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What is Roux-en-Y gastric bypass surgery and how effective is it?

Before and After BMI

September 3, 2018

What is Roux-en-Y gastric bypass surgery and how effective is it?

Roux-en-Y gastric bypass surgery (also known simply as gastric bypass) is one of the most popular types of weight loss surgery. The procedure consists of making surgical changes to your stomach and digestive system that restricts the amount of food you can eat, which can lead to significant long-term weight loss. As a result, not only will you lose weight, you will also improve your overall health and quality of life.

The following explains more about Roux-en-Y gastric bypass, including what it does and how it’s effective in helping you lose excess weight in the short and long term.

What is Roux-en-Y gastric bypass surgery?

Roux-en-Y gastric bypass surgery is a two-step process that reduces the size of your stomach and reroutes your intestines to help you lose weight.

In the first stage of the surgery, the surgeon divides your stomach into two sections — a small portion that’s about the size of an egg and a much larger portion. The smaller section is sewn or stapled together so that it holds only about a cup of food.

In the second part of the surgery, your surgeon will disconnect your smaller stomach pouch from the rest of your stomach and the beginning of your small intestine. The pouch is then connected to a segment of your small intestine that’s further along, which is called the Roux limb. This creates a “Y” shape and allows the food you eat to bypass the larger part of your stomach and the upper part of your small intestine. You’ll absorb less fat and fewer calories as a result, and your new, smaller stomach will limit the amount of food you can eat.

Depending on your needs and your surgeon’s preference, the weight loss procedure can either be performed via open surgery or laparoscopically. If it is performed laparoscopically, the time needed to recover is typically shorter.

During laparoscopic surgery, your doctor makes four to six smaller cuts in your belly; with open surgery, large cuts are required. The doctor will then utilize a robot or small, flexible instruments with a tiny camera on the end (an endoscope) that’s connected to a video monitor. Your surgeon will use the endoscope to navigate the stomach and pass the instruments through the small cuts.

Once the surgery is over, you’ll stay in the hospital for one to two days, and your doctor will give you information about when you can resume being active, how to care for your incisions and other details about the recovery process. You’ll be monitored for any possible complications, such as fever, wound infection, and vomiting or diarrhea.

Before and after diagram of the Roux-en-Y gastric bypass surgery.

Who is a good candidate for Roux-en-Y gastric bypass surgery?

Your doctor will take many factors into account before recommending Roux-en-Y gastric bypass. In general, you may be a good candidate for this type of surgery if:

  • Your BMI (body mass index) is 40 or above
  • Your BMI is 35 or above and you have a serious health problem, such as type 2 diabetes, sleep apnea, or high blood pressure, that’s related to obesity
  • You’ve tried and failed to lose weight with diet and exercise

You’re committed to following the dietary guidelines, taking the necessary vitamins and minerals, and meeting other requirements

What are the short term effects of Roux-en-Y gastric bypass?

Most patients are put on a liquid-only diet for the first week or two after surgery. Over the next month, you’ll be able to add soft food and eventually regular food back into your diet. Since your stomach will be much smaller, you’ll feel full more quickly than you did before your surgery.

One side effect of Roux-en-Y is your body won’t be able to handle sugary or starchy foods as well immediately following the surgery. Eating these foods will likely cause you to experience what’s referred to as “dumping syndrome” within just a few minutes.

Symptoms of dumping syndrome include the following:

  • Vomiting
  • Diarrhea
  • Abdominal pain
  • Sweating
  • Shakiness
  • Rapid heart rate

Dumping lasts about 30 to 45 minutes, and if you’ve experienced this syndrome, you’re unlikely to want to repeat the experience. The motivation of avoiding dumping syndrome will help you make better food choices while avoiding sugary, starchy foods that are often high in calories while providing little nutritional benefit.

Your stomach will be able to only hold a fraction of the amount of food it was previously able to accommodate because of the size reduction. In addition to the practical effects on the amount you can eat, gastric bypass surgery is likely to decrease your hunger and make you feel full and satisfied more quickly. The procedure reduces the amount of ghrelin — a hormone that helps stimulate your appetite — that your stomach produces. If your body is producing less ghrelin, you’ll feel hungry less often.

