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As with any surgical procedure, proper preparation before gastric bypass surgery is extremely important to ensure the experience is not overly stressful. Assuming your doctor confirms that you are a valid candidate for a gastric bypass, the first thing you should do to prepare is to contact your insurance company to see if they cover weight loss surgery.

If the surgery qualifies for coverage, your insurance carrier may require both physical and psychological clearances as part of the gastric bypass preparation. They may accept information sent by your doctors or require you to see doctors of their choosing before they will approve the gastric bypass surgery. You also need to see what your financial responsibility will be, so you can make whatever preparations are necessary to pay for it.

Next, you will need to find a qualified hospital or surgical center and pre-register to undergo weight loss surgery. Pre-screening tests will need to be performed about a week prior to surgery.

Since your stomach must be completely empty to reduce the changes of vomiting during surgery, no food or drink is allowed after midnight the day before your surgery.

Usually, you check into the hospital or surgical center early the morning of your surgery to complete final paperwork and last minute tests. Then, you will be taken to a room where you will change into a surgical gown. Next, you will be taken to a pre-operating holding area where the anesthesiologist will discuss your medical history with you and answer any questions that you may have.

In the operating room, any other necessary preparations will be completed, and then the anesthesiology will start an IV for you. Now it’s time for the surgeons to work their magic.

Gastric bypass surgery is performed under general anesthesia, which means you will be asleep during the surgery. If you are having a laparoscopic procedure, the surgeon will make three to four small incisions in the outer abdomen wall and insert a micro-sized camera and different surgical instruments into your body. Your abdominal cavity will be filled with gas to inflate the space and make it easier for the surgeon to see what he or she is doing. If you are having the Roux-en-Y procedure performed, the surgeon will make a much larger incision, from your bellybutton to breastbone, through which to enter the abdominal cavity and perform the gastric bypass.

In both cases, the surgeon will create a small upper pouch in your stomach using a surgical stapler and reinforcing the staples with stitches. Then the surgeon will divide the small intestine and attach one end to the new stomach pouch, bypassing part of the digestive track so that food will pass directly from the new stomach pouch to the mid-point of the small intestine. The new, smaller stomach pouch prevents the patient from eating large amounts of food, and the bypass prevents the patient’s body from absorbing some of the calories in the food that is eaten.

After the surgery is finished, you will be taken to the recovery room where nurses will monitor your condition. As soon as you are ready, you will be sent home and scheduled for a follow-up with your surgeon two weeks later.

Weight-loss (Bariatric) surgery is like any other major surgery. The best preparation is to understand the risks and potential benefits and to closely follow your doctor’s instructions.

To mentally prepare yourself:

• Understand the surgical process and what to expect after the surgery is complete.
• Talk to people who have had weight-loss surgery.
• Write a letter to yourself and your surgeon explaining your reasons for having the surgery and outline your plans to maintain your weight loss after surgery.
• Start a journal about your experience. Record how you feel now, the obstacles you encounter, the things you hope to be able to do after surgery.
• Get a letter of support from your family. It helps to know you have people supporting your decision.

To physically prepare yourself, it’s important to follow your doctor’s guidelines. These usually include, but are not limited to:

• Restrict yourself to a clear liquid diet 12-24 hours before surgery.
• Stop smoking at least one month before surgery.
• Follow your surgeon’s instructions regarding any medications you may be taking to control other health conditions.
• Arrive on time; with supplies from home for a three to four day hospital stay. If you use special equipment for sleep apnea, please bring your machine to the hospital.
• The decision to undergo Obesity Surgery is a very serious one, and anyone considering it should think about it carefully, because it also involves the individual making significant lifestyle changes after the surgery is conducted.
  Many surgeons, medical centers, and insurance companies require that patients who are to have this surgical procedure undergo a psychiatric or psychological evaluation to assess their psychological status prior to the Gastric Bypass Surgery.  The requirement for the patient to see a psychologist or psychiatrist is part of the preparation for the surgery.

