Gastric bypass surgery is widely considered to be the “gold standard” when it comes to medical weight loss procedures. It is now the most common type of bariatric surgery performed in the United States, and in addition to helping patients shed unwanted pounds, gastric bypass can also help to improve chronic conditions like Type 2 Diabetes, hypertension (high blood pressure), sleep apnea, and high cholesterol.
What is Gastric Bypass Surgery?
With a gastric bypass, also known as Roux-en-Y gastric bypass, your surgeon uses a small portion of your stomach to create a new stomach pouch that is about the size of an egg, which is then connected directly to your small intestine.
The remaining large portion of your stomach and the duodenum is ‘bypassed’, however, the excluded stomach tissue is not removed, ensuring that essential digestive juices, enzymes and hormones continue to be produced and absorbed.
How Does Gastric Bypass Work?
Gastric bypass works by restricting the amount of food you can eat, and altering the way in which fat and calories are absorbed by your body.
The small, egg-sized stomach pouch fills up quickly when you eat, which helps you feel satisfied on a fraction of the food that you consumed prior to the procedure. As a result, you take in fewer calories, leading to a caloric deficit and subsequent weight loss.
Because a portion of the small intestine is bypassed during the procedure, your body will absorb fewer nutrients from the food you eat – this also helps to promote weight loss and long-term maintenance of a healthy body mass index (BMI).
Who Qualifies for Gastric Bypass?
Current guidelines from the American Society for Metabolic and Bariatric Surgery state that gastric bypass may be an option for patients who either have a BMI of 40 or greater, or have a BMI over 35 and suffer from one or more serious, obesity-related conditions such as:
Sleep apnea
High blood pressure
Type 2 Diabetes
Osteoarthritis
Heart disease
Hypothyroidism
In order to qualify for gastric bypass, you may need to show that your efforts to achieve and maintain a healthy BMI through lifestyle changes (diet and/or exercise) have been unsuccessful.
Gastric bypass is a major, life-changing procedure that has been shown to help obese patients shed unwanted body fat and reduce weight-related medical complications. Like all weight-loss surgeries, there are pros and cons associated with gastric bypass.
Advantages of gastric bypass include:
Generally, patients lose about 60 percent of their excess body weight within 18 months of the procedure*
The weight loss associated with gastric bypass surgery can help to reduce the risk of developing comorbid health conditions linked to obesity
Patients can continue to enjoy most foods by limiting portion sizes
The resulting metabolic changes can reduce food cravings
When done using robot-assisted techniques, scarring, complication rates, and post-surgical pain are minimal
Disadvantages can include:
Requires lifelong compliance with specific lifestyle changes (diet and exercise)
Patients need to be monitored for vitamin deficiencies
Overeating following gastric bypass surgery can lead to nausea, diarrhea, and discomfort
Gastric bypass surgery, also called Roux-en-Y gastric bypass (RYGB), is the second most commonly performed bariatric procedure in the United States. It is considered the “gold standard” among medical weight loss procedures. The bariatric surgeon uses laparoscopic techniques to create a small pouch out of a portion of the stomach.
The newly created pouch will be directly attached to the middle portion of the small intestine. Hence, this surgical procedure allows swallowed food to bypass most of the stomach and the first portion of the small intestine to create a “Y-shaped” section. With gastric bypass surgery, your body won’t absorb as many calories as before, and you will feel full much faster immediately after eating, both of which will significantly help you lose weight.
Who is considered for gastric bypass surgery?
In general, gastric bypass surgery is a good option for patients with:
a body mass index (BMI) of 40 or higher (morbid obesity)
a BMI of 35 to 39.9, and have obesity-related health problems like type 2 diabetes, sleep apnea, hypertension, and heart disease.
At Beltline Health, our goal is to provide you with all the information you need to determine if bariatric surgery is right for you. Our team is dedicated to helping you decide which procedure best fits your situation to achieve a healthy and sustainable weight loss.
How is gastric bypass surgery different from gastric sleeve surgery?
Although both gastric sleeve and gastric bypass surgery reduce the size of the stomach, gastric bypass surgery is a more complicated procedure in terms of how it creates a new stomach pouch.
Instead of removing about 80% of the stomach to create a small pouch with the remaining 20%, Roux-en-Y gastric bypass creates a small stomach pouch by “bypassing” most of the stomach and the first portion of the small intestine. It doesn’t remove any portion of the stomach, but it changes how it absorbs and digests food.
What to expect before gastric bypass surgery?
As with other weight loss surgery procedures, patients are encouraged to lose enough weight before the surgery to lower their BMI. This can be done by changing their diet or performing exercise more often, both of which are included in our weight loss program at Beltline Health.
Three to four weeks before surgery, patients will be required to go on a low-calorie liquid diet. These include one to two protein shakes daily, water, and unsweetened tea. Patients can also have sugar-free popsicles, black coffee without sugar, and low-sodium broths in small amounts.
