Overweight and obesity are already recognized as growing health burdens in modern societies, however, when obesity becomes a diagnosed disease according to a patient’s Body Mass Index (BMI), addressing the problem may be even more difficult and complex. Morbid obesity is classified as BMI higher than 30 and in the majority of cases patients are not able to lose weight by themselves by changing their diet and exercise habits.
In order to address this problem, there are currently three types of surgical techniques for the treatment of obesity, which are gastric bypass, sleeve gastrectomy, and gastric banding. Sleeve gastrectomy is the oldest procedure and only permanent one that involves an invasive incision of the stomach, while gastric banding is the least invasive procedure, but can involve additional surgeries.
The Gastric Bypass Procedure
Gastric bypass is one of the three surgical options used to treat obesity. The procedure is conducted in two steps, and the surgeon begins by creating a small pouch in the upper part of the stomach using surgical staples. The second part of the surgery involves connecting the pouch to the middle of the small intestine, so that food bypasses one side of the stomach and the first area of the small intestine. Gastric bypass surgery is the most common weight loss procedure and is also known as “Roux-en-Y gastric bypass.”
By undergoing this procedure, a patient experiences an increase in a sense of satiety after consuming smaller amounts of food, thereby reducing caloric intake. By rearranging the digestive system, the procedure also results in an intentional malabsorption and decrease in the amount of calories that can be absorbed by the digestive system, leading to weight loss. The surgery can be performed either in an open procedure or through a laparoscopic procedure, which involves small incisions in the abdomen.
Following the surgery, patients usually need to stay in the hospital from two to six days and may return to their normal lifestyle three to five weeks later. Research conducted to evaluate the efficacy of gastric bypass revealed that the majority of patients manage to lose 60 to 80% of excessive weight between two to three years following the surgery, while about half of them are able to maintain the weight loss.
Risks Associated with Gastric Bypass
Despite the efficacy of the procedure in helping patients decrease weight, there are serious complications and risks associated with gastric bypass. Patients submitted to Roux-en-Y gastric bypass have an approximate mortality rate of 2.5% 90 days after the procedure. Despite the fact that comorbidities like diabetes and high blood pressure may be minimized or cured, the worse they are prior to the surgery, more likely it is for the patient to suffer further complications.
Most important risks associated with gastric bypass include a severe infection caused by a staple or stitch rupture that leaks from the stomach into the abdominal cavity, called peritonitis; blood clots in the surgical area or in the lungs, which is a pulmonary embolism; dumping syndrome, which can occur when food is transported too fast through the small intestine; gallstones; nutritional deficiency like anemia or osteoporosis; stomach ulcers; hernias or narrowing of the connection between the stomach and the intestines, provoking nausea and vomiting.