Roux-en-y Gastric Bypass

GENERAL INFORMATION:

What is it? Roux-en-Y (roo-ahn-Y) gastric bypass is a type of weight loss surgery. It is done to help a severely obese (very overweight) person lose weight. It makes your stomach smaller so that you feel full sooner and cannot eat as much during meals. It also causes malabsorption (mal-ab-SORP-shun). Since part of your stomach and intestines are bypassed, your body will not absorb as many calories from food. However, you may not absorb as many vitamins or minerals (nutrients) either.

How does my body normally digest food?

• Digestion is the body's way of breaking down food so it can be used for energy and growth. Digestion starts when you put food in your mouth. As you chew, enzymes (chemicals that break down food) in your saliva mix with your food.
  
  
• When you swallow, food goes down a tube called the esophagus and into the stomach. Food is mixed with stomach acid and enzymes. This breaks down the food and turns it into a liquid food mass.
  
  
• The food mass goes into the small intestine. The small intestine is the place where your body breaks down and uses most of the nutrients from food. The small intestine has three parts: the duodenum, the jejunum, and the ileum. Food passes through the small intestine before going into the large intestine where digestion is completed.

How is gastric bypass surgery done?

• Your caregiver may do surgery during a laparotomy or during laparoscopic surgery. During a laparotomy, one large incision (cut) is made in your stomach. During laparoscopic surgery, small incisions are made in your stomach. A laparoscope (tube with a camera on the end) and other instruments are put through the incisions.
  
  
• During surgery, caregivers use staples to make a small stomach pouch that is shut off from the rest of your stomach. Then they connect the jejunum (middle part of the small intestine) to the new stomach pouch. When you eat, food "bypasses" the rest of the stomach and goes directly into the jejunum.

When will I begin to lose weight?

• Right after surgery, you will look and weigh about the same as you did before surgery. As you begin your new eating habits, you will begin to lose weight. The amount of weight and the speed at which you lose it depends on certain things. These include how well you follow your diet and exercise plans, how healthy you are, and how much you weighed before surgery. Losing the amount of weight that you want after gastric bypass takes time. It may take 18 to 24 months to reach the weight that is best for you.
  
  
• It is important to follow your weight loss team or caregiver's instructions for the rest of your life. This may include changing your eating habits and lifestyle, taking vitamins and supplements, and going to regular medical appointments.

What is body mass index (BMI)? BMI is a number that describes the type of weight that you have. People with a normal weight have a lower BMI. An overweight or obese person has a higher BMI. Caregivers can learn what your BMI is by knowing your height and weight. Your BMI number will help caregivers decide whether or not you are someone who can have weight loss surgery. You may learn your BMI using the following:

• Multiply your weight (in pounds) by 703. For example, if you weigh 300 pounds, this equals 210900.
  
  
• Multiply your height (in inches) by your height (in inches). If you are 65 inches tall, this equals 4225.
  
  
• Divide the first number (210900) by the second number (4225). This equals 49.9. This is the BMI for a person who weighs 300 pounds, and is 5 feet, 4 inches (65 inches) tall.

Who should have gastric bypass surgery? You may be able to have roux-en-Y gastric bypass or another type of weight loss surgery if:

• Your bariatric caregiver recommends that you have it.
  
  
• You have tried, but have not been able to lose weight or keep weight off. You may have tried exercise, diets, and weight loss medicines.
  
  
• You have a BMI that is one of the following:
  
  
  • BMI greater than 40 (100 pounds or more overweight).
    
    
  • BMI greater than 35, with a life-threatening health problem that is related to being overweight. Examples of these health problems are heart disease, sleep apnea, high blood pressure, and diabetes.
  
  
• Your obesity causes problems with your lifestyle, movement such as walking, or getting or keeping a job.
  
  
• You are willing to change eating habits and make the lifestyle changes needed to lose weight and keep it off. You agree to work closely with a caregiver or weight management team. You understand what will happen during and after weight loss surgery, and you accept the risks.
  
  
• You will need to talk to doctors to learn if you would be able to have bariatric (weight loss) surgery. You will need to meet with a surgeon to talk about weight loss surgeries. The surgeon may ask you to have other exams and tests. For example, you may need to have a psychological (mental) test. You may need to talk with a specially-trained caregiver about your eating habits. Medical records and test results from other caregivers will help the surgeon decide if you should have this surgery.
  
  
• You do not abuse drugs or alcohol.
  
  
• Your obesity is not caused by a problem with your glands.

What are the benefits of gastric bypass surgery?

• Gastric bypass may cause you to lose more weight than with other types of weight loss surgeries.
  
  
• Losing a large amount of weight may decrease or get rid of obesity-related health problems. These problems include diabetes, and problems with your heart, blood pressure, and joints.
  
  
• Losing a large amount of weight may increase a woman's ability to get pregnant.
  
  
• Losing weight may make you feel better about yourself, your body, and life in general.

What are the risks of having gastric bypass surgery?

• You may get an infection or blood clots. You may bleed too much and need a blood transfusion. Body organs including your lungs or spleen may be injured during surgery. After surgery, your stomach incision could open up. Your stomach staple line could break down. The new connections to your stomach and intestines could form scars, narrow areas, or leaks. Stomach juices may leak into your abdomen and you may need emergency surgery. You may develop gallstones or an incisional hernia (weak area near your surgical incision).
  
  
• If you often eat too much, and do not follow instructions, you may stretch out your stomach pouch. If you eat too much, too fast, or do not chew well enough you may have other problems such as feeling sick to your stomach and throwing up. If you eat sweet foods, or foods high in fat, you may get dumping syndrome. You may get acid reflux (heartburn), gas, or a stomach ulcer. Food that is not chewed well enough may get stuck in your stomach or intestines.
  
  
• You may not get enough protein, iron, and vitamins from your diet. This may lead to some hair loss, bone problems, or anemia (blood cannot carry enough oxygen). You may need a second surgery at a later time. As in any surgery, you may even die from complications. The risk of surgery must be compared to the risk of being severely obese. You may lose weight and then gain it back. You may not lose enough weight. If you get pregnant while you are quickly losing weight, this could harm you and your unborn baby.

For support and information: Talk to your caregivers, family, and friends about gastric bypass and weight loss. Let them help you before and after surgery. Join a bariatric support group and begin attending meetings before you go to surgery. This is a group of people who plan to or have already had weight loss surgery. For more information about support groups, obesity and gastric bypass, contact the following:

• American Obesity Association
  1250 24th Street, NW
  Washington, DC 20037
  Phone: 1-202-776-7711
  Web Address: http://www.obesity.org
  

• American Society of Bariatric Surgeons (ASBS)
  100 SW 75th Street
  Gainesville, FL 32607
  Phone: 1-352-331-4900
  Web Address: http://www.asbs.org
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

Link to this page

Printable Version

Email Page