Obesity is a complex disease that is not caused by one single issue. Many things factor into the equation that leads an individual to gain weight to the point of threatening their health. Genes certainly play a role, but statistics from the last few decades indicate that the environment plays an even more important one. The American Psychological Association states that “the causes of obesity are rarely limited to genetic factors, overeating or leading a sedentary lifestyle. What we do and not do often is the result of how we think and how we feel”[1].
Bariatric or weight loss surgery is now considered the most effective weight loss treatment method there is and it can offer the greatest chance for long term weight loss. This type of surgery can reduce your risk of obesity-related medical conditions, which is one of its many benefits, and an indicator that you may be eligible is if you have a body mass index (BMI) over 35. Your BMI may be aggravated by one or more health issues such as type 2 diabetes, high blood pressure, sleep apnea, cardiovascular disease, high cholesterol or triglycerides.
Once our team at LIMARP® determines that you are a candidate for weight loss surgery, we can determine the most effective type of surgery for you. Weight loss surgery is a serious procedure, with the potential to change your life. Our multidisciplinary team will do both physical and psychological evaluations to determine your possibility of undergoing surgery.
Before and After Gastric Bypass Surgery Transformations
Dr. Liza María Pompa has practiced thousands of gastric bypass surgeries at LIMARP. Patients have travelled from all over the world, mainly United States, Canada, Europe and inner states of Mexico to receive bariatric surgery and obesity treatment at LIMARP. Join us to witness some of their incredible transformations with their before and after gastric surgery photos.
Gastric Bypass Surgery
One of the surgeries that may be the best option for you is the gastric bypass procedure, which can help you lose a significant amount of weight, approximately 85%, and establish positive long-term dietary habits.
By rerouting the stomach, this procedure limits calorie absorption, resulting in rapid weight loss. Dr. Liza María Pompa González and our team at LIMARP® in Tijuana, Mexico, use the latest technology to ensure that your treatment is as safe and successful as possible.
This procedure is beneficial for obese patients that also have diabetes and whose efforts to lose weight with diet and exercise alone have proved unsuccessful. Considered as the gold standard, gastric bypass surgery is one of the most commonly performed bariatric surgeries and it can help you establish a healthy lifestyle and restore your confidence.
What is Gastric Bypass Surgery?
Gastric bypass surgery consists of a twofold method for the reduction of weight. The surgeon reduces the patient’s stomach and connects it to a distal part of the intestine. A smaller stomach is able to hold less food and that which is consumed does not pass through the first part of the small intestine, resulting in reduced calorie absorption. In other words, this surgical procedure creates two different mechanisms that enable weight loss: the reduction of the stomach’s size plus a shortcut passage for the digestive system through the small intestine. In this sense, the gastric bypass is a restrictive and malabsorptive procedure, since it restricts food intake and also modifies the absorptive capacity of the digestive system.
There are several variations to the gastric bypass and while their ultimate goal is the same, the techniques surgeons use to carry them out is what makes them different. Here are some of the types of gastric bypass:
- Roux-en-Y (proximal)
- Roux-en-Y (distal)
- Mini-gastric bypass
- Endoscopic duodenal-jejunal bypass
After gastric sleeve surgery, gastric bypass is the second most popular bariatric surgical procedure in the world.
According to the latest global registry of the International Federation for the Surgery for Obesity and Metabolic Disorders (IFSO), out of all the weight loss surgeries that are practiced around the world, at least 31% account for the gastric bypass. Most of them are performed with laparoscopic techniques. In fact, open gastric bypass procedures are very rare and almost deemed unnecessary due to the great advances that the medical community has achieved with laparoscopic technology and education.
Recovery for this type of intervention is relatively fast. Patients can expect a 2 days post-operative stay in the hospital’s recovery room. Rest after surgery is mandatory and most patients return to their daily-life routine after 1 month. During this time, patients have to follow a very specific and strict diet that goes through different phases, starting from an only liquids diet, transiting to pureed foods, then to soft solids and so on, with a progressive increase in calories.
A gastric bypass procedure usually achieves more drastic weight loss than a sleeve gastrectomy due to the fact that it combines a restrictive and a malabsorptive intervention. Through this procedure, patients start experiencing weight loss as soon as 3 months after surgery, and they can expect to lose more than 70% of their excess weight during their first year after the surgery.
Excess weight represents the difference between a person’s ideal weight and their initial weight before surgery. According to the latest IFCO report, people who undergo a gastric bypass usually lose between 27 and 37% of their body weight one year after surgery. Total weight lost with this procedure will depend on many factors. One of them is the genetic and biologic nature of each individual patient, as not everyone will react the same to the malabsorptive properties of the procedure. Another very important factor is the commitment the patient has to maintaining a healthy diet and lifestyle, as well as their amount of physical activity.
Requirements for Gastric Bypass
Gastric Bypass surgery is ideal for patients who have at least three or four metabolic conditions and a BMI higher than 40. The gastric bypass can highly benefit patients with morbid obesity who suffer from conditions such as diabetes, sleep apnea, and hypertension because this procedure has shown to have a great impact on ameliorating their symptoms and, in some cases, it can lead to their total resolution.
Other requirements a patient needs to meet in order to be a candidate for gastric bypass and other weight-loss surgeries include:
- A body mass index (BMI) is 40 or higher (extreme obesity).
- A BMI that ranges from 35 to 39.9 (obesity), and having a serious weight-related health problem. In some cases, you may qualify for certain types of weight-loss surgery if your BMI is 30 to 34 and you have serious weight-related health problems.
