Considering Gastric Bypass Surgery? Important Questions to Ask Yourself
Medical Author: Melissa Conrad Stoppler, MD
Medical Editor: Jay W. Marks, MD
Bariatric surgery refers to surgery performed on the
stomach and/or intestines to decrease the amount of food that can be consumed
and, as a result, to help a person with extreme obesity lose weight. Adjustable
gastric banding and gastric bypass are the two main types of bariatric surgery.
In adjustable gastric banding, a reversible procedure, insertion of a band restricts the size
of the opening from the esophagus to the
stomach. The size of the opening to the stomach determines the amount of food
that can be eaten. Gastric bypass is a permanent reduction in the size of the
stomach in which a small pouch is created from the proximal portion of the
stomach and attached to the intestine in a location that bypasses about 2 feet
of normal intestine. The amount of food that
can be eaten is limited by the size of the pouch and the size of the opening
between the pouch and the intestine.
If you're interested in bariatric surgery (gastric bypass or gastric banding), the following questions can help
you decide if this type of procedure might be of benefit for you.
- How much weight do you need to lose? Bariatric surgery is an option for
people who have a body mass index
(BMI) above 40, indicative of extreme obesity.
Bariatric surgery may also
be considered for people with a BMI between 35 and 40 who have health problems
like type 2 diabetes or heart disease.
- Have you
tried other weight loss methods, such diets and exercise, without success? Have
you tried such methods repeatedly? Bariatric surgery is considered a last-resort
solution for people who are unable to lose weight by any other means.
- Do you
have a serious medical condition? Some people with serious heart or lung
conditions may not be a good candidate for surgery.
- Are your expectations
realistic? Most people who undergo bariatric surgery can expect to lose
two-thirds to three-fourths of their excess weight. However, up to 25% of
bariatric surgeries are not successful, with patients regaining weight by
slowly ingesting high-calorie foods or even eating quantities significant
enough to stretch the stomach pouch after gastric bypass. Another aspect of
extreme weight loss is the problem of excess skin or unattractive fat pockets and the possible
need for plastic surgical procedures to correct these problems.
- Are you
prepared for significant lifestyle changes? Following bariatric surgery, your eating
patterns and practices will change drastically. Extreme attention to diet is
required, and nutritional supplements are necessary. You will have to eat
numerous small portions of food throughout the day rather than large meals.
You may be also asked to stop smoking prior to the surgery or to begin physical
- Are you prepared to undergo the risks of a major
surgical procedure? As with any operation, there are risks and potential side effects of
the procedure. While newer surgical procedures allow for some bariatric
surgeries to be performed through a laparoscope with a
lower rate of complications, about 1% of persons who have had traditional
gastric bypass surgery have died due to medical complications following the
procedure. Others may develop nutritional deficits after the procedure that
lead to conditions such as osteoporosis or anemia.
- Are you in a state of good emotional health?
Psychological screening is used to help determine if
a person is a good candidate for bariatric surgery. For example, people
suffering from depression
or other emotional conditions may be advised to receive treatment for these
conditions before making the decision to undergo bariatric surgery.
- Will your
health plan cover bariatric surgery? The procedures are very expensive, and your
insurer may require you to meet certain conditions before having the procedure
or to demonstrate that other methods for weight loss have failed.
If you want to learn more about bariatric surgery, talk
to your doctor. He or she can refer you to a bariatric surgeon who can help you
decide if this type of procedure is right for you.
REFERENCE: eMedicine, Bariatric surgery. Last Editorial Review: 4/15/2010