If you’ve tried everything under the sun to lose weight but to no avail, then gastric bypass might be the solution for you. However, before you hurry into the surgery room, you need to meet certain criteria to be eligible. This guide explores the necessary qualifications and what you can expect from different steps of the process.
What is Gastric Bypass?
Gastric bypass, also known as Roux-en-Y gastric bypass (RYGB), is a surgical procedure that aims to help patients lose excessive weight. It works by reducing the stomach size and rerouting the small intestine to limit the amount of food consumed and the number of calories absorbed.
The procedure is often recommended for patients with a body mass index (BMI) of 40 or higher, or 35 or higher with co-morbidities like type 2 diabetes, high blood pressure, joint pain, or sleep apnea.
Types of Gastric Bypass
This type of surgery is performed by making a large incision in the abdomen to access the stomach and intestines. It often requires a longer recovery period than other types of gastric bypass surgeries.
This type of surgery is done through small incisions that allow a tiny camera and instruments to enter the abdomen. The surgeon accesses the stomach and intestines by using the camera to guide them. Laparoscopic surgery often results in a shorter recovery period and less scarring compared to open surgery.
This type of surgery is performed using a robotic arm to control the instruments inserted into the abdomen. Robotic surgery is less invasive than open surgery, and it can also result in less scarring and blood loss. However, robotic surgery may not be suitable for all patients.
The Qualifications for Gastric Bypass Surgery
BMI and Weight Loss Attempts
The first criterion for qualifying for gastric bypass surgery is having a BMI of 40 or higher, or 35 or higher with co-morbidities. The BMI is calculated by dividing weight (in kilograms) by height (in meters squared). A BMI of 30 or higher is considered obese.
In addition to the BMI, patients should have tried to lose weight through lifestyle changes like diet and exercise, and weight loss treatment like medication without success. This requirement shows that the patient has made adequate efforts to lose weight other than surgery and that gastric bypass is the last resort.
Age and Health Status
Patient age is not a strict criterion for gastric bypass surgery. However, the patient must be in good health and fit enough to undergo surgery. Some health conditions may make surgery too risky. Before surgery, patients undergo a comprehensive medical and psychological evaluation to determine whether gastric bypass is safe and appropriate for them.
Dietary and Lifestyle Changes
After surgery, patients must adhere to strict dietary and lifestyle changes to achieve and maintain weight loss. Patients must follow the advice of their healthcare providers and dietitians, exercise regularly, and avoid high-calorie foods and drinks to prevent weight regain or complications.
The Gastric Bypass Process
The Initial Consultation
The first step in the gastric bypass process is to schedule an appointment with a qualified bariatric surgeon. The surgeon will examine the patient’s health history, current health conditions, BMI, and weight loss attempts to determine whether the patient is a good candidate for the surgery.
Preliminary Medical Tests
If the surgeon deems the patient eligible, they will undergo several tests, including blood work, electrocardiograms, X-rays, and endoscopy. These tests help the surgeon ascertain the patient’s overall health status and identify any potential complications that can arise during the surgery.
Preparation for Surgery
Patients must undergo preoperative preparation to ensure that they are healthy enough for surgery. They will need to follow specific preoperative diets and abstain from smoking and alcohol for at least two weeks before the surgery.
Gastric bypass is performed under general anesthesia, which means the patient will be unconscious during the procedure. The surgeon will make small incisions in the abdomen to access the stomach and intestine, and then reroute part of the intestine to create a small pouch in the stomach. The procedure may take between 2 to 4 hours to complete.
After surgery, patients will need to stay in the hospital for two to three days to monitor their recovery. Patients can resume work and other activities after they get the green light from their healthcare providers. However, patients must follow a liquid diet for several weeks before they can start consuming solid foods.
Long-term Follow-up Care
Patients must attend regular follow-up appointments after surgery to monitor their health, weight loss progress, and potential complications. These appointments also help healthcare providers offer better support and guidance during the postoperative recovery process.
Benefits of Gastric Bypass
- Effective Weight Loss: Gastric bypass can help patients achieve significant weight loss and may also reduce the risk of developing obesity-related health issues like type 2 diabetes or cardiovascular disease.
- Improved Quality of Life: After surgery, patients often report fewer instances of joint pain, better sleep quality, and an overall improvement in mood and emotional well-being.
- Lower Costs: Although gastric bypass surgery is pricey, it can save patients money in the long run by eliminating the need for expensive medical treatments associated with obesity-related illnesses.
Risks and Complications of Gastric Bypass
- Bleeding: Bleeding around the surgical site or in the digestive tract
- Infections: Wound or pneumonia infections after surgery
- Blood Clots: Clots forming in veins and potentially travelling to the lungs or heart
- Obstruction: Food may get caught in the new digestive pathway causing blockages
- Dumping Syndrome: When food passes too quickly from the stomach into the small intestine, causing cramps, vomiting, and diarrhea, often relieved by lying down
- Nutritional Deficiencies: As the patient’s digestive pathway becomes shorter vitamin, mineral and macronutrient deficiencies can develop
Gastric bypass is a viable option for patients struggling with obesity and its related health issues. However, it’s crucial to meet the necessary qualifications and understand the process and risks involved. You should always consult with a qualified bariatric surgeon who can guide you through the process and determine whether gastric bypass is the right decision for you.
- How much weight can I lose with gastric bypass?Patients generally can expect 60 to 80% of their excess weight to fall off over two years after gastric bypass surgery. For example, if someone is 100 pounds overweight, they can expect to lose about 60-80 pounds.
- What are the typical costs of gastric bypass surgery?Gastric bypass surgery costs range from $20,000 to $30,000, depending on the surgeon, the type of surgery, and other factors. Most insurance companies cover a portion of gastric bypass cost for eligible patients.
- Can I have gastric bypass if I have previous abdominal surgeries?The answer depends on the extent of the previous surgery and the level of adhesions present. This topic will be discussed with you at your consultation with a bariatric surgeon.
- Can I drink alcohol after the surgery?Patients must avoid drinking alcoholic beverages for at least six months after surgery. Once they do start drinking, they should do so in moderation and avoid carbonated drinks.
- How long will I have to stay in the hospital after the surgery?Patients may need to stay in the hospital for two to three days to ensure that they are stable and there are no complications. Patients will need to be able to walk and consume liquids before they can be discharged.
- Mayo Clinic Staff. (2019, May 23). Gastric Bypass Surgery: What You Need to Know. Mayo Clinic. https://www.mayoclinic.org/tests-procedures/gastric-bypass-surgery/in-depth/gastric-bypass-surgery/art-20046318
- NHS. (2018, December 6). Gastric Bypass. NHS. https://www.nhs.uk/conditions/gastric-bypass/
- Swan, R., Emmett, C., & Scott, J. D. (2019). Gastric bypass. In StatPearls. StatPearls Publishing.