The main goal of sticking with a liquid diet is to “shrink” or decrease the size of the liver, which is assumed to have accumulated fat cells on severely overweight and obese patients. By having a normal-sized liver, the bariatric surgeon can have a better look at the organs since it’s right next to the stomach.
Certain medications like NSAIDs and substances such as tobacco will also be prohibited in preparation for the surgery. Your bariatric surgeon can provide more information about these.
What happens during gastric bypass surgery?
The Roux-en-Y gastric bypass surgery, which takes around two to four hours, almost always uses minimally invasive techniques such as laparoscopic and robotic techniques. During the gastric bypass procedure, the bariatric surgeon will begin by making four to six small incisions in the abdominal area. The surgical instruments and a camera will be inserted into these incisions to access the stomach.
This procedure has two major steps: creating the pouch and bypassing the stomach and small intestine. The first step reduces the capacity of your stomach by using surgical staples to divide your stomach into a smaller top portion and a larger bottom portion. The smaller top portion, about the size of an egg, will be the new pouch where any food you eat will be stored.
The second step connects the bottom portion of the small intestine (jejunum) to a small hole in your new pouch. From the pouch, the food you eat will travel through the small opening into the small intestine. In the end, the digestive juices from the bypassed stomach will pass through the top portion of the small intestine to eventually mix with the food.
What to expect after gastric bypass surgery?
Immediately after a gastric bypass operation, patients are expected to stay in the hospital for two to three days. You will be subjected to a clear liquid diet for the next two weeks, and you may start to walk around the room after a few hours.
After two weeks, you will start a special diet plan that transitions slowly to pureed foods, soft foods, and regular healthy foods. Your bariatric surgeon and nutritionist will explain any food and medication restrictions as well as the limits on how much you can eat and drink.
As a result, you absorb fewer calories and nutrients, so it’s highly recommended to take vitamin and mineral supplements to ensure that you’re getting enough vitamin B12, iron, and calcium.
In the first few months of recovery, you will be required to have frequent medical check-ups to monitor your health and weight loss progress. For reference, most patients lose 60 to 80% of excess weight within the first 12 to 16 months. Our team at Beltline Health will work with you to ensure that your recovery is as smooth as possible.
Since most gastric bypass procedures are performed laparoscopically and robotically, the complication rates are relatively low. Many patients return to their normal daily activities after two to four weeks. During the first three to six months after the major surgery, you may experience any of these normal symptoms as you lose weight:
body aches
fatigue
feeling cold, as if you have a flu
dry skin
hair thinning and hair loss
sudden mood changes
Depending on the situation, it might take around four weeks before you can return to your normal workout routine. It takes about two to three months for patients to recover from gastric bypass surgery. During those times, our team at Beltline Health will provide you with personalized health and mental support before and after your bariatric surgery to ensure successful and sustainable weight loss.
What are the advantages of gastric bypass surgery?
Gastric bypass surgery, typically performed laparoscopically or robotically, has been proven to have low complication rates, minimal post-surgical pain, shorter hospital stay, and faster recovery.
Other advantages are:
may improve weight-related medical problems like type 2 diabetes, hypertension, high cholesterol, gastroesophageal reflux disease, and sleep apnea
may be a suitable weight loss surgery procedure for patients with severe obesity
may be performed in patients with high-risk and complicated medical conditions
may improve symptoms of depression and anxiety
may offer positive short-term and long-term weight loss results
does not require placing a foreign object inside the body
What are the disadvantages of gastric bypass surgery?
Even as the second most common weight loss surgery procedure, gastric bypass surgery is a non-reversible procedure that carries more risks than sleeve gastrectomy. Some potential complications are:
nutritional deficiencies
pouch stretching
blood clots
internal bleeding
stomal stenosis (narrowing of stomach-small intestine connection)
bowel obstruction
“dumping syndrome” (rapid gastric emptying)
gallstones
leaks in your gastrointestinal tract
hypoglycemia (low blood sugar)
stomach or intestines perforation
ulcers
How much weight can you lose with gastric bypass surgery?
Gastric bypass surgery has been proven to be one of the most effective weight loss surgery procedures worldwide. Based on our gastric bypass patients’ experiences, they typically lose about 60% of their excess body weight within 18 months of the procedure.
Many clinical trials suggest that many patients lose weight quickly after the surgery until 18 to 24 months after the procedure, especially with patients with higher initial BMI. In some studies, patients maintain as much as 60% of excess weight within 14 years after surgery when combined with regular exercise and a balanced diet.
At Beltline Health, we offer the best surgical weight loss options that fit your needs to help you achieve a healthy weight loss and resolve any health conditions associated with obesity. Our team of experienced health professionals will guide you through the bariatric surgery process in detail, as well as the lifelong changes you would need to adopt to prevent weight gain.
If you’re interested to know more about weight loss surgery, register for our free weight loss seminar to get started. You may also check our article where we detail the different types of bariatric procedures we offer. For inquiries, head on to our website to message us or call us at (470) 419-4380.
