Gastric Bypass
What is gastric bypass?
A laparoscopic Gastric bypass often called a “Roux en Y” gastric bypass, is a weight loss surgery that involves bypassing most of your stomach. Dr. Fermelia creates a small pouch from the upper part of the stomach and bypasses the lower stomach. No part of the stomach is removed. The small intestine is connected to the pouch in a “Y” shaped configuration that separates the food stream from the digestive enzymes. The enzymes and the food are brought together to allow absorption of ingested calories.
The gastric bypass is NOT a malabsorptive procedure. This is a common misperception, even by some medical professionals. The Roux en Y gastric bypass allows the calories ingested to be absorbed. There is not a risk of protein or other calorie malabsorption due to the procedure. There is no diarrhea associated with this operation. This connection does cause a very effective durable change in your metabolism.
Gastric bypass surgery offers effective long-term weight loss by restricting the amount of food your stomach can hold AND by changing your metabolism. Dr. Fermelia makes a stomach pouch out of the stomach and bypasses about 3/4 of the stomach. The remaining stomach remains in place and continues to supply gastric acid and mucous to the digestive tract. The new stomach is considerably smaller than your natural stomach, allowing you to consume smaller meals and fewer calories, yet still, be satisfied. Long-lasting metabolic changes are created by changing the way gastrointestinal hormones respond to the food you eat.
How does a gastric bypass work?
Once Dr. Fermelia has reduced the size of your stomach, the new pouch holds a much smaller volume of food, ensuring you can only consume a certain amount of calories each time you eat. You will be satisfied with a very small meal. The procedure prevents “binge eating” by decreasing hunger and limiting the amount one can eat at a time. The gastric bypass significantly alters the gastrointestinal hormones in your gut to control your blood sugar, your feelings of hunger, and your fullness after eating.
The best example of the gastrointestinal hormone change is the hormone Ghrelin. Ghrelin is the main hunger hormone and stimulates hunger. It is made primarily in the part of the stomach that is bypassed. Bypassing this part of the stomach has been proven to drastically reduce this hunger-stimulating hormone. Gastric bypass also changes a number of other GI hormones that promote weight loss and satiety (hunger satisfaction).
The gastric bypass has been proven over and over again that it is effective in helping you manage or prevent medical conditions like type 2 diabetes and other health issues influenced by obesity. Many of these comorbidities of severe obesity go into remission.
What are the benefits of gastric sleeve surgery?
By restricting the amount of food you can put into your stomach, the gastric sleeve can provide you with fast and significant durable weight loss. The great thing is that you will feel satisfied after a small meal. Additionally, sleeve surgery impacts the hormones that control your appetite and hunger. You can feel fuller eating less, while still dropping a considerable amount of weight. There is a very impressive “rapid weight loss” period that occurs especially in the first 6-9 months after metabolic surgery. Patients typically lose 60 to 70% of their excess body weight in the first 6-9 months. Dr. Fermelia will work with you to use this period to change the way you approach food and activity to provide a lasting result. Metabolic changes and clinical durable success is well documented in the medical literature, and in Dr. Fermelia’s experience.
Gastric bypass statistically provides a little more weight loss than a gastric sleeve, up to 10-15%, and provides a somewhat more reliable reversal of severe obesity-related co-morbidities. It may be the right balance of results without being too “radical” compared to malabsorptive procedures (like the duodenal switch).
Gastric bypass is an excellent procedure for gastroesophageal reflux (GERD) and is the procedure of choice for those with severe reflux.
Gastric bypass surgery requires no removal of stomach or intestines and doesn’t rely on foreign devices, like the gastric band, to achieve successful weight loss.
Gastric bypass is a laparoscopic procedure most often done as an overnight stay. It is a proven procedure that is considered safe and effective with several decades of clinical experience. It is considered by many to be the “Gold Standard” of Metabolic Surgery.
Does the gastric bypass have any drawbacks?
The gastric bypass procedure should be considered to be a non-reversible procedure. However, so is your genetic propensity for obesity and the problems associated with obesity nonreversible. You need the lifelong solution that gastric bypass provides. Dr. Fermelia will review your medical history and expectations to help you determine if the gastric bypass is the best way to achieve your goals.
Following a gastric bypass, you are recommended to take a multivitamin, as it may be difficult to eat the quantity and variety of natural sources of important vitamins consuming smaller quantities of healthy foods. We have to make sure that you take additional vitamin B12 supplements as the bypassed stomach will not be able to provide enough intrinsic factor, which is necessary for absorbing vitamin B12. We should keep track of certain vitamin levels for the rest of your life. Dr. Fermelia provides support and guidance in helping you create a new eating and activity lifestyle to accommodate your smaller stomach and get the nutrients you need. However, to be frank, if you simply eat healthily, the benefits of the gastric bypass will do the rest.
Follow up with Dr. Fermelia will help you optimize your success with your weight loss, helps you to manage your transition in caring for your weight-related medical problems, and helps you avoid post-surgery complications.
To learn more about the weight loss and metabolic benefits of a gastric sleeve, schedule an appointment with Dr. Fermelia today.