeled with ads for food. It's not about discipline or being lazy – does anyone want to tell New Jersey Governor Chris Christie he's lazy? Like everyone else who is overweight, it's a daily battle.

When Surgery May Be the Answer

When all the diets have failed; when your doctor tells you you're pre-diabetic; when all other options have failed, many people who are morbidly obese turn to bariatric (weight loss) surgery. Jefferson's Bariatric and Metabolic Surgery Program, led by David Tichansky, MD, FACS, is a Center of Excellence and offers a range of fully laparoscopic procedures – gastric bypass, gastric banding and sleeve gastrectomy – to help you begin the journey to a healthier life.

Understanding the pros and cons of each weight loss surgical procedure and identifying which one is right for you can be a challenge, especially when that decision can be life changing. Dr. Tichansky will help you understand some of the pros and cons of each surgical solution.

Laparoscopic Adjustable Gastric Banding

A band with a balloon on its inner surface is placed around the upper part of your stomach. The band separates your stomach into a small upper component (about the size of an egg) and the remainder of your stomach. This helps you feel satisfied or full after consuming a small amount of food by sending a signal to your brain that you're full.

Results: By eating less food with the band, most people will lose about 40 percent, on average, of their excess body weight. This usually occurs in the first one-and-a-half years.

At some point your weight will stabilize, and you will not feel comfortable eating with the band any tighter.

Pros: This procedure is considered less invasive because the stomach is not divided.

Cons: New data shows high rates of long-term weight regain and band removal surgery after 10 years.

Bottom Line: Gastric banding can be effective in very select patients, but there is uncertainty due to recent reports of long-time failure.

Laparoscopic Gastric Bypass Surgery

This weight loss procedure alters the process of digestion and involves stapling and dividing the stomach to make a new, smaller stomach about the size of an egg. A piece of the intestine is then connected to the new smaller stomach for food to pass through and is then reconnected to the lower intestine to form a Y. The smaller stomach helps you feel satisfied, even full, after consuming a very small amount of food.

Results: By eating less and not fully absorbing calories in food, most people will generally lose 60 to 70 percent of their excess body weight with this procedure. Most weight loss occurs in the first one-and-a-half years. At that point, your weight will stabilize. The gastric bypass will, however, help you to continue to feel satisfied on very little food, and you can maintain this healthy weight for the rest of your life.

Pros: This procedure is considered the "gold standard," with reliable and long-term weight loss. It's also the most common weight loss procedure. Another important benefit is for patients with Type 2 diabetes. Studies have shown that up to 80 percent of patients with the condition are cured after gastric bypass surgery and even before significant weight loss has occurred.

Cons: This is an extensive surgery that requires lifelong vigilance in following the plan.

Bottom Line: While gastric bypass is a more extensive surgical procedure, there are more long-term benefits.

Laparoscopic Sleeve Gastrectomy

This procedure provides weight loss by reducing the size of the stomach and controlling hunger. Approximately 70 to 80 percent of the stomach is removed while creating the new smaller stomach in the shape of a "sleeve." The part of the stomach that is removed is where chemicals are made that tell your brain that you are hungry (even when you may not need to eat). This results in a decrease in hunger since the amount of these chemicals reaching your brain is less.

Results: The average weight loss after a sleeve gastrectomy is 55 percent of excess weight.

Pros: This is good middle ground between gastric bypass and gastric banding. A sleeve gastrectomy only makes your stomach smaller without intestinal bypass. Weight loss is almost as good as bypass and much better than banding, with the risks associated with intestinal bypass or having a foreign body implant (band).

Cons: Some patients will develop reflux symptoms, which are treated with antacids.

Bottom Line: Theoretically, sleeve gastrectomy is the best procedure in terms of the benefit gained for the amount of risk. It makes sense: a smaller stomach and less hunger leads to weight loss.

We recognize that this is a highly personal decision and we invite you to schedule an appointment to meet us so we can discuss your health and walk you through the process. To make an appointment, please call 1-800-JEFF-NOW or search for a doctor.