What is gastric bypass surgery?
How effective is the Roux-en-y gastric bypass procedure?
What are the main differences in Roux-en-y Gastric Bypass and Laparoscopic Gastric Bypass?
Can anyone who is overweight have gastric bypass surgery?
I've had an obesity operation. I lost a lot of weight but some came back. Can something be done?
Is the surgery painful?
How long will I be in the hospital?
Will I miss work for very long?
Can this operation be reversed?
What is the risk of dying from a surgical complication after having the gastric bypass?
Will the obesity operation get me down to normal body weight?
How much weight can I be expected to lose?
After surgery, how fast does the weight come off?
How can I maintain adequate food nutrition and avoid losing too much weight when the capacity for food is so small?
I have been extremely obese most of my life, should I be concerned about the psychological adjustment facing my family or me following a large weight loss?
Are there certain medications that should be avoided after gastric bypass surgery?
What are some reasons a person should not have obesity surgery?

Q. What is gastric bypass surgery?
A. Gastric bypass surgery is a surgical method used to help people with morbid obesity lose weight and reverse other health problems associated with being overweight, such as high blood pressure and Type II Diabetes. The Roux-en-y gastric bypass creates a small pouch in the top of the stomach to which the small intestine is connected. With a smaller stomach, the patient feels "full" sooner and is less likely to overeat. Depending upon what is best for each individual patient, the bypass can be performed as an "open" procedure, or with a minimally invasive technique using laparoscopes.

Q. How effective is the Roux-en-y gastric bypass procedure?
A. The Roux-en-y gastric bypass is the "gold standard" operation for obesity because of permanent, successful weight loss.

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Q. What are the main differences in Roux-en-y Gastric Bypass and Laparoscopic Gastric Bypass?
A. A laparoscopic operation is performed with the aid of a laparoscope, a fiberoptic tube and a light source connected to a small video camera, which allows the visualization of the abdominal organs on a TV monitor. Surgical instruments are inserted through small incisions in the abdominal wall. This is less invasive and reduces pain and the risk of wound complications. Recovery is usually more rapid, shortening the hospitalization.

Laparoscopic operations have been used in general surgery for more than a decade, and the technique is not experimental.

Laprascopic procedures for morbid obesity employ the same surgical principles as in "open" gastric banding, vertical gastroplasties and gastric bypass. The laparoscopic technique must be precise and should vary from open operations only in the size of the abdominal incision. However, these techniques are not free of complications and require special surgical expertise to reduce operative time and other risks.

Not all patients are candidates for this procedure. Accordingly, the American Society for Bariatric Surgery recommends that laparoscopic operations for obesity should be performed only by surgeons who are experienced in both laparoscopic and open bariatric surgery and who understand the complexities of surgical treatment of morbid obesity.

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Q. Can anyone who is overweight have gastric bypass surgery?
A. The surgery is not a cosmetic procedure, but rather, a course of last resort for people who are at least 100 pounds over their ideal weight and have a body mass index (BMI) of over 40. Patients with a slightly lower BMI may be considered for the procedure if they have other obesity-related problems such as Type II diabetes, cardiovascular disease, or sleep apnea, osteoarthritis of weight-bearing joints. Gastric bypass is also generally reserved for patients who have been unable to lose weight through weight reduction programs and exercise.

Q: I've had an obesity operation. I lost a lot of weight but some of it has come back. Can something be done?
A: Patients with this problem come to us frequently. We can usually help, though surgery is sometimes required.

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Q: Is the surgery painful?
A: Using advanced technology and patient-controlled IV pain medication, the discomfort is minimal.

Q: How long will I be in the hospital?
A: Usually two to three days. If they surgery is done laparoscopically, the hospital stay is usually less than 24 hours.

Q: Will I miss work for very long?
A: Most patients are back to work 10 to 21 days after surgery. This is a question you will want to discuss with your surgeon.

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Q. Can this operation be reversed?
A. Yes. The bypass portion of the stomach remains normal.

Q. What is the risk of dying from a surgical complication after having the gastric bypass?
A. Nationally, the risk is about 1 in every 1000 patients in the hands of experienced bariatric surgeons.

Q: Will the obesity operation get me down to normal body weight?
A: The majority of patients get to normal or near-normal body weight.

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Q. How much weight can I expect to lose?
A. Patients who are motivated and follow their surgeonsÂ’ nutrition and exercise guidelines achieve the most weight loss. Patients who fail to reach this level of weight reduction usually have problems with compliance; this includes failure to eat structured meals and continuous snacking of high calorie foods.

Weight loss results will vary according to your starting weight, your compliance, the type of procedure you have and other factors. In a study conducted by Surgical Weight Loss Clinic in Tacoma, patients who had the distal Roux-en-y gastric bypass lost 89 percent of excess weight after five years.

Q: After surgery, how fast does the weight come off?
A: Most patients will lose 100 pounds the first six to 12 months after surgery, depending on how heavy they were at the time of surgery.

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Q. How can I maintain adequate food nutrition and avoid losing too much weight when the capacity for food is so small?
A. The average patient can soon eat about a cup of well-chewed soft food without nausea or distress. Most patients eating three meals per day have no problem maintaining normal caloric intake once they are one year out from surgery. It is very uncommon to lose too much weight.

Q. I have been extremely obese most of my life. Should I be concerned about the psychological adjustment facing my family or me following a large weight loss?
A. Most patients, following major weight loss, have more positive perception of body image and feeling of self worth. There will be adjustments, especially if your friends and family are opposed to your losing a large amount of weight.

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Q. Are there certain medications that should be avoided after gastric bypass surgery?
A. Due to the risk of peptic ulceration patients should avoid chronic use of NSAIDs (non-steroidal anti-inflammatory drugs, e.g. aspirin and aspirin-like drugs). Other safer drugs are available for various types of arthritis for which you can consult your private physician.

Q. What are some reasons a person should not have obesity surgery?
A. Drug and/or alcohol addiction, unstable psychiatric disorder.

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