What is gastric bypass surgery?
According to the American Society for Metabolic & Bariatric Surgery and the National Institutes of Health, Roux-en-Y gastric bypass (also known as gastric bypass or stomach stapling) is the current gold standard procedure for weight loss surgery.
Gastric bypass surgery
The surgeon creates a small upper section of the stomach, called a pouch, about the size of an egg. The remaining, larger part of the stomach is bypassed, so it no longer holds or digests food. The small portion of the stomach is designed to initially hold less than an ounce.
The small intestine is divided and connected to the new, smaller stomach pouch so food can pass through. The part of the intestine that carries digestive juices from the bypassed stomach is then reconnected about 3 to 4 feet down, forming a Y-shaped connection.
Over time, the digestive juices from the bypassed part of the stomach and the upper small intestine will mix with the food you eat to help with digestion.
How gastric bypass helps with weight loss
The Roux-en-Y gastric bypass procedure is a restrictive and malabsorptive procedure. These surgical changes physically restrict food intake and limit the sensation of hunger.
Like many weight loss surgeries, this procedure creates a smaller stomach pouch that holds less food, helping you eat fewer calories. When your smaller stomach pouch fills with food, it sends signals to your brain to help you feel full and turn off feelings of hunger. It also changes the path food takes through your digestive system, so your body absorbs fewer calories and nutrients from the food you eat.
The very small opening between the stomach pouch and the small intestine limits how fast the pouch can empty. Thus, you feel full after eating only a small amount of food or liquid, and you stay full longer.
Changing the path food takes through your digestive system helps reduce hunger, helps you feel full sooner and supports your body in reaching and maintaining a healthier weight. These changes can also improve hormone and metabolic health, and many people see improvements in Type 2 diabetes even before they start losing weight.
Many, if not most, gastric bypass surgeries are performed using a minimally invasive, or laparoscopic procedure. In comparison to traditional open procedures, this approach offers less pain and discomfort, a quicker recovery, and less scarring. It also reduces the risk of certain complications.
The effectiveness of gastric bypass surgery depends on many factors, including participation in preoperative and postoperative education programs, ongoing support and the age and sex of the patient. The most important success factor is the patient’s commitment to follow recommended guidelines, incorporate healthy eating habits (high-protein, low-sugar and low-fat eating plan) and exercise.
In addition to eating a nutritious diet, patients need to space meals properly. For gastric bypass surgery patients, the small pouch and the rearrangement of the bowel make this procedure easier because they help eliminate hunger pangs and limit the amount that can be eaten at one time. Surgeries are considered successful when patients lose 40 percent or more of their excess weight.
In terms of weight loss, depending on the factors above, most people (around 90 percent), will lose between 50 and 80 percent of their excess body weight. For someone weighing 350 pounds, with an ideal body weight of 150 pounds, this is equal to a loss of 100 to 160 pounds. Most of the weight loss occurs in the first six months; people usually reach a stable weight within 18 to 24 months.
A team committed to your success
At Sentara, your weight loss journey is supported by a full team of experts, including board-certified surgeons, nurses, nurse practitioners, physician assistants, registered dietitians and experienced support staff. Together, they create a personalized, comprehensive program designed to help you succeed.
According to Sentara patient data:
- The average weight loss for patients undergoing laparoscopic gastric bypass surgery is 75 percent.
- All patients who have undergone gastric bypass surgery have lost weight.
- Two years after gastric bypass surgery, 98 percent of patients have lost more than 50 percent of excess weight, with an average of 75 percent of excess weight.
One of the most important benefits of gastric bypass surgery is how it can improve or even resolve other health conditions related to obesity.
For example:
- Type 2 diabetes: About 80–90% of people no longer need diabetes medications within days to months after surgery.
- Acid reflux: Many people experience complete relief from acid reflux.
- High cholesterol: Cholesterol levels often improve and return to a healthier range.
- High blood pressure: Many patients no longer need blood pressure medication.
- Joint pain: As weight is lost, there is less stress on your joints, which can reduce pain and improve mobility.
- Sleep apnea: Airway obstruction is reduced, often curing sleep apnea and improving sleep quality.
