Weight loss or bariatric surgery is usually the last resort for patients who struggle with obesity and have tried but failed to lose weight with other medically supervised weight loss programs. Laparoscopic Roux-en-Y gastric bypass or just gastric bypass is one type of bariatric surgery conducted in the United States, alongside adjustable gastric banding, sleeve gastrectomy and biliopancreatic diversion with duodenal switch. Gastric bypass is currently one of the most common types of bariatric surgeries performed in the country, but prior to making a decision on choosing it, patients and physicians should consider the risks and success rates of each weight loss surgery type.
During a gastric bypass procedure, the surgeon creates a small pouch in the upper part of the stomach using staples, which decreases the amount of food that the stomach can hold. The second step is to create the bypass by connecting part of the small intestine to the new pouch. The bypass prevents food from going into part of the stomach and small intestine, reducing the absorption of calories. The surgery can be conducted either through open surgery or with a laparoscopy, using a tiny camera placed into a small incision in the abdomen, and it is recommended for patients with Body Mass Index (BMI) higher than 40 or higher than 35 and at least one comorbidity.
Gastric Bypass Success After Surgery
“Laparoscopic Roux-en-Y gastric bypass is considered by many to be the gold standard bariatric operation and is the most commonly performed bariatric operation in the United States,” note the authors of the study “Quick fix or long-term cure? Pros and cons of bariatric surgery,” which compared the different methods. “Weight loss averages 65% for most patients with over 85% of patients losing and maintaining 50% initial excess weight loss.” Weight loss achievement and maintenance is a key indicator of the surgery’s success, but low complications, morbidity and mortality rates are also important variables for patients and doctors to consider as well.
The same study demonstrated that mortality rates are about 0.1% and serious early complication rates 5%. “Long-term issues with fat malabsorption, protein-energy malnutrition and micronutrient deficiencies are relatively uncommon and can usually be managed with oral supplementation. Reoperations are infrequently needed for failures or complications. Despite the high likelihood of success both in weight loss and correction of obesity-related medical conditions, the operation requires advanced laparoscopic surgical skills with a learning curve as long as 100 cases, and a 10-15% long-term failure rate.”
Long-Term Impact of Gastric Bypass
While the success of gastric bypass surgery depends most importantly on choosing an experienced and accredited center and surgeon, the long-term success of the treatment is determined by the patient’s behavior — or more specifically, the patient’s willingness to change their eating and exercise routines. The surgery does not “work miracles” and patients need to commit to behavioral changes, including adopting a healthy diet, regular exercise, taking vitamins and supplements, and following other recommendations established by their medical team. In addition, patients can compare the results of gastric bypass to the results of other types of surgery to evaluate the long-term impact of the surgery.
Patients submitted to a biliopancreatic diversion with duodenal switch have the highest probability of losing excessive weight, while those who undergo gastric banding lose less weight, but benefit from a minimally invasive surgery that is 100% reversible and with few serious complications. Biliopancreatic diversion is able to lead to an average of 73% excessive weight loss after two years, while gastric bypass about 65%, sleeve gastrectomy 56%, and gastric banding 49%, according to the study “Biliopancreatic Diversion: The Effectiveness of Duodenal Switch and Its Limitations.” Despite the choice of procedure, a patient who undergoes bariatric surgery and follows all treatment guidelines is expected not only to lose weight, but also to improve quality of life, associated comorbidities like type 2 diabetes, heart disease, lung problems or sleep apnea, as well as overall health.