The Roux-en-Y procedure, the most common form of gastric bypass surgery, can help obese people lose weight and maintain that weight loss. It is intended for those who have been unsuccessful in losing weight by other methods. The Roux-en-Y procedure is a specific approach in which the stomach is stapled to create a smaller pouch and food is rerouted through a new duct into the small intestine. After surgery, eating patterns must change drastically for weight-loss success.
Background
Obesity has become a major health problem in the United States, and epidemiologists estimate that approximately 12 million Americans struggle with severe obesity. Obesity can cause many serious medical conditions, such as diabetes, cardiovascular disease, sleep apnea and degenerative joint disorders, according to the Cleveland Clinic website.
Gastric bypass surgery comes in several different forms, including permanent stomach reductions and stomach bypass procedures, as well as temporary stomach banding that reduces stomach size, but which can be reversed.
Procedure
In the Roux-en-Y procedure, surgeons separate a small portion of the stomach to form a small pouch. The small intestine is then rerouted to this pouch, bypassing much of the stomach and upper small intestine, which limits the body's ability to absorb calories, according to the University of Maryland website. Physicians can perform this surgery either in standard open form or laparoscopically, using small incisions, under general anesthesia.
Intended Patient Population
People are considered eligible for gastric bypass surgery if they have a body mass index (BMI) of at least 40--roughly equivalent to 80 to 100 pounds overweight--or have a BMI of at least 35 and co-existing conditions, such as diabetes or heart disease, that render the obese condition particularly dangerous. The person must show an ability to be an active participant in treatment by losing some weight before surgery and be willing to adhere to a strict diet afterward, according to the Weight-control Information Network website.
Post-Surgery Experience
According to the Cleveland Clinic, most patients lose 60 to 80 percent of their excess body weight after surgery. Weight loss continues for 18 to 24 months, but in order to achieve significant weight loss, patients must adhere to a very strict diet, as their gastrointestinal physiology has changed and will not digest certain nutrients as effectively anymore. It also continues to be possible to overeat and not lose weight.
Patients generally start out on a liquid diet to allow their stomach to heal and to become comfortable eating smaller amounts of food. They then move gradually through eating pureed and soft foods, toward a solid diet. Vitamin and mineral supplements are encouraged throughout all phases, according to the Mayo Clinic website. Tough and fibrous foods are avoided due to potential digestive difficulties.
Side Effects and Risks
Any invasive surgery carries a risk of infection and surgical complications. After surgery, the Roux-en-Y procedure carries risks specific to gastric bypass surgery. A patient might experience "dumping syndrome" after eating too many carbohydrates or fats, leading to diarrhea and stomach cramps. Patients also need to drink plenty of water between meals, or risk dehydration. Nausea, vomiting and constipation can occur if the diet is not followed. The opening to the stomach pouch also can become blocked if too much food is eaten, according to the Mayo Clinic website.
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