The Purpose of the Psychological Evaluation:

Prior to the Gastric Bypass Surgery, patients should be evaluated to rule out any existing eating disorders or any other psychiatric or psychological issues that might adversely affect the results of the surgery.  The evaluation assesses whether the patient is mentally and emotionally prepared for the surgery, and is mentally and emotionally prepared to deal with the outcome of the surgery.

Psychological Evaluations assess the presence of any psychiatric issues that are relevant to the Gastric Bypass Surgery, such as:

• Whether or not the patient is psychotic or clinically depressed.
• Whether the patient is competent in making the decision to proceed with Gastric Bypass Surgery.
• Whether the patient fully comprehends to serious of the procedure and the lifestyle changes that must take place once it is done.
• Whether the patient has unrealistic expectations about the outcome of surgery.
• The patient’s ability to handle the stress of the period following surgery.
• Any history of substance or alcohol abuse.

Psychosocial assessment: Because gastric bypass surgery is a life-altering operation, you must be mentally prepared to deal with the significant changes that will occur after surgery. This mental preparation includes ensuring that you have a good support system of friends and family; that you understand how important it is to adhere to new routines after the surgery, such as diet; and that you have a realistic plan for physical recuperation after surgery. Before you undergo surgery, a social worker will explain these changes so that you will know exactly what to expect. You will also be given information on the support groups available.

Support groups
Talking to others who have had Bariatric surgery will help you better understand how the procedure will affect your life. There are many support groups for people who have had or are considering a Bariatric procedure.

Growing up, Lisa Goetze always detested gym class. In fact, running was never an option for Ms. Goetze. For her, the mere act of walking was a battle. Throughout her life Ms. Goetze had struggled with morbid obesity. Her world as an adult consisted of commuting from home to work, and work to home. Venturing anywhere beyond those places was rare and extremely difficult because at 550 pounds she could only stand for a limited amount of time. In 2000, Ms Goetze underwent gastric bypass surgery—a decision that changed her life, and more importantly, her attitude regarding healthy living and remaining active. Today, she is a 32-year-old full-time business professional and part-time personal trainer in Bergen County, New Jersey. After a very long and difficulty journey, she has learned to appreciate a full routine—and a little sweat in her life.

Ms. Goetze describes herself as “the fat kid at school,” even going back to kindergarten. She says her food intake was always monitored, limited, and criticized. By her 21st birthday, Ms Goetze had seen her fair share of therapists, doctors, and had been to countless weight clinics and programs. She had clinical diagnoses for depression and eating disorders, and had been hospitalized and medicated for both

Obesity penetrated every corner of Ms. Goetze’s life. If I flew anywhere, I had to buy two tickets and dehydrate myself so that I would not have to use the plane’s bathroom during the flight—and just forget the whole seatbelt issue. If I went to the movies or a concert I had to bring my own extra-sturdy folding chair and sit in handicapped areas,” she explains

“When I decided that surgery was the way to go, my next step was finding someone who specialized in not just surgical options and procedures, but who truly understood obesity. That meant understanding its very nature—from its origin, its progression, and its effects physically and emotionally,” she explains. “I didn’t want just any doctor who could and would perform the surgery. I wanted the right doctor.

Ms. Goetze had her surgery on September 11, 2000. The decision to have the surgery was a clear one for her, even though her family was concerned. “I remember closing my eyes on the OR table and saying to myself, ‘I can’t wait to start my life,'” says Ms. Goetze. “I was very aware of all the risks, but what I had already endured physically and emotionally through struggling with my obesity was far worse than any of the possible risks that Dr. Bessler and his staff explained.”

Today, exercise has become an integral part of Ms. Goetze’s personal life and professional life. Once she began feeling and seeing the changes exercise brought to her life, she decided it was something she wanted to do for a living. She explains, “I became a personal trainer because I know what exercise has done for me and if others need help incorporating exercise into their lives, then I want to be the one to help them. I still don’t like to sweat, but feel great once I have, so go figure! And I still won’t run unless my life is in immediate danger, but not because I don’t see the point—but because my poor over-worn joints just can’t handle the impact.”

