By definition, the goal of weight loss surgery is to help you lose weight. The mechanism may differ depending on the type of surgery, but each surgery has the potential to promote great long term weight loss and help maintain that weight loss in the future.
There are two different ways that bariatric surgery fights weight. Depending on the procedure, it can promote weight loss by:
- Decreasing the amount of space in your stomach (restriction)
- Preventing the body from absorbing all of the calories from food (malabsorption)
These are the two strategies that each weight loss surgery uses. Some, like gastric banding (LAP Band), are strictly restriction based. Others, like gastric bypass, use a combination of both, decreasing the size of the stomach and bypassing a portion of the intestine so that food that is consumed has less time to digest.
All weight loss surgeries fall into at least one of the two categories – restriction and malabsorption. There is a secondary benefit of some weight loss surgeries that can not only make it easier to lose weight – it can also change the desire you have for food.
Bariatric Surgery and Hunger Hormones
Most of the time, the reason you eat is that you feel hungry. Hunger is your body’s way of telling you it needs food. Those with obesity tend to feel hungry more than those that do not have obesity, and this drives them to further excess eating. It also affects their quality of life, because hunger is an unpleasant sensation and the desire to eat is both uncomfortable and stressful for those with obesity.
The feeling of hunger is not just something that occurs magically. It is caused by the creation of two separate hormones – Leptin and Ghrelin. When your body creates ghrelin, it tells your brain that you’re hungry, which in turn gives you the unpleasant hunger feeling and makes you desire food. When your body creates leptin, it tells you that you’re full.
Shrinking the stomach can reduce the amount of hunger you feel because being full tells your body to stop creating the hormone and those with a smaller stomach get full faster. But some bariatric surgeries can change some hunger hormones your body produces.
- Ghrelin – Gastric sleeve, especially, has been proven to decrease ghrelin production significantly after the procedure is over. Gastric bypass has more mixed results, but studies have shown at least some degree of ghrelin reduction after the surgery. Gastric banding and other procedures that do not alter the stomach do not seem to offer the same benefits.
- Leptin – Leptin is responsible for feeling full, so in some ways, you would want an increase in ghrelin levels to reduce hunger. But studies have shown something interesting – those with obesity already have higher than normal leptin levels. It appears that those with obesity may become less sensitive to the leptin hormone. After most forms of bariatric surgery, leptin levels decrease (which reduces feelings of being full) but that this decline may correlate to being able to feel full easier.
Those that struggle with obesity often have trouble controlling their hunger, and this not only causes them to eat more food – it also makes life a lot more uncomfortable in the day to day. Bariatric surgery, then, not only increases the amount of food that you eat but also how much and how often you desire it and how your body feels when you’re not eating.
If hunger has bene one of the primary challenges you’ve had losing weight or one of your least favorite struggles with obesity, several forms of bariatric surgery can also reduce how much hunger you experience and how severe it that hunger feels.
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