Considering Gastric Bypass Surgery?

Why Should I Consider Bariatric Surgery?

Many people struggle with weight loss and attempt to make dietary changes, only to fall back into old habits. For some who need the help to lose a larger amount of weight, typically 100 pounds or more, gastric bypass can be an option to help them begin to lose weight.

"Bariatric surgery can offer people the opportunity to accomplish what they could not do on their own," said weight loss surgeon Gerald Cahill, MD, medical director of the Franciscan Health Center for Bariatric Surgery in Olympia Fields, Illinois, and Dyer, Indiana. "It can be a life-changing step that helps them reset the clock."

For people who are obese and have type 2 diabetes, weight loss surgery leads to more than a slimmer figure. Bariatric surgery also reduces the risk of heart complications and premature death by about 40% compared to standard medical care, new research says.

What Is Gastric Bypass Surgery?

Gastric bypass surgery, also known as roux en y gastric bypass, makes the stomach smaller and allows food to bypass part of the small intestine. You will feel full quicker than when your stomach was its original size, and this smaller stomach size reduces the amount of food you eat and thus the calories you consume. Bypassing part of the intestine also results in fewer calories being absorbed. This reduced calorie absorption leads to weight loss.

"In a gastric bypass, the stomach is transected very high up, where you create a small pouch the size of an egg," Dr. Cahill said. "The small bowel is reconstructed to bypass most of the stomach."

Is Gastric Bypass Surgery The Right Decision For Me?

For Danille Perez, gastric bypass was the right decision for her weight loss and her health. She lost her father to complications brought on by obesity. Weighing 310 pounds herself, Danille promised her dying father that she would change her life.

After her gastric bypass surgery, Danille went from being the biggest friend in her social group to its most physically fit friend.

"I’m the one they call for advice on nutrition or how to get into running. It’s great," Danille said. "It’s amazing – I feel wonderful! I wake up in the morning and spring out of bed. I want to get up for the day, spend time with my kids, walk the dogs and go to the beach."

Patients who are eligible for weight loss surgery typically have a body mass index, or BMI, of 40 or greater. A BMI of 40 translates to about 100 pounds over ideal body weight for men and 80 pounds over ideal body weight for women. Gastric bypass surgery may also be an option for people with a BMI of 35 or greater who suffer from life-threating health problems such as diabetes, sleep apnea or obesity-related heart disease.

On average, people shed more pounds with gastric bypass. A 2018 study of 46,000 patients found that bypass patients lost, on average, one-quarter of their starting weight over five years. That compared with 19% among sleeve gastrectomy patients.

Since her gastric bypass surgery, Danille has lost 140 pounds, and she is off her blood pressure and blood sugar medications.

What Are The Advantages And Disadvantages To Gastric Bypass Surgery?

The simple nature of the operation makes gastric bypass very safe without some of the potential complications from surgery on the small intestine. However, like any surgical operation, gastric bypass surgery has possible complications, such as bleeding, infections, inflammation of the lining of the stomach, gallstones due to significant weight loss in a short amount of time, and other usual complications associated with bariatric surgery.

One advantage of gastric bypass surgery, according to the American Society for Metabolic and Bariatric Surgery, is the impact on hormones and metabolic health often results in improvement of adult onset diabetes even before any weight loss occurs.

Gastric bypass also helps patients with acid reflux, and often heartburn symptoms quickly improve. Along with making appropriate food and exercise choices, patients must avoid tobacco products and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen.

There are pros and cons to gastric bypass surgery.

Pros

• Reliable and long-lasting weight loss
• Effective for remission of obesity-associated conditions
• Refined and standardized technique

Cons

• Technically more complex when compared to sleeve gastrectomy or gastric band procedures
• More vitamin and mineral deficiencies than sleeve gastrectomy or gastric banding
• Risk for small bowel complications and obstruction
• Risk of developing ulcers, especially with NSAID or tobacco use
• May cause "dumping syndrome," a feeling of sickness after eating or drinking, especially sweets

Can I Eat Normally After Gastric Bypass Surgery?

While dieting recommendations may not be seen as a "con" to many, the topic is essential to understand before having gastric bypass surgery.

Diet recommendations after a gastric bypass can differ per patient. The goal of a recommended diet is to comfortably return the patient to eating solid foods over time, but that depends on the overall progress of your recovery, including how you handle new meals. It’s crucial to follow dieting recommendations from your provider during recovery.

Still, even after a full recovery, it’s just as important to follow a diet that matches your weight loss goals all while maintaining proper nutrition. Your provider may recommend the following for your diet:

• Prioritize meals that are high in protein
• Avoid meals that have high fat or sugar
• Take your time eating meals
• Stick to small portions
• Chew well before swallowing
• Drink beverages between meals to avoid early fullness while eating
• Continue to use recommended vitamins