Ms. Goetze’s advice to others who have had weight loss surgery is simple and straightforward. It’s not the advice of a personal trainer, but of a survivor, and of a believer. “Be patient and compassionate with yourself. When you receive compliments, thank the person who is giving you the compliment and revel in it. Smile and laugh. Don’t diminish your accomplishments. Don’t slack off on prescribed vitamin and mineral supplementation, and make smart informed decisions about your food choices. Most of all, charter your own course, and never, never put limits on yourself. Today, I realize I own it all. No one can limit my success. I have the power to either create my own failures, or achieve my own successes—and that’s exactly what I did.”

Bariatric surgery

Bariatric surgery, the surgical reduction of stomach volume, is performed using one of two procedures: gastric bypass or gastric banding. Bypass surgery, the more common of the two, generally produces faster results in weight loss, while gastric banding is more easily reversible.

Both procedures reduce stomach volume to about 30 ml. After surgery the amount of food intake must decrease and all food must be chewed thoroughly. Benefits of the surgery include weight loss and reversal of such diseases as type II diabetes and sleep apnea. However, the bariatric patient should be aware of surgical risks.

How It’s Done

In gastric bypass surgery a new, smaller, stomach is created by a line of staples and is connected to a loop of the small bowel. During gastric banding, a silicone band is placed around the upper stomach creating a small reservoir and a restricted passage to the lower stomach. The average length of surgery is about 2 hours.

Technology

Most gastric bypass surgery is now done with the use of laparoscopic technology. Instead of a large abdominal incision, the laparoscopic technique employs the use of a small video camera and several tiny, customized instruments. This technique results in smaller incisions, less scarring, less pain, and in most cases a quicker recovery time.

Choosing Your Surgeon

Finding a surgeon that is right for you should involve direct, one-on-one consultation and inquiries about the doctor’s surgical background and success rate. Ultimately, he or she should be someone you are comfortable with, as well as someone your friends and family are comfortable going to with questions about the surgery and how to offer support after the operation.

• Make a list of things that are important to you and choose a surgeon that fits that criterion.
• Ask your family physician for recommendations.
• Visit online list serves for qualified surgeons in your area
• Choose a surgeon who has experience doing hundreds of surgeries instead of 15 or 20.

Recovery / Post Op Expectations

After surgery you should expect a hospital stay of at least 2 to 3 days, and absence from work for 3 to 6 weeks depending on your job. For the first several days you will experience discomfort and be unable to eat solid foods as your body adjusts to the operation.

You will be able to consume food only in small quantities. Based on health risks and your individual case the types of food you consume, like sugars fats and carbohydrates, may be limited as well.

Complications

There is no comprehensive data for complications from bariatric surgery; however, the postoperative mortality rate is estimated from 0.1% to 1 – 2%. Complications include:

• Respiratory failure
• taple leaking
• Stenosis (obstruction of stomach)
• Bleeding

Am I A Candidate?

In order to be a candidate for this surgery you are required to have a Body Mass Index (BMI) of at least 40, or a BMI of at least 35 with life threatening health risks such as diabetes or respiratory diseases. In addition to this, a successful candidate should be motivated, acceptable of associated risks, and view surgery as a last resort after diet and exercise has failed.

Cost

The average cost of surgery is $25,000 and can range from $20,000 to $50,000 depending on the surgeon, clinic or hospital, and location.

Patients may also consider cosmetic surgery to remove unsightly skin after the bariatric procedure, which would add additional costs.

Before you decide to undergo Gastric Bypass Surgery, there are a few qualifying conditions you may want to consider. First and foremost, you must be at least 100 pounds over your recommended weight and have exhausted all efforts to lose weight by reducing your food intake, changing your eating habits, planning your meals, and exercising.

Keep in mind that there are no miracle weight loss cures. Any type of weight loss or maintenance regimen requires a lifetime commitment to be successful.

