Are You Considering Gastric Bypass Surgery?

By Lisa Kroulik © June 2, 2011

For people who are morbidly obese, defined in medical terms as being at least 100 pounds overweight with a Body Mass Index (BMI) greater than 40, one alternative for permanent weight loss is a surgical procedure known as Gastric Bypass or Bariatric surgery. This procedure may be recommended by a doctor or undertaken as an elective surgery by the patient himself. It is a major surgery with many factors to consider. The most common type of Gastric Bypass surgery is the Roux-en-Y, which is what this article will focus on.

Why People Consider Weight Loss Surgery

Many people who seek this surgery have health factors due to their obesity, such as diabetes, that could be improved with significant weight loss. When doctors recommend the surgery, it is usually due to the co-existing conditions which threaten the health of the individual. The patient has usually had several previous attempts at weight loss that have been unsuccessful.

Obtaining Approval for Surgery

Insurance carriers vary widely in their coverage of Gastric Bypass surgery. Some will outright deny it, others will require various documentation to support medical necessity. Most require a letter to be written by you detailing previous weight loss attempts and how your excess weight is impacting your daily life.

In addition to the paperwork, there are educational requirements to meet, such as classroom style lectures with other surgery candidates and meeting one on one with a nutritional counselor. A psychological evaluation is also performed and surgery will be denied to anyone with drug or alcohol dependency or a mental health diagnosis.

Risks Associated with Surgery

As with all major surgeries, there are risk factors to considered before making the final decision. Some of the more common ones are:

• infection in the incision
• leak from the stomach to the abdominal cavity
• blood clot in the lungs
• development of gallstones, ulcers or hernia
• development of anemia or osteoporosis, which are nutritional deficiencies
• vitamin B12 deficiency
• staples may become loose

There is a less than 1 percent chance of death resulting directly from Gastric Bypass surgery.

Once the decision for surgery has been made, the prerequisites have been met and the surgery date has been scheduled, you will need to take some steps to prepare your body to undergo this invasive procedure. You are allowed no solid foods, only clear, decaffeinated liquids, for 48 hours prior to surgery. Your doctor may also require an enema.

The Surgical Procedure

A small pouch is made at the top of the stomach using surgical staples or a plastic band. It is then connected to the middle portion of the small intestine (called jejunum) and bypasses the rest of the stomach and upper part of the small intestine (called duodenum). Weight loss is achieved when food you eat bypasses part of the small intestine and fewer calories are absorbed. Your stomach size is greatly reduced, thereby causing the sensation of fullness much sooner.

Recovery and Dietary Changes After Surgery

Gastric bypass is a major invasive surgery that will take your body up to six weeks to recover from. It will also require permanent changes in how you eat. From now on, you will need to consume at least 100 grams of protein per day, while at the same time limiting fat, carbohydrates and calories. Protein makes you to feel full sooner, in addition to helping your body with the healing process of muscle and soft tissue. Your doctor will probably require you to take over-the-counter vitamins and supplements for the rest of your life.

Some other major changes in how you interact with food are as follows:

Your new stomach will only be able to hold a few ounces of food at a time.

Food must be chewed slowly and to the consistency of mush. Swallowing large pieces of unchewed food can cause pain and vomiting.

You won't be able to drink for 30 minutes prior to eating, during your meal, or for 30 minutes after you eat because your new stomach cannot hold both liquids and solid food at the same time.

Foods that contain simple sugars, like candy and soft drinks, will have to avoided all together since they can contribute to "dumping syndrome." This is the medical name given to describe what happens when food moves too quickly through the small intestine and causes a rapid heart rate, dizziness, sweating, shaking, stomach pain and severe diarrhea.

Success Rates and Benefits of Surgery

Most patients lose up to 80 percent of their excess body weight within the first year after surgery, with weight loss continuing for up to three years. There is the possibility of regaining some of the weight, even when in accordance with dietary restrictions and when living an active lifestyle.

With patients who are able to achieve their ideal body weight via Gastric Bypass surgery, there is a far greater likelihood of reducing or even eliminating previous co-existing conditions like sleep apnea and hypertension. Also, a recent study by the American Society for Metabolic and Bariatric Surgery indicates an 89 percent reduction in death rates due to obesity-related causes in the five years following surgery.