- Fertility: Some women with fertility challenges see their ovulation cycles return to normal, making pregnancy possible.
Gastric bypass surgery is more than a weight loss tool; it can help you improve your overall health and quality of life, allowing you to live more actively and comfortably.
No. Gastric bypass surgery should be considered permanent.
- Considered a reliable and long-lasting weight loss
- Effectively relieves many obesity-associated conditions
- Newer techniques are more refined and standardized
- Cutting and stapling of the stomach and bowel is required
- More operative complications than with the gastric band
- A portion of the digestive track is bypassed, reducing the absorption of essential nutrients
- Complications due to malabsorption are reported
- It is not adjustable
- Higher mortality rate than the gastric band
- Patients must avoid non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen
What are some of the possible complications of gastric bypass surgery?
- Over one-third of the people who have gastric bypass develop gallstones. Your surgeon will review this possibility with you and discuss ways to prevent or treat the issue.
- People who have had this surgery are more likely to develop liver problems.
- Between 10% and 20% require a second surgery to repair a complication. The most common complication is a hernia.
- It is possible for the staples to pull loose (so there is no longer a pouch).It is possible for a leak to occur from the stomach or intestine into the abdominal cavity. This will result in a serious infection called peritonitis.
- There is a very small risk of death from the surgery. About 1 in 2,000 (0.5%) people die from the surgery.
- Other risks associated with major surgery include infection in the incision, an abscess inside the abdomen, deep vein thrombosis and pulmonary embolism.
There may be other complications; be sure to discuss your concerns with your weight loss surgeon.
The cost of weight loss surgery can vary depending on your individual health needs and the type of surgery you have. While a typical range for surgery is around $17,000 to $26,000, insurance may cover part or all of the cost. Co-pays for pre-surgery labs and other testing may be required and can also impact the cost of surgery.
At Sentara, we recognize that understanding the financial aspects of surgery can be overwhelming. Our weight loss surgery team will work closely with you and your insurance provider to check your coverage, explain what is required for approval, and help you understand any out-of-pocket costs you might have.
If your insurance plan covers weight loss surgery, we will provide the necessary medical documentation and work directly with your insurance company to support the approval process. While your insurance provider makes the final decision on payment, our team will guide you every step of the way to help you feel informed and prepared.
After gastric bypass surgery, you will need to follow specific dietary guidelines for several weeks to help your body heal and adjust to your new stomach size. Over time, you will gradually transition back to a wider variety of foods; however, you will need to continue making healthy eating choices in the long term to support weight loss and maintain your overall health.
Lifestyle changes are an important part of your journey. Staying active, making nutritious food choices and attending regular follow-up appointments will help you achieve lasting success.
Many patients find it helpful to join a support group to connect with others who understand the challenges and victories that come with weight loss surgery. Support groups can give you encouragement and a safe space to talk about personal, family or work-related concerns during your journey.
Ask your weight loss surgery team about support groups and additional resources that can help you stay motivated and on track as you build a healthier life.
It’s important to remember that weight loss surgery is a tool to help you on your journey to better health. If used incorrectly or not at all, the weight will return. In other words, the pouch can be "beaten." Like any tool, it works best when used correctly and consistently, alongside healthy eating and lifestyle habits. If these habits aren’t followed, weight regain can happen over time.
After surgery and over time, the small stomach pouch created will gradually stretch and may be able to hold more food. Certain habits, like frequent snacking or drinking high-calorie beverages, can cause the pouch to stretch more quickly. This is why following the dietary guidelines provided by your Sentara care team is so important.
As the pouch and the opening to the small intestine enlarge over time, food may pass through more quickly, which can trigger feelings of hunger. This is a normal part of your body adjusting, and it’s why developing healthy, mindful eating habits early on is key for lasting success.
We expect that during the first two years after surgery, you will develop and adopt new, healthier eating habits. Most patients find that once they have made these changes, they can maintain them for life and continue to manage their weight, even if hunger returns.
If weight regain happens, it does not mean you have failed. Many people can get back on track by returning to the healthy habits learned after surgery and using the pouch as a tool to support weight management again. Our team is here to help you every step of the way, providing guidance and support whenever you need it.