Our Summary

Roux-en-Y gastric bypass surgery is a procedure that helps patients lose a great deal of excess weight and improves or even eliminates related health problems. However, up to 20% of all patients who undergo this surgery, and 40% of extremely obese patients, end up gaining a significant amount of weight back. The reasons for this weight regain can vary greatly, so it’s crucial to manage it from different angles. If non-surgical approaches fail, some potential surgical solutions include adjusting the size of the part of the stomach that has been bypassed, or making changes that make it harder for the body to absorb calories. While the first option generally has limited success, the second one can lead to significant long-term weight loss. The best surgical approach depends on the individual, considering factors like their eating habits, mental health, the structure of their bypass, and the risks associated with anesthesia and surgery.

FAQs

  1. What is the Roux-en-Y gastric bypass (RYGB) surgery and what are its benefits?
  2. What is the cause of weight regain after the RYGB surgery?
  3. What are the revision options for patients who experience significant weight regain post-surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about gastric bypass is to prioritize long-term lifestyle changes, such as adopting a healthy diet and regular exercise routine, to maintain weight loss and prevent weight regain. It is important to work closely with a healthcare team, including a dietitian and psychologist, to address any underlying issues that may contribute to weight regain. Additionally, attending regular follow-up appointments with your healthcare provider can help monitor progress and make necessary adjustments to ensure long-term success.

Suitable For

Patients who are typically recommended for gastric bypass surgery are those who have a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related comorbidities such as diabetes, hypertension, or sleep apnea. Additionally, patients who have tried and failed to lose weight through diet and exercise may also be recommended for gastric bypass surgery. It is important for patients to undergo a thorough evaluation by a multidisciplinary team, including a surgeon, dietitian, psychologist, and other specialists, to determine if they are suitable candidates for the surgery.

Timeline

Before Gastric Bypass:

  1. Patient undergoes a thorough evaluation by a multidisciplinary team including a surgeon, dietitian, psychologist, and other healthcare professionals.
  2. Patient must meet specific criteria for surgery, including a high BMI and failed attempts at weight loss through diet and exercise.
  3. Patient undergoes pre-operative testing and preparation for the surgery.
  4. Surgery is performed, which typically takes several hours and involves creating a small pouch in the stomach to restrict food intake and bypassing a portion of the small intestine to reduce absorption of calories and nutrients.

After Gastric Bypass:

  1. Patient stays in the hospital for a few days for monitoring and recovery.
  2. Patient undergoes a strict post-operative diet and exercise regimen to promote weight loss and prevent complications.
  3. Patient experiences rapid weight loss in the first few months after surgery due to reduced calorie intake and malabsorption.
  4. Patient may experience changes in appetite, taste preferences, and emotional well-being as they adjust to their new eating habits and body size.
  5. Patient continues to follow up with their healthcare team for monitoring of weight loss, nutritional status, and management of any complications or side effects.
  6. Long-term weight loss and maintenance are achieved through ongoing lifestyle changes, including healthy eating habits, regular exercise, and psychological support.
  7. Some patients may experience weight regain or complications post-operatively, which may require further interventions such as revision surgery or medical management.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with gastric bypass surgery?

  2. What is the expected timeline for recovery and when can I expect to see weight loss results?

  3. How will my diet and eating habits need to change after surgery?

  4. What kind of follow-up care and support can I expect after surgery?

  5. What are the potential long-term effects on my health after gastric bypass surgery?

  6. What are the chances of experiencing weight regain after surgery and what can I do to prevent it?

  7. Are there any specific dietary supplements or vitamins I will need to take after surgery?

  8. How will my current medications be affected by gastric bypass surgery?

  9. Are there any restrictions on physical activity or exercise following surgery?

  10. What are the signs of complications that I should watch out for and when should I contact my doctor?

Reference

Authors: Dayan D, Kuriansky J, Abu-Abeid S. Journal: Isr Med Assoc J. 2019 Dec;21(12):823-828. PMID: 31814347