Weight Loss Articles
Gastric Bypass - A Closer Look
January 1, 2008
It would be easy to assume that gastric bypass - the best-known of the bariatric (weight-loss) surgeries, commonly known as “stomach-stapling” - is a viable option for anyone looking to lose a few pounds. After all, Star Jones had it.
But gastric bypass procedures (GBPs) aren’t trivial or for the faint-of-heart (nor the slightly overweight). And in a country increasingly concerned with obesity and image, it’s indeed easy to imagine that dozens of men and women, looking for the newest weight-loss secret, would go blindly seeking a doctor willing to staple their guts.
Not that most would be eligible for the surgery. Gastric bypasses, as invasive, dangerous procedures, aren’t simply handed out by nutritionists and dieticians. You’ll need to qualify, and that means you’ll have to pass a few tests:
If, in the end, you’ve qualified, there are still major considerations. Gastric bypass, unlike some other bariatric procedures, is irreversible - once you’ve stapled your stomach, there’s no going back. That’s a concern, because gastric bypass procedures permanently alter your anatomical functions. Once you've had the surgery, there's no going back.
"Stomach stapling" is, in a way, a misnomer - while the stomach is reduced to about 35% of its original size, the "bypass" part refers to the bypassing of a significant section of the small intestine. The surgery, like many bariatric procedures is classified as restrictive (the smaller stomach means you’ll eat less, and feel full faster). Unlike most other procedures, it's also malabsorptive - because the small intestine is partly being skipped, less of that ingested food is being properly absorbed, meaning less fat and calories, but also fewer nutrients.
Possible complications from the surgery are numerous, and the death rate can be as high as one in twenty in men aged 35 to 54. As you get older, the rate goes up.
And, after the one- to three-month recovery from the surgery, you’ll need to adhere to a strict diet. While nearly all gastric bypass procedures lead to a huge loss of excess weight (60 to 80%), you can gain that weight back if you’re not careful. A gastric bypass procedure isn't a final solution, nor does it come with a guarantee.
None of which is to say the surgery isn’t effective - there’re dozens of studies indicating that gastric bypass drastically decreases the number of deaths related to obesity in patients, and, if you can change your lifestyle to suit the procedure, you can live a healthy, normal life.
But gastric bypass isn’t the new Atkins diet, or even South Beach. If you’re looking to lose twenty pounds to fifty pounds or less, you should be looking elsewhere. Gastric bypass is a serious and complicated surgery. It becomes an option only when it becomes necessary.
If you're looking to lose weight, diets don't work, and the permanent plunge of gastric bypass is a little daunting, there are other bariatric procedures that are safer and still effective. Probably the safest is gastric banding, where an adjustable implant is placed around the stomach. Like gastric bypass and gastroplasty, it's restrictive, but unlike many other procedures, it’s also adjustable and reversible.
But gastric bypass procedures (GBPs) aren’t trivial or for the faint-of-heart (nor the slightly overweight). And in a country increasingly concerned with obesity and image, it’s indeed easy to imagine that dozens of men and women, looking for the newest weight-loss secret, would go blindly seeking a doctor willing to staple their guts.
Not that most would be eligible for the surgery. Gastric bypasses, as invasive, dangerous procedures, aren’t simply handed out by nutritionists and dieticians. You’ll need to qualify, and that means you’ll have to pass a few tests:
- First up, is your body mass index 40 or higher? If not, you can’t have gastric bypass. Those with a 40+ BMI are considered “morbidly obese,” and gastric bypass procedures are designed specifically for these individuals; occasionally there are exceptions made for those with a BMI of 35 to 40 if they’re living with what’s called a “comorbidity” - a life-threatening complication due to obesity. Other bariatric surgeries, such as sleeve gastrectomy or laparoscopic banding, can be used in the case of simple obesity, or for those considered overweight.
(If you don’t know your BMI, you can have it measured by a doctor or specialist, or try an online calculator or similar service. As an example, if you’re 6’0”, and weigh 200 pounds, you have a BMI of around 27. If you’re the same height and weigh over 300 pounds, you’re nearer the 40 mark.) - The second requirement: a complete medical evaluation and analysis of your overall health. If your body’s not prepared for general anesthesia and a few hours under the knife, you’re out.
- Requirement number three: pass the psychological tests. These are administered to see if, A) you’ve made attempts to lose weight and change your lifestyle prior to the procedure, B) you’ll be ready to live healthy afterwards, and C) there are any possible dangers of relapse or emotional complication from the surgery. In addition, many doctors won’t treat you if you have a history of depression or a psychiatric disorder.
- So, you’ve passed the weight requirement, the mental and physical tests. You’re eligible right? Maybe. Depends on the doctor. Have you been obese for less than five years? Do you have a history of alcohol or drug abuse? Are you under 18, or over 65? If you’ve answered yes to any of those questions, chances are you’re out.
If, in the end, you’ve qualified, there are still major considerations. Gastric bypass, unlike some other bariatric procedures, is irreversible - once you’ve stapled your stomach, there’s no going back. That’s a concern, because gastric bypass procedures permanently alter your anatomical functions. Once you've had the surgery, there's no going back.
"Stomach stapling" is, in a way, a misnomer - while the stomach is reduced to about 35% of its original size, the "bypass" part refers to the bypassing of a significant section of the small intestine. The surgery, like many bariatric procedures is classified as restrictive (the smaller stomach means you’ll eat less, and feel full faster). Unlike most other procedures, it's also malabsorptive - because the small intestine is partly being skipped, less of that ingested food is being properly absorbed, meaning less fat and calories, but also fewer nutrients.
Possible complications from the surgery are numerous, and the death rate can be as high as one in twenty in men aged 35 to 54. As you get older, the rate goes up.
And, after the one- to three-month recovery from the surgery, you’ll need to adhere to a strict diet. While nearly all gastric bypass procedures lead to a huge loss of excess weight (60 to 80%), you can gain that weight back if you’re not careful. A gastric bypass procedure isn't a final solution, nor does it come with a guarantee.
None of which is to say the surgery isn’t effective - there’re dozens of studies indicating that gastric bypass drastically decreases the number of deaths related to obesity in patients, and, if you can change your lifestyle to suit the procedure, you can live a healthy, normal life.
But gastric bypass isn’t the new Atkins diet, or even South Beach. If you’re looking to lose twenty pounds to fifty pounds or less, you should be looking elsewhere. Gastric bypass is a serious and complicated surgery. It becomes an option only when it becomes necessary.
If you're looking to lose weight, diets don't work, and the permanent plunge of gastric bypass is a little daunting, there are other bariatric procedures that are safer and still effective. Probably the safest is gastric banding, where an adjustable implant is placed around the stomach. Like gastric bypass and gastroplasty, it's restrictive, but unlike many other procedures, it’s also adjustable and reversible.