Weight loss surgery has been around in one form or the other for over fifty years. The first known bariatric surgery was performed in 1954. Doctors connected the upper and lower intestines in such a way as to interfere with normal digestive absorption. The next development in bariatric surgery occurred in 1963 when the procedure that has become known today as gastric bypass surgery was developed, involving the connection of the upper small intestine directly to the colon. These early versions of the gastric bypass resulted in severe side effects: including unmanageable diarrhea.
The next improvement to the procedure occurred in 1973 the existing surgery was modified to involve using smaller lengths of the small intestine in the bypass. This version of the surgery still had severe side effects including diarrhea, severe dehydration, and a significant number of patients (one third) developing cirrhosis of the liver.
It was not until 1996 that a new development occurred in gastric bypass surgery, formally named “bilio-pancreatic diversion” which involves a partial removal of the stomach. As with all the previous procedures, the result was a significant malabsorption of food/nutrients. This development was the first truly effective form of weight loss surgery, with loss of mass maintained for 18 years on average. The procedure’s side effects of stomach ulcers and dumping syndrome (ingested foods are not broken down by the stomach, but passed nearly intact into the intestinal tract) were corrected by a modification to this surgery called the “duodenal switch”. This improvement did not alleviate side effects that continue to plague the procedure to the present: malnutrition, vitamin deficiency and recurrent diarrhea. These consequences of the surgery require long term, possibly life-long management by doctors.
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