Gastric Bypass Surgery
Gastric bypass surgery, the most common being Roux-en-Y gastric bypass, makes the stomach smaller and allows food to bypass part of the small intestine, allowing the patient to feel full more quickly, which reduces the amount of food you eat and thus the calories consumed. Bypassing part of the intestine also results in fewer calories being absorbed, which in conjunction leads to weight loss.
Expected Weight Loss
Weight loss of 80 - 100% of excess body weight is achievable for most patients, and long-term maintenance of weight loss is very successful -- but does require adherence to a simple and straightforward behavioral regimen.
How is it done?
In a Roux-en-Y gastric bypass surgery, creating a small pouch at its top using surgical staples or a plastic band reduces the stomach size. The smaller stomach is connected directly to the middle portion of the small intestine (jejunum), bypassing the rest of the stomach and the upper portion of the small intestine (duodenum). This procedure can be done by making a large incision in the abdomen (an open procedure) or by making an incision and using small instruments and a camera to guide the surgery (laparoscopic approach).
Why is Gastric Bypass Surgery done?
The purpose of the operation is to reduce food intake to a very low portion without causing hunger. Appetite is dramatically controlled by the restrictive effect of the new stomach pouch, which is filled up when just a small amount of food is consumed, leading to an early feeling of fullness in the course of eating a meal. With reduced calorie intake, the body consumes stored body fat in order to meet the daily calorie need, resulting in rapid loss of body fat weight. With time, the restrictive effect of the pouch gradually diminishes but never disappears completely. This gradually allows bigger meal-sizes until a normal size is reached in 12-18 months, at which point most of the unwanted excess body fat is completely depleted.
Why might Gastric Bypass Surgery be necessary?
Being very overweight is a serious problem because of its negative health effects, impact on quality of life, and the frustration of dieting and not losing. If you suffer from uncontrollable weight problems, you need to know about your disease (obesity/morbid obesity), and about the most successful way of treating it; this is through weight loss (bariatric) surgery. With one operation, a person can be potentially cured of numerous obesity related medical diseases (called comorbidities) including:
• Diabetes (a disease characterized by abnormally high glucose levels in the blood) • hypertension (persistent high blood pressure)
• High cholesterol (collects on the walls of arteries and interferes with blood flow)
• Sleep apnea (temporary suspension of breathing occurring during sleep)
• Chronic headaches (constant pain in the head)
• Venous stasis disease (discoloration around ankles and lower legs)
• Urinary incontinence (loss of bladder control)
• Liver disease (accumulation of fat in the liver cells resulting in inflammation)
• Arthritis (joint disorder featuring inflammation)
Candidate Eligibility
Although guidelines vary, surgery is generally considered when the body mass index is 40 or higher or the patient has a life threatening or disabling condition related to their weight. Furthermore, the doctor may only consider doing gastric bypass surgery if the patient has not been able to lose weight with other treatments, has been obese for at least 5 years, and the candidate does not have problems with alcohol or depression.
Risks & Complications
Risks common to all weight loss surgery include an infection in the incision, a leak from the stomach into the abdominal cavity or where the intestine is connected (resulting in an infection called peritonitis), and a blood clot in the lung (pulmonary embolism). About one-third of all people having surgery for obesity develop gallstones or a nutritional deficiency condition such as anemia or osteoporosis. Also the bypassed stomach may enlarge, resulting in hiccups and bloating.
It’s a personal decision, as well as a medical one. Your doctors can teach you about the risks, and help you measure the likelihood of benefits, and will tell you frankly, if they are out of balance for you. Still, the final decision is up to you. To make it intelligently, you need to know all about the risks, and the benefits, of weight loss surgery.