Next, before you seriously consider either of these procedures, you should investigate the possible risks of the procedures, potential side effects after the procedures, and whether or not your insurance will cover the procedures.

The stomach stapling procedure, also known as Gastric Bypass Surgery is a permanent procedure that requires a lifetime commitment to eating well and staying fit.

Gastric Bypass is traditionally a laparoscopic or minimally invasive procedure. During the operation, which requires general anesthesia, a surgeon makes tiny incisions in the abdominal area and working with a miniature scope, divides the stomach into two sections with two rows of stitch-like staples. Between the rows of staples, the surgeon makes incisions so scar tissue will grow over the staples to secure them in place.

The top section, called the pouch, holds the food (about a tablespoonful, compared to the normal stomach, which holds about a quart). The pouch will eventually expand enough to hold no more than one cup of chewed-up food, so you will feel full quickly. Then, the intestines are detached from the bottom of your stomach, and attached to the pouch. Since the intestines are brought up and not shortened, the food can be fully absorbed, eliminating the chance of vitamin and mineral deficiencies, a problem with previous surgeries of this type. The unused part of the stomach still produces gastric juices, which will help the body absorb important nutrients.

The surgery generally costs between $15,000 and $20,000. Today, many insurance carriers are covering the procedure because it has been proven to improve some obesity-related health problems, such as diabetes and high blood pressure.

The risks of the surgery include bleeding, infections, and respiratory problems. Generally, the procedure requires a three- to four-day hospital stay. Afterwards the patient will need to follow strict dietary instructions. For the first few weeks after surgery, it might be difficult to eat anything without feeling uncomfortably full, and your stomach will still be very tender. It will take six to eight weeks, before the patient is able to digest complex carbohydrates and protein, (i.e. chicken, pasta, and dairy products) without vomiting. It will be difficult to digest large amounts of fat, alcohol, or sugar. Most patients lose an average of 10 pounds per month, before they plateau to a stable weight, 18 months after surgery.

Points to remember about laparoscopic bypass surgery:

• Laparoscopic Bypass surgery is not a miracle cure for quick weight loss. It’s a major one-and-a-half to two-hour surgery with possible complications and side effects.
• Laparoscopic Bypass surgery is only available to those who are at least 100 pounds over their recommended weight, and have unsuccessfully tried other diet and exercise programs.
• For more information, contact a Bariatric doctor at your local hospital.

If you weigh 500 pounds or more, your doctor might recommend a low-protein diet or the mouth-wiring procedure for a few months so that you can lose some weight before a gastric bypass can be performed. While your mouth is wired shut, you will lose weight quickly because your food intake, provided in liquid form, is strictly regulated.

Weight loss before Gastric Bypass Surgery may be necessary because the endoscopes equipment is not long enough to accommodate the girth of a patient weighing 500 or more pounds. In addition, most operating tables can hold up to 400 pounds. Other risks, such as reaction to anesthesia, are also increased in patients who weigh more than 500 pounds; so wiring your mouth shut to promote weight loss might be suggested. However, wiring your mouth shut is only a temporary solution, usually only suggested for a few months. Then, the Gastric Bypass procedure and reducing and monitoring food intake are needed for long-term success.

Gastric Bypass Surgery via the Roux-en-Y is considered to be the best surgical procedure for the treatment of morbid obesity. Weight loss is achieved by reducing the functional portion of the stomach to a pouch one ounce or less in size, and by creating a small opening between the stomach and the intestine. The small size of the stomach pouch causes the patient to have a sensation of fullness after eating only a small portion of food. This small stoma delays stomach emptying, making the sensation of fullness last longer. These are called the Restrictive components of the procedure. The limb of intestine coming down from the small pouch is called the Roux limb.

