Hi skeptic

i think you know already that BMI 40 is considered obesity and surgery may be also considered to help if there is obesity -related cardiomyopathy or severe sleep apnea

there are many operations to reduce weight ,some of them are obsolete such as jejunoileal bypass cause of many complications post operatively like protein deficiency, liver diseases and renal stones.( one of the old operations was to wire the patient's jaws shut so that intake is restricted to fluids and i wish to perform this one on kotkot and make it permenant:lol:)

operations now in use are horizontal gastroplasty, gastric bypass , vertical banded gastroplasty and adjustable gastric banding .

the general idea of those operations is to decrease the capacity of the stomach and train patients to eat small amount of food.

bypass operations have a problem of stomal dilatation later on or staple disruption and success is defined as loss of more than 5o% of excess weight and you get the best results regarding weight loss with gastric bypass ( stoma is the opening between the 2 parts of the gastrointestinal tract when they are connected together)

by doing any of those operations doesn't mean that your role is over and you get the best results with post operative compliance with your doctor and dietician plus you need supplemental B vitamins, iron and folate postoperatively.

regarding the AGB, it can be done laparoscopically and it is less invasive than other bypass surgery . you have to take your decision after discussing all aspects of it with your doctor and there are many centers in America specialized in those kinds of operations but i never heard of any mortality regarding AGB and the final outcome varies from one patient to another depending on many factors.

:kiss2:Good luck and thanks for the kiss.