However, gastric bypass isn’t for everyone who is severely overweight. Patients may need to meet certain medical guidelines to qualify for weight-loss surgery and will likely have an extensive screening process to see if you qualify.
Patients interested in receiving a gastric bypass should be aware of the possible outcomes and benefits of this surgery, and they should also keep in mind that they have to put in the work to reap the benefits. In order to avoid regaining the excess weight and to obtain the best possible results that this procedure has to offer, a gastric bypass candidate must be willing to commit to drastically change their eating habits and to take on an exercise routine. At LIMARP®, we are committed to helping you achieve your goals and our integral treatments include education, guidance, and continuous follow-up provided by our bariatric nutritionist, psychologist, and fitness expert.
What to Expect on the Day of Surgery
Prior to your procedure, Dr. Pompa and her multidisciplinary team will provide you with a list of pre-op instructions to follow, including a strict supervised diet to help prepare your body for surgery.
On the morning of your procedure, it is vital that you do not eat or drink anything, unless your doctor instructs you to take some type of medication before arriving at LIMARP®. Once you are at our surgical facility, you will be taken to a private room where you will meet your surgical team. They will answer any last-minute questions and provide a hospital gown, head and foot coverings, and compression hose to wear. Foreign patients will have pre-surgical tests done. If necessary, our anesthesiologist can provide you with oral sedation beforehand to help you relax. You will then be taken to the surgical room and given general anesthesia. Once you are comfortably sedated, Dr. Pompa will begin the procedure.
Gastric Bypass: How is it Done
During the first part of the procedure, Dr. Pompa will carefully divide your stomach into two portions using laparoscopic technology. Once the smaller pouch is created, she will connect it to the lower part to the small intestine (jejunum). This small pouch will be able to hold only about a cup of food at a time, restricting your portions and allowing you to feel full faster; food will then travel to the intestine, preventing the absorption of sugars and fats in its first sections, and a mixture of nutrients takes place in the lower part of the intestine, where the second connection is made.
By creating a smaller stomach that bypasses the duodenum and reroutes food directly into the lower part of the small intestine, much of the food will not be processed, thus restricting the absorption of calories and nutrients. To achieve the best possible benefits, you will be working with a LIMARP® nutritionist.
Recovering from Gastric Bypass Surgery
Once the procedure is completed, you will be taken to a comfortable, private recovery room where Dr. Pompa will monitor you for the first few days before you return home. Because this procedure is considered major abdominal surgery, it is imperative that you follow your postsurgical at-home care instructions carefully to reduce your chances of developing complications.
As your stomach adjusts, you may experience discomfort, nausea, vomiting, constipation, fatigue, and even mild depression for a few weeks after your procedure. Resting, taking medications as directed, minimizing your daily activity, and following your post-op diet can help reduce any uncomfortable symptoms you may experience.
Since each patient responds differently to surgery, the rate of recovery varies from patient to patient, but in most cases, you can expect to return to work around two to three weeks after surgery. As your diet advances, in a few weeks you will be able to enjoy a wider variety of healthy foods, this will be a gradual process that lasts around three months. The key to recovery is maintaining a healthy diet and being patient with your body as it adjusts.
Risks of Gastric Bypass Surgery
For reasons that can range from the very anatomy of the procedure, to lack of proper supplementation or failure to follow post-surgical instructions, patients who undergo gastric bypass surgery may develop:
- Nutritional and vitamin deficiencies
- Stomach stretching caused by overeating
- Stomal stenosis
- Gallstones
- Dumping syndrome
- Prolonged digestive issues, such as nausea, diarrhea or constipation
- Complications due to this procedure are very rare, and its mortality rate is less than 0.2%
Working with qualified healthcare providers and following their instructions can greatly reduce these risks.
Due to the malabsorptive properties of the gastric bypass surgery, there is the possibility to develop intolerance or higher sensitivity to certain foods. Patients should acknowledge that their body has been through a major change and that their reactions to some meals might change too. As part of their new and healthier lifestyle, bariatric patients should avoid alcohol, sweets and fats, and prefer high-protein meals and nourishing treats.
Benefits of Gastric Bypass Surgery
The gastric bypass has proven to be effective on ameliorating and even resolving obesity-related comorbidities such as type 2 diabetes, hypertension, osteoarthritis, dyslipidemia, obstructive sleep apnea, asthma, varicose veins, even infertility.
Choosing to improve your health with gastric bypass surgery can provide many benefits, including:
- Remission of type 2 diabetes
- Relief from joint pain
- Resolution of sleep apnea
- Reduction in the risks related to hypertension and heart disease
- Healthier lifestyle
- Better quality of life
- Dramatic, long-term weight loss
- Enhanced self-confidence
A gastric bypass might be reversible if the patient faces long-term complications, although a reversal also implies risks as any surgical procedure would.
The outcomes and benefits to obtain from this surgery will depend on many factors, including compliance to prescriptions, medical and nutritionist recommendations, maintenance of a healthy lifestyle, and even genetic predisposition. But when you get treatment with our expert team, you are not alone. We provide long-term to lifelong follow-up, where we monitor your progress, supervise your biometric records, and provide guidance and counseling according to your specific needs. At LIMARP®, our main focus is your health and your long-lasting wellbeing, and our commitment is to help you reach your goals, because we take them as seriously as you do.
Contact Us to Learn More
If you want to learn more about gastric bypass surgery, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.
References
[1] “Mind/body health: Obesity”. https://www.apa.org/topics/obesity/mind-body-health. (Accessed November 23, 2022).