The Benefits for GBP

The benefits of the gastric bypass procedure very much outweigh the risks. 75% of patients are expected to lose 75 to 80% of their excess body weight. Well over 70 to 80% of patients with hypertension will be off medications and well over 90% of patients with type II non-insulin dependent diabetes mellitus are expected to be off medication. Drastically improved, if not completely resolved includes sleep apnea, asthma, joint pain, arthritis, reflux, fatigue, shortness of breath and an overall increased sense of well-being.

Candidates for GBP

Gastric bypass surgery is recommended for those persons who are 90 pounds or more overweight and have or are likely to have medical complications that will be helped, and in many instances, cured by substantial weight loss. While weight loss surgery is not for everyone, there are a large number of patients for whom losing a lot of weight is imperative, including those suffering from diabetes, high blood pressure, heart trouble, shortness of breath, arthritis and orthopedic (bone) problems with their legs, hips or back. Weight loss surgery actually fails in those persons who drink large quantities of regular soft drinks, consume sweets, ice cream, chips and fatty fried foods. If you are one of these people and feel you cannot switch to diet drinks and cut out sweets and fried foods then gastric bypass surgery is not for you.

Gastric Bypass Surgery Risks

Statistics show that 1 in 300 die from gastric bypass surgery. People who suffer from morbid obesity can have other serious medical conditions, which are related to or caused by being overweight. The higher your BMI is, the more likely it is that other medical problems will exist. Other medical problems can increase the risk of complications from gastric bypass surgery and the recovery period after gastric bypass surgery. Another risk factor is age, although this increases the need for surgery there is generally a higher risk. Any medical procedure that involves humans and reactions to stress, trauma, drugs, and other causes, unpredictable negative results can and will occur. This surgery should be considered only after many attempts with other diet control and exercise have failed. Diet and exercise will be required before and after this surgery.

What To Expect After GBP

When you are able to move about without too much discomfort, to take in food by mouth, and can do without injected pain medication (about 4 to 5 days), you are ready to leave the hospital. At the time of discharge, you will be given specific instructions indicating what you may and may not do and when to come back to the office for follow-up. You will need to remain on a liquid diet after discharge and you will receive additional instructions regarding your diet from the surgeon. Several weeks after you have left the hospital, you will be able to eat regular food in small quantities.

Insurance Coverage and GBP

Most insurance companies will pay for gastric bypass surgery procedures that are medically necessary. Morbid obesity is a life threatening disease and it is normally covered. Aetna Insurance is now asking for the patients’ entire medical work-up along with the pre-authorization request as well as documented weight loss attempts supervised by a physician for the last 2 years. They also want documented weight history for the last 5 years.

Many insurance plans do not provide reimbursement for weight loss treatment. According to many practitioners, few private insurance indemnity plans or managed care organizations appear to cover the costs of obesity treatment regardless of whether the service is a medically supervised program of weight reduction or maintenance, nutrition counseling, surgery or a pharmaceutical product. The countless number of available insurance plans and ever changing policies have made it difficult to assess the extent to which obesity treatment and prevention services are covered by third party insurers. More data and better tracking is necessary to determine the health needs of persons with obesity.

Gastric bypass surgery makes the stomach smaller and allows food to bypass part of the small intestine. You will feel full more quickly than when your stomach was its original size, which reduces the amount of food you eat and thus the calories consumed. Bypassing part of the intestine also results in fewer calories being absorbed. This leads to weight loss.

In normal digestion, food passes through the stomach and enters the small intestine, where most of the nutrients and calories are absorbed. It then passes into the large intestine (colon), and the remaining waste is eventually excreted.

In a Roux-en-Y gastric bypass, the stomach is made smaller by creating a small pouch at the top of the stomach using surgical staples or a plastic band. The smaller stomach is connected directly to the middle portion of the small intestine (jejunum), bypassing the rest of the stomach and the upper portion of the small intestine (duodenum).

This procedure can be done by making a large incision in the abdomen (an open procedure) or by making a small incision and using small instruments and a camera to guide the surgery (laparoscopic approach).

