Gastric bypass surgery is performed with the goal of enhancing weight loss. There are multiple different types. There is the classic Roux-en-Y gastric bypass which bypasses and reconnects the connection between the stomach and the small intestine. There is the sleeve gastrectomy which removes about 80% of the stomach that leaves a tube-like pouch that can’t hold as much food. It also reduces the production of a hormone called ghrelin. Ghrelin is a hormone that regulates appetite. The is the biliopancreatic diversion with duodenal switch. This is usually a two-part surgery that takes place all at once. The first part is the sleeve gastrectomy and then there is a second part that involves the closing off of the middle section of the intestine and attaching the main part to the duodenum. This surgery is usually reserved for the folks that have a bmi over 50. There are two other types but these three are the main ones.
Can these surgeries help produce miraculous results? Yes? Can they be long lasting? Yes. Unfortunately, can those awesome effects disappear and reverse over time? Also yes.
There are multiple things to consider before pursuing gastric bypass surgery. There are potential malabsorption and vitamin issue complications. There are potential anemia complications. There is the possibility of having huge leftover rolls of skin that will require additional surgeries with large scars. There is the possibility of initial success with eventual reversion back to obesity, even after undergoing that surgery. Yes, those pouches can be re-stretched eventually with overeating.
So, what kind of things do you have to consider to have long-term success after making such a huge decision? The first thing to consider is that this is a very big decision with lifelong consequences.
You need to realize that this is not the perfect magic wand that you are hoping for that does not require any change on your part. You need to be the person that has actually tried everything to lose weight consistently for at least 6 months. Despite me hearing patients say that a lot, it is not often true or they haven’t been counselled appropriately about the changes that their body would respond to before resorting to surgery.
You need to be psychologically ready to change your relationship with food permanently, BEFORE having the surgery or you are at risk of going back to your same habits and being obese once again. Remember what I said, these pouches can eventually be re-stretched.
Having said all of this, if you do fit that category and have actually tried all the things and have actually changed your mental relationship with food, then I say go for it and good luck to you!
Dr. Katz