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Weighing the Pros and Cons of Gastric Bypass

Weighing the Pros and Cons of Gastric Bypass

There are several types of weight-loss surgeries if you are looking to lose a significant amount of weight. One of the most common procedures is gastric bypass surgery. Bariatric surgeons and patients often choose this procedure because it has a high success rate for helping people meet their weight loss goals. However, it does entail making significant alterations to your digestive tract. As with any surgical procedure, there are pros and cons to having gastric bypass. Let's weigh the pros and cons of gastric bypass surgery.

Quick Overview of Gastric Bypass Surgery

To understand the gastric bypass pros and cons, it is crucial to understand what the procedure entails. Gastric bypass, formally known as Roux-en-Y, is a two-part surgical procedure.

The first part of this procedure involves reducing the stomach's size so that a small pouch forms in the organ's upper section. Generally, this pouch is about the size of an egg. The stomach is stamped into this smaller shape so that it severely restricts the volume of food you can eat at one time.

The second part of the surgery involves attaching the new stomach pouch to the small intestine's 'Roux' limb. This new attachment forms a 'Y' shape, hence the name of the procedure. A large portion of the small intestine is bypassed so that so you cannot absorb as many calories and fats from your meals. Consequently, you also cannot absorb essential vitamins and minerals, which can be problematic down the road.

Gastric bypass is performed in a hospital and usually requires at least one overnight stay.

A bariatric surgeon performs this surgery in the hospital, and it usually requires at least one overnight stay following the procedure. In the past, a surgeon had to make a large surgical incision to perform this procedure. Now, most Roux-en-Y procedures are laparoscopic, meaning that there are only tiny incisions in the abdomen. In some cases, laparoscopic surgery is not an option, so some people may still need an open incision.

Pros of Gastric Bypass Surgery

People who are overweight and obese are at risk for health complications, including:

  • Type II Diabetes
  • Heart disease
  • Sleep apnea
  • Hypertension
  • Gallbladder disease
  • Osteoarthritis
  • Stroke
  • High cholesterol

Losing excess weight can significantly decrease your risk for these health conditions, and in some cases, weight loss can treat the condition. For example, people who have gastric bypass and type II diabetes may no longer struggle with blood sugar control following weight loss.

Some people find their diabetes goes into remission after gastric bypass.

Highly Effective at Helping People Lose Weight

Gastric bypass can help people lose 60-80% of their excess weight. Indeed, it is one of the most popular WLS options because it often leads to successful long-term weight loss. Sometimes, patients can hit a weight loss plateau after gastric bypass, but most people can continue to lose weight with diet and lifestyle changes.

Reduces Cravings for High Fat, High Sugar Foods

Gastric bypass not only changes your digestive anatomy but alters your gut hormones, which helps control craving sensations. Studies suggest that post-gastric bypass patients find their cravings more controllable following surgery.

Decreases Your Tolerance For Certain Foods

Along with reduced cravings, people often no longer want to eat high fat, high-sugar foods because they wreak havoc on the digestive system. The small intestine is the primary place for fat absorption, but because it bypasses most of the small intestine, people often have unfavorable results when eating fatty foods. For example, high-fat meals can lead to dumping syndrome.

People often find their cravings change following sugary, making it easier to adopt a healthier diet.

May Be Reversible

Gastric bypass can be reversible. However, the procedure to reverse it often is greater than the original procedure, and it can carry further risks. People usually choose to have revisional surgery for the following reasons:

  • Poor weight loss or regaining weight
  • Complications from the original procedure

Cons of Gastric Bypass

The Risk for Nutritional Deficiencies

Perhaps the biggest risk factor of gastric bypass is developing vitamin and mineral deficiencies. Because much of the small intestine is bypassed, it is difficult to absorb all of the essential nutrients you need to support a healthy body. Furthermore, because you can only eat a small number of calories due to your stomach's volume restrictions, it further challenges your body.

You will need to take vitamins for the rest of your life to avoid nutrient deficiencies.

While nutrient deficiency is not the goal - calorie restriction is a goal of gastric bypass to lose weight. With a personalized vitamin regimen, you can get all of the nutrients you need following gastric bypass, thus preventing nutritional deficiency.

Intra-Op and Post-Op Complications

All bariatric surgeries carry similar complications that can arise during and after the procedure. Indeed, with any surgical procedure, there is a risk for:

  • Blood clots developing in your legs (DVT, or deep vein thrombosis) or lungs (PE, or pulmonary embolism)
  • Hemorrhage
  • Infection at the incision site
  • Side effects and complications from having general anesthesia
  • Leak, intra-abdominal infection

Longer Recovery Period Compared to Other WLS Options

Because gastric bypass is a highly involved, two-part surgical procedure that significantly alters your digestive anatomy, your recovery time will be longer than other surgical procedures. Firstly, you will likely need to spend 1-2 nights in the hospital to make sure you can keep liquids down and no complications arise. It can then take about four to six weeks to get back to your normal abilities as far as activity and exercise.

Part of the recovery period also involves dietary changes, which can take some time to adjust to, including transitioning from liquids to pureed foods. Keep in mind: most bariatric surgeries require that you slowly advance your diet to solid foods over the first two months.

Sensitivity to Alcohol

The absorption and metabolism of alcohol are much faster in people with gastric bypass, meaning that you are more likely to feel the effects of drinking more quickly and with less alcohol content in your system. In general, it is best to avoid alcohol altogether following gastric bypass, as even one small glass of wine or champagne can have severe effects on your system. Not to mention, alcohol is high in calories and sugar.

Dumping Syndrome Is More Likely

Dumping syndrome is an unpleasant complication of bariatric procedures, especially gastric bypass surgery. In this condition, food literally gets "dumped" into your small intestine from your stomach without enough time for digestion.

You can experience early dumping or late dumping.

  • Early dumping occurs 10-30 minutes following a meal and can include nausea, vomiting, diarrhea, and cramping.
  • Late dumping occurs 1-3 hours after a meal and can include sweating, fainting, heart palpitations, and tremors.

Sagging Skin

One of the main reasons for undergoing this bariatric procedure is to help you lose significant weight. However, when people lose excess weight, they are often left with sagging skin. Generally, this skin does not "go back" without the aid of a cosmetic procedure. Thus, some people will need additional surgery to remove their excess skin down the road.

If you consider any type of weight loss surgery, it is important to weigh the pros and cons. As with any procedure, there will be risks. However, there are also risks in not losing excess weight. To learn more about the pros and cons of gastric bypass and learn about your unique risk factors, meet with your bariatric surgeon.

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Julia Rae Walker, RN, BSN, BA

Author

Julia is an experienced critical care nurse with a background in pediatric and adult patient populations. Her passion is helping patients maximize their quality of life.

Gintas Antanavicius, MD, FACS, FASMBS

Medical Reviewer

Dr. G is a co-founder of BariBuilder. A US-based expert surgeon with over 10 years of bariatric experience, he regularly publishes research in medical journals like SOARD, Obesity Surgery, etc.