This surgery usually involves a 4- to 6-day hospital stay (2 to 3 days for a laparoscopic approach). Most people can return to their normal activities within 3 to 5 weeks.

Gastric bypass surgeries may cause dumping syndrome. This occurs when food moves too quickly through the stomach and intestines. It causes nausea, weakness, sweating, faintness, and possibly diarrhea soon after eating. These symptoms are made worse by eating highly refined, high-calorie foods (like sweets). In some cases you may become so weak that you have to lie down until the symptoms pass.

Although guidelines vary, surgery is generally considered when your body mass index is 40 or higher or you have a life-threatening or disabling condition related to your weight.Your doctor may only consider doing gastric bypass surgery if you have not been able to lose weight with other treatments.

The following conditions may also be required or are at least considered:

• You have been obese for at least 5 years.
• You do not have a history of alcohol abuse.
• You do not have untreated depression or another major psychiatric disorder.
• You are between 18 and 65 years of age.

Most people who have gastric bypass surgery quickly begin to lose weight and continue to lose weight for up to 12 months. One study noted that people lost about one-third of their excess weight (the weight above what is considered healthy) in 1 to 4 years. Some of the lost weight may be regained. The laparoscopic approach showed similar results, with 69% to 82% of excess weight lost over 12 to 54 months.

Risks common to all surgeries for weight loss include an infection in the incision, a leak from the stomach into the abdominal cavity or where the intestine is connected (resulting in an infection called peritonitis), and a blood clot in the lung (pulmonary embolism). About one-third of all people having surgery for obesity develop gallstones or a nutritional deficiency condition such as anemia or osteoporosis. Fewer than 3 in 200 (1.5%) people die after surgery for weight loss.

After a Roux-en-Y gastric bypass:

• An iron and vitamin B₁₂ deficiency occurs more than 30% of the time. About 50% of those with an iron deficiency develop anemia.
• The connection between the stomach and the intestines narrows (stomal stenosis) 5% to 15% of the time, leading to nausea and vomiting after eating.
• Ulcers develop 5% to 15% of the time.
• The staples may pull loose.
• Hernia may develop.
• The bypassed stomach may enlarge, resulting in hiccups and bloating.

In a gastric bypass, the part of the intestine where many minerals and vitamins are most easily absorbed is bypassed. Because of this, you may have a deficiency in iron, calcium, magnesium, or vitamins. This can lead to long-term problems, such as osteoporosis. To prevent vitamin and mineral deficiencies, you may need to work with a dietitian to plan meals, and you may need to take nutrient supplements and injections of vitamin B₁₂.

Early studies of the laparoscopic approach to surgery for obesity suggest that it reduces recovery time and postsurgery complications.

Gastric bypass is a type of surgery in which the stomach is reduced in size by one of several methods. This smaller stomach is then reconnected or bypassed to the small intestine. Having a gastric bypass can help speed weight loss by making it difficult to eat too much food at one time and to feel satisfied after very small meals.

After a gastric bypass, the volume the new, smaller stomach can hold is reduced from about 1 quart to about 1 ounce, or 2 tablespoons. Over time, the stomach pouch will stretch until it can hold 4 to 8 ounces, or about 1/2 to 1 cup, at a time. The size of the opening created between the stomach and small intestine is smaller, roughly 1/4 inch wide; which slows the rate at which food is emptied from the stomach into the small intestine.

Gastric bypass is usually performed only after many other methods of weight loss have been tried and failed. However, the surgery is not an end in itself. It is important to work closely with a physician and registered dietitian (R.D.) to start a program of new eating habits to ensure that weight loss is safe and successful. A regular, simple exercise program and psychological support are often recommended to create a better self-image and a whole new attitude to food.

Nutrition Facts
The gastric bypass diet is designed to bring about significant weight loss. Learning new eating habits and following the diet correctly will help to maintain this weight loss over time. In general, the gastric bypass diet includes foods that are high in protein, and low in fat, fiber, calories, and sugar. Important vitamins and minerals are provided as supplements.

