Gastric bypass and other weight loss surgeries – collectively known as bariatric surgery – involve making changes to your digestive system to help you lose weight. Bariatric surgery is performed when diet and exercise don’t work or when you have serious health problems due to your weight. Some procedures limit how much you can eat. Other procedures work by reducing the body’s ability to absorb nutrients. Some procedures do both.

While bariatric surgery can provide many benefits, all types of weight loss surgery are important procedures that can pose serious risks and side effects. Also, to ensure the long-term success of bariatric surgery, you must make permanent healthy changes to your diet and exercise regularly.

 

Species

Biliopancreatic diversion (BPD / DS) with duodenal switch

Gastric bypass (Roux-en-Y)

Gastrectomy arm

Bariatric surgery is done to help you lose excess weight and reduce your risk of potentially life-threatening weight-related health problems.

Heart disease and stroke

Hypertension

Non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH)

Sleep apnea

2 types of diabetes

Bariatric surgery is typically done only after you’ve tried to lose weight by improving your diet and exercise habits.

 

For whom

In general, bariatric surgery may be an option for you if:

  • Your body mass index (BMI) is 40 or higher (extreme obesity).
  • Your BMI is between 35 and 39.9 (obesity) and you have a serious weight-related health problem such as type 2 diabetes, high blood pressure or severe sleep apnea. In some cases, if your BMI is 30 to 34 and you have serious weight-related health issues, you may be eligible for certain types of weight loss surgery.
  • Bariatric surgery is not for everyone who is overweight. To qualify for weight loss surgery, you may need to follow certain medical guidelines. You will likely have a thorough screening process to see if you qualify. You must also be willing to make permanent changes to maintain a healthier lifestyle.
  • You may need to participate in long-term follow-up plans that involve monitoring your diet, lifestyle and behavior, and medical condition.

 

Risks

As with any major procedure, bariatric surgery poses potential health risks, both in the short and long term.

Risks associated with the surgical procedure can include:

  • Excessive bleeding
  • Infection
  • Adverse reactions to anesthesia
  • Blood clots
  • Lung or breathing problems
  • Leaks in your gastrointestinal tract
  • Death (rare)

 

The longer term risks and complications of weight loss surgery vary depending on the type of surgery. They can include:

  • Intestinal obstruction
  • Dumping syndrome causing diarrhea, rash, dizziness, nausea or vomiting
  • Gallstones
  • Hernias
  • Low blood sugar (hypoglycemia)
  • Not enought feeding
  • Ulcers
  • Vomiting
  • Acid reflux
  • Need for a second or revision, surgery or procedure
  • Death (rare)

 

How do you prepare

If you qualify for bariatric surgery, your healthcare team will give you instructions on how to prepare for your specific type of surgery. You may need to have various laboratory tests and examinations before surgery. You may have restrictions on eating, drinking, and what medications you can take. You may need to start a physical activity program and stop all forms of tobacco use.

You may also need to be prepared by planning ahead for your recovery after surgery. For example, get help at home if you think you will need it.

 

What can you expect

Bariatric surgery is performed in the hospital using general anesthesia. This means you are unconscious during the process.

The characteristics of your surgery depend on your personal situation, the type of weight loss surgery you have, and the practices of the hospital or doctor. Some weight loss surgeries are done through traditional large or open incisions in your abdomen.

Today, most types of bariatric surgery are performed laparoscopically. A laparoscope is a small tubular instrument with a camera attached. The laparoscope is inserted through small incisions in the abdomen. The tiny camera at the end of the laparoscope allows the surgeon to view and process the inside of your abdomen without making traditional large incisions. Laparoscopic surgery can make your recovery faster and shorter, but it is not suitable for everyone.

The surgery usually takes a few hours. After surgery, you wake up in a recovery room where medical staff will watch you for any complications. Depending on your procedure, you may need to stay in the hospital for a few days.

 

Types of bariatric surgery

Every obesity surgery has its pros and cons. Be sure to talk about them with your doctor. Here’s a look at common types of bariatric surgery:

  • Roux-en-Y (roo-en-wy) gastric bypass. This procedure is the most common method of gastric bypass. This surgery is typically irreversible. It works by reducing the amount of food you can eat in one sitting and reducing the absorption of nutrients.
  • The surgeon cuts off the upper part of your stomach and separates it from the rest of your stomach. The resulting pouch is about the size of a walnut and can only hold about an ounce of food. Normally, your stomach can hold about 3 liters of food.
  • The surgeon then cuts the small intestine and sews some of it directly onto the pouch. The food then goes to this small stomach pouch and then directly to the small intestine sewn onto it. Food bypasses most of your stomach and the first part of your small intestine and instead enters directly into your mid-section.