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Life After Gastric Bypass Surgery Medical Authors: Angela Generoso and Laura Lee Bloor Staff Writers, MedicineNet.com Medical Editor: William C. Shiel Jr., MD, FACP, FACR As of July 14, 2008, Mara Owens has lost 132 pounds. "I feel amazing; I feel really good about what I’ve done. It takes a while for you to wrap your head around not being as big [anymore]. I still think I won’t fit into that airline seat or [I’ll] take up too much room. But that will come," she says. At 5-foot-5, 272 pounds, Owens underwent gastric bypass surgery, a procedure in which part of her stomach was stapled down to create a small pouch, limiting the amount of food she can eat. A Y-shaped part of the small intestine was attached to the pouch, which lets food bypass the first part of the small intestine and a section of the second part. This results in fewer calories and nutrients taken in altogether. Owens says her decision to undergo weight-loss surgery stemmed from years of research after countless failed diets and exercise programs. She felt she had tried everything that was reasonable in an effort to bring her weight down. "I didn't have high blood pressure yet," she says. "I didn't have diabetes yet. But if I didn't do something soon, I would have it." Read on as Mara awaits surgery »

Introduction

Gastric bypass operations combine 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).

What Types of Gastric Bypass Operations Are There?

• Roux-en-Y gastric bypass (RGB). This operation 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.



• Extensive gastric bypass (biliopancreatic diversion). In this 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.