Activity 1: Bariatric Surgery Refits

Approximately 75-80% of the stomach (your vessel's main 'fuel tank') is removed, leaving a smaller, banana-shaped, tubular stomach.

• Reduced Fuel Capacity (Restriction): The smaller stomach holds significantly less food, meaning you feel full with smaller portions.
• Altered Navigational Signals (Hormonal): Removal of a large part of the stomach reduces the hunger hormone ghrelin and positively alters other gut hormones, often leading to decreased hunger and improved satiety.

50-60% at 1-2 years.

• Lifelong vitamin and mineral supplementation.
• Significant, permanent changes to eating habits (small, frequent, nutrient-dense meals).
• Regular, long-term medical follow-up.

• Staple line leaks (rare but serious early complication).
• Nutrient deficiencies if supplementation is not diligent.
• Potential for new or worsened acid reflux in some individuals.

A small stomach pouch (about the size of an egg) is created from the top of the stomach. A segment of the small intestine is then rerouted and connected directly to this new pouch, bypassing the larger part of the stomach and the first part of the small intestine.

• Severely Reduced Fuel Capacity (Restriction): The tiny pouch limits food intake significantly.
• Profoundly Altered Navigational Signals (Hormonal): Rerouting the intestine leads to substantial and often very favorable changes in gut hormones that regulate appetite and blood sugar.
• Altered Fuel Processing (Mild Malabsorption): Some calories and nutrients are not fully absorbed due to the intestinal bypass.

60-70% at 1-2 years.

• Lifelong, more extensive vitamin and mineral supplementation.
• Strict adherence to specific dietary guidelines to avoid "dumping syndrome" (nausea, cramping, diarrhea after consuming sugary or fatty foods).
• Consistent, long-term medical follow-up.

• Dumping syndrome.
• Higher risk of certain nutrient deficiencies (e.g., iron, B12, calcium).
• Potential for internal hernias, ulcers, or strictures.

This is a two-part procedure: first, a sleeve gastrectomy is performed. Then, a very long portion of the small intestine is bypassed, significantly reducing the area where nutrients are absorbed.

• Drastically Altered Fuel Processing (Significant Malabsorption): The primary effect; many calories and nutrients (especially fats and proteins) are not absorbed.
• Reduced Fuel Capacity (Restriction): Due to the sleeve gastrectomy component.
• Major Navigational Signal Changes (Hormonal): Profound alterations in gut hormones.

70-80%+ at 1-2 years (often the highest among procedures).

• Lifelong, high-dose, and most extensive vitamin/mineral supplementation.
• Very strict dietary monitoring, especially high protein intake to prevent malnutrition.
• Frequent and highly specialized medical follow-up is critical.

• Highest risk of severe malnutrition (protein, vitamins, minerals).
• Frequent, loose, and potentially foul-smelling stools/gas.
• Higher risk of surgical complications compared to other procedures.

An inflatable silicone band is placed around the upper part of the stomach, creating a small pouch above the band. The tightness of the band can be adjusted via a port under the skin.

• Reduced Fuel Intake (Restriction): The band creates a small upper pouch that fills quickly, and the narrowed opening slows the passage of food into the lower stomach.
• (Minimal direct hormonal effect compared to other procedures).

40-50% (Note: Often less effective long-term, with higher rates of re-operation or band removal compared to other procedures).

• Requires regular follow-up visits for band adjustments ("fills").
• Specific dietary restrictions (e.g., avoiding certain textures) to prevent food from getting stuck.
• Chewing food very thoroughly is essential.

• Band slippage, erosion (band growing into the stomach), or leakage.
• Problems with the access port.
• Esophageal dilation or pouch enlargement.
• Less reliable long-term weight loss maintenance for many.