Roux-en-Y gastric bypass, also simply known as “gastric bypass,” is the most common type of bariatric surgery in the United States. The surgical procedure is designed to help obese patients, who failed at losing weight using other non-surgical options. The procedure is conducted in two phases as the surgeon begins by stapling the stomach to create a small pouch in the upper part of the organ. The surgeon will then connect the newly-created pouch to the middle of the small intestine.
The purpose of gastric bypass surgery is to transport food directly from the pouch to the middle of the small intestine, without passing through the other part of the stomach and the first part of the small intestine. The procedure increases satiety so that the patient feels full faster with smaller amounts of food. However, it is not always successful and there are cases of failed gastric bypass. Failure occurs either when patients experience severe side effects or when they are unable to lose weight.
Possible Side-Effects Associated with Gastric Bypass Failure
Despite being a safe and effective type of weight loss surgery, there are also risks and side effects associated with gastric bypass. While the majority of potential side effects are minor complications that can be easily solved, there are also more severe ones that can compromise patients’ health and treatment success. Long-term complications due to the gastric bypass procedure occur in 15.3% of the patients.
Complications can occur for many reasons, such as patients’ health characteristics as well as physicians’ level of experience and medical center accreditation. Potential long-term gastric bypass side effects include bowel obstruction; dumping syndrome that results in diarrhea, nausea or vomiting; the development of gallstones or hernias; low blood sugar, also known as hypoglycemia; malnutrition (more common when patients don’t take supplementary vitamins and minerals); iron or calcium deficiencies; stomach perforation; ulcers; vomiting; and staple-line failure in the pouch.
Failure in Losing Weight After a Gastric Bypass Procedure
Research has demonstrated that gastric bypass helps the majority of patients lose between 60% and 80% of excessive weight two to three years after the procedure. However, there are cases in which this is not the reality. Gastric bypass does not provoke weight loss on its own, but it helps patients achieve weight loss when combined with a healthy diet and regular physical activity. Therefore, it is essential for patients to follow their physician’s recommendations regarding diet, exercise, medication, and supplements, before and after the procedure. There are other causes for gastric bypass patient to fail at losing weight, but lack of compliance is the most common.
The study “Predictors for weight loss failure following Roux-en-Y gastric bypass” presents a retrospective analysis focused on identifying factors related to weight loss failure in patients submitted to gastric bypass. The researchers demonstrated that 24 months after surgery there was a weight loss failure rate of 11.2% — an important concern regarding the procedure. The results were close to previous reports, while advanced age and diabetes were statistically associated with failure.
What to Do to Avoid or Correct a Failed Gastric Bypass
The first step to avoid a failed gastric bypass needs to be taken even before the surgery. There are three other types of bariatric surgery, adjustable gastric band, sleeve gastrectomy and biliopancreatic diversion with duodenal switch (BPD/DS), in addition to gastric bypass. Not all surgical procedures are appropriate for all patients. Consulting with an experienced physician at a certified medical center about the most suitable type of weight loss program is the first step to avoid failure.
However, when complications do occur, patients may need to undergo additional surgeries in order to correct the problem. “As weight loss failure represents an important concern, there is the possibility to perform revisional surgeries, which may emphasize the restrictive or malabsorptive characteristics of RYGB, leading to varied results. It is reinforced that weight loss cannot be used as the unique outcome to evaluate the success of surgery,” explain the authors of the cited study. In some cases, the results may be rectified only by adopting a healthy diet and performing regular exercise.
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