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Morbid obesity is a condition which arises from severe accumulation of excess weight as fatty tissue, and the resultant health problems which occur. Gastric bypass operations which cause malabsorption and restrict food intake produce more weight loss than restriction operations, which only decrease food intake. Gastric bypass surgery creates dramatic changes in the size and shape of the stomach. People who have bypass operations generally lose two-thirds of their excess weight within 2 years.
Introduction to gastric bypass
Gastric bypass surgery makes the stomach smaller and allows food to bypass a part of the small intestine. It has several advantages:
- You will feel full more quickly than before
- The amount of food you eat will be significantly reduced
- You can eat everything you want
- Bypassing part of the intestine also results in fewer calories being absorbed which leads to weight loss
Gastric bypass surgery may improve or resolve the following conditions associated with obesity: Type 2 diabetes, high blood cholesterol, high blood pressure, obstructive sleep apnea and gastroesophageal reflux disease (GERD)
Gastric bypass consists of dividing the stomach into a small upper pouch and a much larger, lower pouch. This is accompanied by rearrangement of the small intestines to permit both pouches to remain connected. The operation leads to a marked reduction in the functional volume of the stomach, accompanied by an altered physiological and psychological response to food.
Weight loss is typically dramatic, and co-morbidities are markedly reduced. It is important to note that the gastric bypass reduces the size of the stomach by well over 90%. A normal stomach can stretch, sometimes to over 1000 ml, while the pouch of the gastric bypass may be 15 ml in size. Over time, the functional capacity of the pouch increases and the increased capacity serves to allow maintenance of a lower body weight.
Indications for the operation: Who’s the best candidate?
Gastric bypass surgery is reserved for people who:
- are unable to achieve or maintain a healthy weight through diet and exercise
- are severely overweight
- have health problems as a result of their obesity
To be more precise - gastric bypass may be considered if:
- Your body mass index (BMI) is 40 or higher
- Your BMI is 35 to 39.9 (obesity), and you have a serious weight-related health problems such as diabetes or high blood pressure.
People shouldn’t undergo these operations easily. They should note that gastric bypass surgery shouldn’t replace the need for following a healthy diet and regular physical activity program. In fact, the success of the surgery depends in part on your commitment to following the guidelines given to you about diet and exercise.
Preparation for the operation
Preparation for the operation isn't easy at all. It is important to know that candidates for the operation go through an extensive screening process and not everyone meets the criteria for gastric bypass. A whole team of professionals evaluates whether the surgery is appropriate for you including a:
This involves identifying which aspects of your health would be expected to improve after surgery and what aspects of your health may increase the risks of surgery. The operation may not be recommended if there's any sign that a patient isn't psychologically or medically ready for surgery. It's important to follow your doctor's directions in preparing for gastric bypass surgery. This includes eating and drinking restrictions, starting a program of physical activity, and limiting or stopping the use of nicotine products.