Close-up of person measuring unbuttoned-pant waist with measuring tape.

You’ll also have to chew your food slowly and fully so that your smaller stomach can digest it. This has the added benefit of making you more mindful about what you’re eating. Like many people, you probably had your share of rushed meals prior to your surgery, and this behavior can lead to overeating since it doesn’t give your brain the chance to register that you’re full. By slowing down the process, you’ll be able to savor your food and reduce overall eating. In addition, you’ll need to refrain from drinking any liquids within 30 minutes before or after you eat.

You may initially lose a significant amount of weight quickly since you’ll be consuming fewer calories. For the first two weeks post-surgery, you’ll start with a portion size of 1 tablespoon, which increases to 2 tablespoons when you can tolerate it. During the first weeks, you shouldn’t consume more than 400 calories a day.

After that, and until about the two-month mark, you’ll increase your portions to one quarter-cup for solids and one half-cup for liquids. You’ll take in no more than 500 calories a day.

Two to six months after the surgery, your body will consume about 900 to 1,000 calories a day. Over time, you can introduce more foods into your diet while keeping the same approximate calorie count. Since this is much less than you were probably eating before your surgery, you’ll lose weight quickly.

As your caloric intake is severely curbed, you’ll be getting fewer nutrients from your food. You may need to have your blood tested every six months to make sure you’re getting the nutrients you require, and you’ll also need to commit to taking the following supplements:

  • Daily multivitamins
  • Daily calcium supplements
  • Vitamin B12 supplements
  • Vitamin D supplements
  • Iron supplements

Your doctor will recommend the specific supplements and daily values of nutrients you’ll need to take.

What are the long term effects of Roux-en-Y gastric bypass?

One year after surgery, Roux-en-Y gastric bypass patients have lost an average of about 34 percent of their total body weight from the time of the procedure. Overall, this weight is usually kept off. At the three-year mark post-surgery, patients have lost around 31.5 percent of their total body weight from the time of the procedure, on average.

Gastric bypass patients can lose up to 67 percent of their excess pounds within two years. During this time, significant health improvements are also often made that continue to improve quality and longevity of life long after the surgery is complete.

After having the surgery, it’s vital not to increase the amount of food you’re eating, as this can cause your new stomach pouch to stretch and hold more food. Your goal should be to maximize the nutrients you’re getting from the food you’re eating as you stay within your caloric guidelines. Portion sizes should be no more than 6 to 8 ounces, which should make you feel satisfied rather than leaving you hungry.

After any type of bariatric surgery, you should closely monitor your diet with a dietitian and stick with an exercise program that helps you stay healthy. Maintaining your weight loss and improving your health is a long-term commitment, but it’s well worth the effort. Gastric bypass patients often achieve greater mobility and quality of life. You may also avoid, improve or resolve serious chronic health conditions related to obesity, including type 2 diabetes and coronary artery disease. According to the American Society for Metabolic and Bariatric Surgery (ASMBS), bariatric surgery, including gastric bypass, reduces mortality from cancer by 60 percent, coronary artery disease by 56 percent and type 2 diabetes by 92 percent. In addition, you can significantly cut down on healthcare costs.

Psychological counseling and meeting with a bariatric surgery support group can also be helpful post-surgery. You may need help adjusting to life post-surgery, including the changes you’ll need to make. If you previously used food to help cope with stress or anxiety, you may have to develop new ways of dealing with these challenges.

It’s also important to note that while gastric bypass surgery can have an amazing impact on the quality of your life, it can’t solve every problem. While it may give you confidence in your appearance that might carry over into other areas of your life, you should have realistic expectations of what changes to expect. That’s where post-surgery support from your doctor and other patients comes in.

Plus-size woman eating a plate of vegetables and smiling at the camera.

Find out more

To learn more about whether Roux-en-Y gastric bypass surgery would be a good option for you, make an appointment today for a consultation with BMI of Texas by calling 210-405-6424. We offer weight loss surgery as well as medical weight management, and you’ll be supported by a team that includes dietitians, behavioral health specialists and exercise physiologists. Working together, we can help you reshape your life!