Gastric bypass surgery is a procedure designed to help individuals with severe obesity lose weight by altering the digestive system.
The most common type is the Roux-en-Y gastric bypass. This procedure changes the way your stomach and small intestine handle the food you eat, leading to significant weight loss and helping to treat obesity-related health conditions.
Bariatric surgeons at WashU Medicine
Our bariatric surgeons are part of a weight loss team committed to helping people take charge of their health. We see patients at convenient locations in St. Louis, and we work with nutritionists, psychologists, and others to provide the care you need in a nationally accredited program.
Types of gastric bypass surgery
Open surgery
- Procedure: A large incision is made in the abdomen to access the stomach.
- Recovery: Longer recovery time, more pain, and a higher risk of complications compared to minimally invasive methods.
Laparoscopic surgery
- Procedure: Several small incisions are made, and a laparoscope (a small camera) is used to guide the surgery.
- Benefits: Less postoperative pain, shorter hospital stay, quicker recovery, and lower risk of infection.
Robotic surgery
- Procedure: Similar to laparoscopic surgery but performed with robotic arms controlled by the surgeon, who sits at a console in the operating room with the patient. The surgical robot can offer higher precision than laparoscopic surgery in many cases.
- Benefits: Greater precision and flexibility, potentially enhanced recovery times, and reduced risk of complications.
Who is a candidate for gastric bypass surgery?
Body mass index (BMI)
- Severe obesity: Ideal candidates usually have a BMI of 40 or higher.
- Obesity-related health conditions: Candidates may qualify with a BMI of 35 or higher if they have obesity-related health conditions such as type 2 diabetes, hypertension, or sleep apnea.
Learn more about obesity>>
Additional criteria
- Failed weight loss efforts: Individuals who have tried and failed to lose weight through diet, exercise, and possibly medications.
- Commitment: Candidates must be committed to making significant lifestyle changes, including dietary adjustments and regular follow-ups.
- Overall health: Suitable candidates should be in good overall health to withstand surgery and recovery.
- Age considerations: Typically, candidates are adults, though younger patients may be considered in specific circumstances.
Expected weight loss
Patients can typically expect to lose 60-80% of their excess body weight within the first 12-18 months after surgery. Weight loss continues as patients adhere to dietary guidelines and incorporate regular physical activity.
Post-surgery diet and lifestyle
After surgery, you will have to make adjustments to your eating habits and lifestyle. Some changes are for a short time right after surgery, while others are lifestyle changes that you will need to continue for the rest of your life after surgery. Below are some common recommendations your doctor might provide. Be sure to follow any instructions as provided by your health care team.
Read more: What does a day of eating look like after bariatric surgery?
Immediate post-surgery diet
- Phase 1: Clear liquids for the first few days to prevent dehydration and facilitate healing.
- Phase 2: Gradual introduction of pureed foods, protein shakes, and specific nutrient supplements.
- Phase 3: Soft foods after about 3-4 weeks as the stomach begins to tolerate more textures.
- Phase 4: Introduction of solid foods, usually after around 2 months, but in smaller portions to accommodate the smaller stomach size.
Dietary guidelines
- High-protein diet: Emphasize protein to aid healing and maintain muscle mass.
- Hydration: Drink plenty of fluids but avoid drinking 30 minutes before and after meals to prevent overfilling the stomach pouch.
- Vitamins and supplements: Regular intake of vitamins and minerals such as Vitamin B12, iron, calcium, and daily multivitamins to prevent deficiencies.
- Eating habits: Smaller, frequent meals, chewing food thoroughly, and avoiding high-sugar, high-fat foods to prevent dumping syndrome (rapid emptying of stomach contents).
Long-term dietary and lifestyle changes
- Incorporate regular exercise into daily routines to maintain weight loss and overall health.
- Continue focusing on a balanced and healthy diet, emphasizing nutrient-rich foods.
- Avoid high-calorie, high-fat, and high-sugar foods and beverages.
Follow-up care
- Regular check-ups: Scheduled follow-up visits to monitor progress, nutritional status, and address potential complications.
- Support groups: Participation in support groups for emotional support and practical advice.
Potential risks and complications
Common risks
- Infection: Risk of infection at the surgical site.
- Bleeding: Minimal bleeding at the incision sites.
Specific complications
- Dumping syndrome: Rapid emptying of stomach contents causing nausea, vomiting, and diarrhea, typically when high-sugar foods are consumed.
- Nutritional deficiencies: Risk of deficiencies requiring lifelong supplementation.
- Hernia: Risk of developing abdominal hernias post-surgery.
- Stomal stenosis: Narrowing of the connection between the stomach and small intestine, which may require intervention.
Rare complications
- Blood clots: Risk of developing blood clots in the legs or lungs.
- Adverse reactions to anesthesia: Rare complications related to anesthesia.
Gastric bypass surgery is a significant step toward weight loss and improved health for individuals struggling with severe obesity. Understanding candidate criteria, expected outcomes, dietary guidelines, and the importance of post-surgery care is crucial for long-term success. If you are considering gastric bypass surgery, consult with a health care professional to explore this option and determine the best approach for your specific situation.