Protein is the nutrient that the body uses to build new tissue. It is important to get enough protein right after surgery, to make sure that wounds heal properly. Over the long term, protein in the diet will help preserve muscle tissue, so that weight can be lost as fat instead. Foods like lean red meat or pork, chicken or turkey without the skin, fish of almost any type, eggs, and cottage cheese are high in protein and low in fat.

Sugary foods include candy, cookies, ice cream, milkshakes or slushes, soda pop, sweetened juices or gelatin, and most desserts. The gastric bypass diet is low in sweet and sugary foods for three reasons. First, these foods are high in calories and fat. Even in small amounts, they could make weight loss difficult. Second, eating sweet or sugary foods promotes “dumping,” a reaction that can occur after the gastric bypass operation. Experiencing the unpleasant symptoms of dumping syndrome may limit the desire to eat sweet foods. Finally, most sweet and sugary foods don’t provide many vitamins or minerals for the calories they take up; and since calories are so limited on the gastric bypass diet, it is important that every food contribute its fair share of nutrients.

Fat may be difficult to digest after gastric bypass surgery. Too much fat delays emptying of the stomach and may cause reflux, a back up of stomach acid and food into the esophagus that causes heartburn. Fat may also cause diarrhea, nausea, or stomach discomfort. High-fat, fried foods and fatty meats are common offenders.

Fiber, found in foods like bran, popcorn, raw vegetables, and dried beans, is also limited on the gastric bypass diet. There is less space in the stomach to hold these bulky foods, and less gastric acid available to digest them. Some kinds of fiber could get stuck in the pouch itself, or block the narrow opening into the small intestine. Do not take any fiber pills or laxatives without the advice of a physician.

Vitamins & Minerals are an important part of the gastric bypass diet. Since the diet allows only small amounts of a limited variety of foods, it may be difficult to get enough vitamins and minerals from food alone. Deficiencies can develop in a matter of months. Iron, foliate, vitamin B-12, and calcium are the nutrients most affected. Most physicians require their gastric bypass patients to take a multivitamin/mineral supplement.

Gastric bypass surgery creates dramatic changes in the size and shape of the stomach. It may take awhile to get used to these changes. Patients report a wide variety of complications after surgery. Some of these will go away with time, while others can be lessened with adjustment of the diet. Some of the symptoms are: nausea and vomiting, dehydration, dumping syndrome, food intolerances and overeating

Gastric bypass is the surgical creation of a small pouch in the stomach to restrict food intake to far less than could be eaten before. A typical bypass patient, for instance, will only be able to hold a cup of food or less at a single meal. Weight is lost because far fewer calories are consumed and because a large section of the small intestine is bypassed which causes a decreased ability to absorb nutrients in food.

The benefits of gastric bypass include having a more normal life by losing massive amounts of weight – often over 100 to 200 pounds. Patients look better, fit into more normally sized clothes, are able to return to a more active lifestyle and drastically lower the risk factors associated with the major illnesses and conditions associated with morbid obesity. Yearly, 300,000 people in the U.S. die prematurely because of complications from massive obesity. Obesity is a cause of death second only to premature deaths related to cigarette smoking. In the year 2000, (the last year for which census statistics are available) costs related to obesity and overweight amounted to $117 billion. Obesity has been recognized as a chronic disease since 1985. About one-third of U.S. adults Americans are obese.

The ideal patient is at least one hundred pounds overweight, has tried – and failed – at least six diets, is between 15 and 65 years old, understands all the risks of the bypass procedure and is psychologically suited and able to actively take part in the many aspects of the post-operative, follow-up program for life. The most common way physicians screen candidates is by figuring their Body Mass Index, or BMI, a number that shows body weight adjusted for height. Candidates for gastric bypass must have a BMI of 40. Some patients who are suffering related conditions like life-threatening cardiopulmonary ailments or severe diabetes mellitus can have a BMI of 35 or more. Obesity is established as a major risk factor for diabetes, hypertension, cardiovascular disease and some cancers. Other associated conditions include sleep apneas, osteoarthritis, stroke infertility, intra-cranial hypertension, gastro-esophageal reflux and urinary stress incontinence.

