Gastric Bypass

Gastric bypass is surgery that helps you lose weight by changing how your stomach and small intestine handle the food you eat.

After the surgery, your stomach will be smaller. You will feel full with less food.

The food you eat will no longer go into some parts of your stomach and small intestine that absorb food. Because of this, your body will not get all of the calories from the food you eat.

Weight-loss surgery may be an option if you are very obese and have not been able to lose weight through diet and exercise.

Doctors often use the body mass index (BMI) and health conditions such as type 2 diabetes and high blood pressure to determine which patients are most likely to benefit from weight-loss surgery.

Gastric bypass surgery is not a quick fix for obesity. It will greatly change your lifestyle. After this surgery, you must eat healthy foods, control portion sizes of what you eat, and exercise. If you do not follow these measures, you may have complications from the surgery and poor weight loss.

This procedure may be recommended if you have

  • A BMI of 40 or more. Someone with a BMI of 40 or more is at least 100 pounds over their recommended weight. A normal BMI is between 18.5 to 25.
  • A BMI of 35 or more and a serious medical condition that might improve with weight loss. Some of these conditions are obstructive sleep apnea, type 2 diabetes, and heart disease.

Gastric bypass is major surgery and it has many risks. Some of these risks are very serious. You should discuss these risks with your surgeon.

Risks for anesthesia and surgery in general include

  • Allergic reactions to medicines
  • Breathing problems
  • Bleeding, blood clots, infection

Risks for gastric bypass include

  • Gastritis (inflamed stomach lining), heartburn, or stomach ulcers
  • Injury to the stomach, intestines, or other organs during surgery
  • Leaking from the line where parts of the stomach have been stapled together
  • Poor nutrition
  • Scarring inside your belly that could lead to a blockage in your bowel in the future
  • Vomiting from eating more than your stomach pouch can hold

 

You will have general anesthesia before this surgery. You will be asleep and pain free.

There are two steps during gastric bypass surgery

  • The first step makes your stomach smaller. Your surgeon uses staples to divide your stomach into a small upper section and a larger bottom section. The top section of your stomach (called the pouch) is where the food you eat will go. The pouch is about the size of a walnut. It holds only about 1 ounce (oz) of food. Because of this you will eat less and lose weight.
  • The second step is the bypass. Your surgeon connects a small part of your small intestine (the jejunum) to a small hole in your pouch. The food you eat will now travel from the pouch into this new opening and into your small intestine. As a result, your body will absorb fewer calories.

Gastric bypass can be done in two ways. With open surgery, your surgeon makes a large surgical cut to open your belly. The bypass is done by working on your stomach, small intestine, and other organs.

Another way to do this surgery is to use a tiny camera, called a laparoscope. This camera is placed in your belly. The surgery is called laparoscopic surgery. The scope allows the surgeon to see inside your belly.

In this surgery

  • The surgeon makes 4 to 6 small cuts in your belly.
  • The scope and instruments needed to perform the surgery are inserted through these cuts.
  • The camera is connected to a video monitor in the operating room. This allows the surgeon to view inside your belly while doing the operation.

 

Most people lose about 10 to 20 pounds a month in the first year after surgery. Weight loss will decrease over time. By sticking to your diet and exercise from the beginning, you lose more weight.

You may lose half or more of your extra weight in the first 2 years. You will lose weight quickly after surgery if you are still on a liquid or pureed diet.

Losing enough weight after surgery can improve many medical conditions, including:
  • Asthma
  • Gastroesophageal reflux disease (GERD)
  • High blood pressure
  • High cholesterol
  • Obstructive sleep apnea
  • Type 2 diabetes

Weighing less should also make it much easier for you to move around and do your everyday activities.

To lose weight and avoid complications from the procedure, you will need to follow the exercise and eating guidelines that your doctor and dietitian have given you.