Gastric Bypass Surgery And Weight Loss

Gastric bypass (also called bariatric surgery) closes off a​ large portion of​ the​ stomach,​ leaving only a​ pouch the​ size of​ an​ egg. Gastric bypass works by restricting food intake. Patients feel full after eating small amounts of​ food. Fewer calories are eaten and weight is​ lost. Gastric bypass patients typically lose 70% of​ their excess weight,​ most of​ it​ in​ the​ first year after surgery.

Gastric bypass surgery combines the​ creation of​ a​ small stomach pouch to​ restrict food intake and construction of​ bypasses of​ the​ duodenum and other segments of​ the​ small intestine to​ cause malabsorption (decreased ability to​ absorb nutrients from food).

There are two types of​ gastric bypass surgery: Roux-en-Y gastric bypass (RGB) and extensive gastric bypass (biliopancreatic diversion).

Roux-en-Y gastric bypass is​ the​ most common gastric bypass procedure performed in​ the​ U.S. First,​ a​ small stomach pouch is​ created by stapling part of​ the​ stomach together or​ by vertical banding. This limits how much food you can eat. Next,​ a​ Y-shaped section of​ the​ small intestine is​ attached to​ the​ pouch to​ allow food to​ bypass the​ duodenum as​ well as​ the​ first portion of​ the​ jejunum. This causes reduced calorie and nutrient absorption. This procedure can now be done with a​ laparoscope (a thin telescope-like instrument for viewing inside the​ abdomen) in​ some people. This involves using small incisions and generally has a​ more rapid recovery time.

In extensive gastric bypass – a​ more complicated gastric bypass operation - the​ lower portion of​ the​ stomach is​ removed. the​ small pouch that remains is​ connected directly to​ the​ final segment of​ the​ small intestine,​ thus completely bypassing both the​ duodenum and jejunum. Although this procedure successfully promotes weight loss,​ it​ is​ not as​ widely used because of​ the​ high risk for nutritional deficiencies.

Gastric bypass operations that cause malabsorption and restrict food intake produce more weight loss than restriction operations,​ which only decrease food intake. People who have bypass operations generally lose two-thirds of​ their excess weight within 2 years.

There are risks associated with gastric bypass surgery. People who undergo this procedure are at​ risk for: pouch stretching (stomach gets bigger overtime,​ stretching back to​ its normal size before surgery),​ band erosion (the band closing off part of​ the​ stomach disintegrates),​ breakdown of​ staple lines (band and staples fall apart,​ reversing procedure),​ leakage of​ stomach contents into the​ abdomen (this is​ dangerous because the​ acid can eat away other organs),​ nutritional deficiencies causing health problems.

Gastric bypass operations also may cause "dumping syndrome,​" whereby stomach contents move too rapidly through the​ small intestine. Symptoms include nausea,​ weakness,​ sweating,​ faintness,​ and,​ occasionally,​ diarrhea after eating,​ as​ well as​ the​ inability to​ eat sweets without becoming extremely weak. Gallstones can occur in​ response to​ rapid weight loss. They can be dissolved with medication taken after the​ surgery.

The limited absorption of​ vitamin B12 and iron can cause anemia. the​ lack of​ calcium absorption can cause osteoporosis and metabolic bone disease. People who undergo this procedure are required to​ take nutritional supplements that usually prevent these deficiencies. the​ more extensive the​ bypass operation,​ the​ greater is​ the​ risk for complications and nutritional deficiencies. People who undergo extensive bypasses of​ the​ normal digestive process require not only close monitoring,​ but also lifelong use of​ special foods and medications.

Low carbs,​ the​ bottom line: you may lose weight quicker on​ a​ low-carbohydrate diet than on​ a​ diet to​ cut calories. However,​ don't expect to​ lose as​ much weight as​ diet books say you will and remember that the​ risks of​ heart disease,​ stroke,​ cancer,​ and osteoporosis for people on​ low-carb diets have not been tested. There's plenty of​ research that shows the​ way to​ go is​ moderation in​ eating a​ diet rich in​ fruits,​ veggies,​ beans,​ whole grains,​ seafood,​ poultry,​ and low-fat dairy products.

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