Table 2.
Patient selection and suitability for different weight loss procedures.
| Weight loss procedure | Suitability and patient profiles | Surgical risks and considerations | Factors influencing decision-making |
|---|---|---|---|
| Sleeve gastrectomy (SG) | - Suitable for a wide range of individuals, including lower BMI and significant health risks26 | - Less technically demanding, rapid recovery, lower adverse events26 | - Medical history, obesity-related health conditions25,26 |
| - Particularly useful in low-resource settings26 | - BMI27 | ||
| Gastric bypass (RYGB) | - Recommended for higher BMI or inadequate weight loss with less invasive options26 | - Increased risks of dumping syndrome and marginal ulceration26 | - Surgical risks and patient preferences28 |
| - Patients on chronic NSAIDs for arthritis may require careful consideration26 | - Severe perioperative complications, such as anastomotic leaks30 | - Desire for a reversible or permanent solution | |
| - Daily multivitamin intake is necessary26 | - Stomal stenosis, nutrient deficiencies, and internal hernia formation30 | - Experience and expertise of the bariatric surgeon30 | |
| Adjustable gastric banding | - Suitable for patients preferring less permanent solution or with lower BMI30 | - Less invasive, reversible, and faster recovery30 | - Assessment of patient’s suitability for a complex procedure |
| - May be more appropriate for individuals with fewer obesity-related health issues30 | - Shorter hospital stays and less serious side effects30 | ||
| Biliopancreatic diversion with duodenal switch (BPD/DS) | - Highly effective for severe obesity and significant health risks26 | - Requires specialized surgical skills26 | - Surgical risks, patient preferences |
| - Careful evaluation is necessary due to potential malabsorption26 | - Highest incidence of adverse effects26 | - Patient commitment to dietary changes29 |
NSAIDs, non-steroidal anti-inflammatory drugs; RYGB, Roux-en-Y gastric bypass.