Because there are so many complications, and because the surgery itself carries many risks, candidates must go through extensive psychological counseling and screening before going through with the operation.

To find out which procedure works best for you, consult a qualified practitioner who has extensive experience in performing gastric bypass. During consultations, doctors can learn more about the patients and vice versa. This visit gives the doctor a chance to evaluate the current state of the patient’s body and discuss options that will help the patient achieve a desired look. Consultation visits also give patients the opportunity to talk about their goals and expectations for their treatment and to ask any questions they might have. These visits also allow the doctors to inform the patient of the benefits, precautions, treatment response, adverse reactions, methods for administration and other important information.

Currently, there are two main types of gastric bypass procedures: The Roux-en-Y and the Extensive Gastric Bypass.

Roux-en-Y: The most common gastric bypass procedure currently performed. It creates a small stomach pouch to hold food by stapling most of the stomach and causes much of a meal to bypass that area of the intestines where many nutrients are absorbed. In some cases, a restrictive band is added to the bottom of the pouch. The band slows emptying of the pouch and is known as Vertical Banded Gastroplasty.

Extensive gastric bypass (bilopancreatic diversion.): A more complicated operation; this procedure surgically removes portions of the stomach and attaches it directly to the small intestine.

Your Bariatric surgeon will suggest, which procedure is right for you.

Adjustable Gastric Banding is one of the latest procedures in Bariatric surgery. The procedure has already received accolades for its safety and effectiveness, along with the fact that it does not require major reconstruction of the internal organs.

A Gastric Band (lap band) surgical procedure is a purely restrictive approach to reducing the capacity of the stomach by which a band is placed around the upper most part of the stomach giving it the shape of an hourglass. This band divides the stomach into two portions, one small and one larger portion. No stomach stapling is required.

The Lap Band induces an early feeling of stomach fullness, thereby decreasing food intake. You naturally feel the need to eat less. Any food you eat will be absorbed by your body at least as well as before the operation, as your digestive system is not altered in any way.

Weight reduction will instead be achieved by the fact that you will simply feel the need to eat less. This is because it only takes a small amount of food for the Lap Band to give you a true feeling of appetite satisfaction.

There are, however, some disadvantages that come with adjustable gastric banding. One of the most common downfalls includes slippage and erosion. Others include: Scar tissue can build up around the band and reduce the outlet, the band can loosen and fail to restrict eating, and in rare cases, the band can penetrate the stomach

As a consequence of these side effects, a person can experience repeated vomiting or failure to lose weight. This may require another surgery to correct the problem.

Patients are usually able to leave the hospital the day after surgery, but this depends on your surgeon’s recommendation about your specific case.

Typically, after three months, weekly meetings will become monthly. These meetings provide the patient with support from others who have had the same type of procedures and information from clinical dietitians and other weight management professionals.

In an effort to improve the reliability of adjustable gastric banding, several North American surgeons have started to use a combination of a laparoscopic gastric bypass with an adjustable gastric band. Because of concerns regarding a possible negative outcome, expert meetings were organized to evaluate the current situation and future application. The overall complication rate was acceptable, but the percentage of the band erosions was still too high (close to 7%). The potential advantages (adjustability, maintained access to the stomach and biliary tree, and reversibility) do not always compensate for this complication rate. Based on the results and the opinion of the surgeons experienced in this technique, it is concluded that the combination of gastric bypass with an adjustable gastric band to form the pouch is not recommended.

Despite these restrictions, Adjustable Gastric Banding is still considered a very safe alternative to Bariatric surgery that requires the reworking of major intestinal organs and tissue. The LapBand is adjustable and can be removed if complications arise of persist, leaving tissue and organs intact. Adjustable Gastric Banding is quickly becoming the clear choice for controlling weight and bettering the overall health for the morbidly obese.