There are 4 types of bariatric surgery procedures: laparoscopic sleeve gastrectomy (gastric sleeve), gastric bypass, gastric band and duodenal switch. Of all of these, gastric sleeve and gastric bypass are top choices by patients looking to lose weight through surgery.
Roux-en-Y Gastric Bypass, also known simply as gastric bypass, is one of the bariatric surgeries performed for the treatment of obesity or morbid obesity. While the adjustable gastric band, sleeve gastrectomy, and biliopancreatic diversion with duodenal switch are also conducted, gastric bypass is the most common procedure. Bariatric surgery is only indicated for patients who failed to lose weight with other methods, and like any other type of surgery, there are pros and cons of undergoing a gastric bypass.
Gastric sleeve surgery (sleeve gastrectomy) is now more popular than gastric bypass for weight loss. In this surgery, the stomach is reduced to about 15% of its original size—giving it a sleeve-like structure. Patients lose weight because they feel full from smaller food portions, eat less and have a significantly decreased feeling of hunger.
Benefits of gastric bypass surgery
Gastric bypass promotes weight loss by restricting the amount of food your stomach can hold and changing the way your stomach and small intestine absorb calories and nutrients from food.
Gastric bypass surgery also affects hormone levels that regulate feelings of hunger and fullness and changes your brain’s response to eating. As a result, patients who undergo gastric bypass surgery feel full most of the time, experience less pleasure from eating and are less susceptible to emotional eating and external eating cues.
As an added bonus, people who have had gastric bypass surgery often report changes to their food preferences, including:
- Fewer cravings for foods that is high in fat and sugar
- Decreased preference for sugary foods and carbohydrates
- Decreased tolerance for specific foods/beverages, such as meat, dairy, carbohydrates, water or sweets
Some gastric bypass patients find that foods they previously enjoyed now taste bitter, have an unappealing consistency or smell bad. Hormonal changes also cause some gastric bypass patients to experience rapid gastric emptying, or “dumping syndrome,” a condition that causes food to travel to the small bowel too quickly after eating meals that are high in carbohydrates and/or sugar. Dumping syndrome can cause a variety of uncomfortable symptoms, including:
- Abdominal cramps
- Mood changes
Patients who experience dumping syndrome quickly learn what foods their bodies can and can’t tolerate. They also use the way they feel after eating to help them regulate what and how much they eat.
Gastric Bypass Pros and Cons: Advantages
Gastric bypass is considered the “gold standard” of bariatric surgery, which means not only that it the most commonly performed bariatric procedure worldwide, but also that it has been widely experimented and studied, leading to most effective results. It is not uncommon for a bariatric surgery to reduce the size of the stomach, restricting the amount of food it can hold, but a gastric bypass also alters the food course, so that it won’t pass through a segment of small intestine that would normally absorb calories and nutrients.
Patients are proven to suffer alterations in gut hormones that promote satiety, suppress hunger, and reverse one of the primary mechanisms that cause obesity-related type 2 diabetes. In addition, the surgery causes on average 60 to 80% long-term excess weight loss, which is superior to adjustable gastric band, while typical maintenance is higher than 50%. Other advantages include improvements in overall health, comorbidities, mobility, and increase in energy expenditure and quality of life.
Gastric Bypass Pros and Cons: Disadvantages
However, there are not only advantages associated with gastric bypass. The surgery is technically a more complex operation than the adjustable gastric band or laparoscopic sleeve gastrectomy, which can possibly result in greater complication rates. 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.
Unlike the gastric band, but similarly to the other procedures, it is an irreversible surgery. Other disadvantage shared with biliopancreatic division with duodenal switch is that it is highly likely to cause long-term vitamin or mineral deficiencies particularly in vitamin B12, iron, calcium, and folate. In addition, it generally has a longer hospital stay than the AGB and it requires adherence to dietary recommendations, life-long vitamin/mineral supplementation, and follow-up compliance, as explained by the ASMBS.