Thousands of people undergo weight loss surgery each year in the United States alone. It wasn’t until the 1950s that the dangers of morbid obesity really came into the public eye and interventions began being explored. Thanks to technological advancements and enhanced techniques, bariatric surgeries are the most effective and safest that they have ever been. Everyday, people decide to go under the knife in the hopes of improving their quality and, potentially, quantity of life. Let’s look at some of the steps that it took to get to where this specialized field is today!
One of the earliest examples of a bariatric procedure dates back to 10th century Spain. D. Sancho, King of Leon, was so obese that he was unable to function in a normal capacity. He had very little use of his arms, could not walk or ride his horse, and was seen as an easy target. Upon losing his claim to the throne, he sought assistance from a respected Jewish surgeon, Dr. Hasdai Ibn Shaprut of Cordoba. He managed to assist Sancho in losing half of his body weight by sewing his mouth shut. This prevented the man from eating and restricted him to a liquid-only diet. Eventually, the wires were removed and he returned to Leon (Faria). Other early examples of weight loss interventions included a variety of purgatives to induce vomiting or diarrhea and swallowing capsules containing tapeworms. Beauty standards change from generation to generation and men and women have always found incredibly interesting, sometimes vile, methods of keeping off the pounds. The bariatric surgical procedures we will be discussing though, were only intended for individuals who were morbidly obese.
In 1954 Dr. A.J. Kreman connected the stomach to a sectioned out part of the intestine, thus bypassing a large portion of the intestine. This not only limited the amount of food that could be consumed at a given time, but it also lessened absorption by stopping food travel through the section of the intestine where nutrient absorption was the strongest. Complications associated in the early phases of this technique included uncontrollable diarrhea, malabsorption, and discomfort (McCue). Gastric bypasses today involve the same ideas as in the 50s. A pouch is created on the top portion of the stomach, separating it from the lower portion. It is closed off usually using staples or bands. Then a segment of the small intestine is connected to the stomach (“Bariatric Surgery”) Gastric bands, developed in the 1990s, are a non-permanent solution to decreasing the size of the stomach. They can be placed non-invasively and doctors can inflate or deflate them using a port in the patient’s skin. Although they are designed to last a person’s lifetime, they can be removed with little to no long-term damage.
In 1977, Rodger et al. reported 17 cases where obese patients underwent a procedure to have their jaws wired shut (Faria). As expected, the patients saw significant weight loss, but 75% of the group gained weight back after the wires were removed. Today, most patients looking for surgical intervention are required to see a variety of specialists to ensure that they are healthy enough both physically and mentally before being scheduled for surgery. Dieticians and therapists are often important players on these medical teams because they help the person understand their bad habits and triggers and assist them in changing their damaging behavioral patterns in order to prevent weight gain in the future.
Another common procedure is called a gastrectomy. Gastrectomies involve the removal of a large portion of the stomach, thus resulting in the creation of a small sleeve. This reduces intake and also signals to the brain that a person is full sooner. This was first performed in 1881 to remove a cancerous section of the stomach, but then was later improved upon for purposes of weight loss surgery.
In 1994 the very first laparoscopic gastric bypass was performed by Alan Wittgrove. Laparoscopy is a less invasive surgical procedure involving the insertion of rods and microscopic cameras into small incisions. It enables the surgeon to complete tasks without having to fully open the patient up. Laparoscopy is commonly used in weight loss surgeries, biopsies, tubal ligations, cyst and polyp removals, and in excising abdominal tumors. Laparoscopic bypasses are less invasive and result in shorter recovery times, less scarring, and reduced pain.
The 1990s saw a spike in magazine and television coverage of successful weight-loss stories. One example of this is the story of famous weather anchor, Al Rocker, who lost over 100 pounds after weight loss surgery. He had attempted to lose the weight himself for years with diets and supplements but had been previously unsuccessful. In 2002, there was a 40% increase in scheduled bariatric surgeries (McCue).
One of the big appeals that weight loss surgery has to many people is that it seems easier than dieting and exercising. Although doctors have managed to develop successful methods of weight-loss for the morbidly obese, these surgeries are not quick fixes. If a person doesn’t drastically and permanently change their habits, their stomachs will stretch back out, rendering the procedure unsuccessful. It is also important to recognize that any surgery comes with risks. Some of the potential complications still associated with bariatric surgeries include bleeding, pain, infection, hernias, blood clots, bowel obstructions, leaks, reflux, malabsorption, and death. It is estimated that 250,000 weight-loss operations take place each year in the United States.
Disclaimer: This blog offers no medical advice and is not operated by a medical professional. This page only explores the general history of the topic and should not be used in association to any degree with medical decision-making.
Until Next Time
- Bariatric Surgery.” Cleveland Clinic. Accessed 10 May, 2023. https://my.clevelandclinic.org/health/treatments/17285-bariatric-obesity-surgery#:~:text=Bariatric%20surgery%20procedures%20work%20by,digestive%20system%20to%20your%20brain.
- Faria, Gil r. “A Brief History of Bariatric Surgery.” National Center for Biotechnology Information. 6 March, 2017. Accessed 10 May, 2023. ncbi.nlm.nih.gov/pmc/articles/PMC6806981/.
*McCue, Mandy. “The History of Bariatric Surgery.” First health. 17 September, 2012. Accessed 10 May, 2023. firsthealth.org/lifestyle/news-events/previous-years/2012/09/the-history-of-bariatric-surgery.