
	Medical Edge


	About

	Television

	Radio

	Newspaper

		Participating Newspapers

	Magazine

	Contact


	About Mayo Clinic

	Make an Appointment at Mayo Clinic

Medical Edge Newspaper Column from Mayo Clinic

GASTRIC BYPASS SURGERY CAN FACILITATE MAJOR WEIGHT LOSS

DEAR MAYO CLINIC: I was wondering if you have any information about gastric bypass surgery for weight loss. I need to lose 200 pounds for a number of health reasons. I’ve heard of people who have the surgery, lose the weight but then gain it back. What does it take to be successful over the long haul? — Gloversville, N.Y.

ANSWER: Gastric bypass helps many people lose weight successfully. However, there is an important element you need to consider: a support group whose members have undergone the surgery. As a surgeon who has performed more than 100 gastric-bypass procedures this year alone, I personally feel that a support group is essential to weight-loss success because a person-to-person connection helps reinforce the new, healthy lifestyle habits you need to keep the weight off.

Think of it this way: Gastric bypass is just a dramatic first step that sets the stage for a lifetime of health benefits. The second step is up to you. It’s a matter of attitude and willingness to actively commit to a support group. Talking to others who share a similar path will help you adhere to a new lifestyle marked by healthier food choices, portion control and regular exercise.

Here is what’s involved in the gastric bypass evaluation we use, which our Gastric Bypass Support Group helps at each step along the way.

Medical evaluation. A family physician refers a patient to a bariatric endocrinologist, the medical specialist who treats obesity. The patient undergoes a physical exam and tests to determine if there are any medical complications caused by excess weight — for example, heart problems, high blood pressure, diabetes, or hip and knee problems. A psychiatrist also completes an evaluation to assess the patient’s mental health.
Education about obesity. Obesity is on the rise among both adults and children in the United States. It’s responsible for about 300,000 deaths a year. This startling figure prompted the following comment from one of our patients, who lost 115 pounds: “This is a health issue, not a dress size.”
Education about the procedure. First developed about 40 years ago, the procedure has vastly improved with time and new technology. For example, with the new laparoscopic method, the surgery involves a smaller incision and less recovery time in the hospital.
During the procedure, the surgeon creates a permanent pouch about the size of a walnut in the stomach. The small intestine is then cut, and rerouted to connect to the pouch, thus “bypassing” the remainder of the stomach and the first part of the small intestine. As a result of this smaller food chamber, a person is limited in the amount of food he or she can eat by a conspicuous feeling of fullness. The surgery also creates a small amount of malabsorption. This means some of the food is not fully digested, so the calories are not absorbed.

According to the National Institutes of Diabetes and Digestive and Kidney Diseases, most patients lose weight rapidly following surgery and continue to lose for 18 to 24 months. Although some people regain a little bit of the weight, few regain it all. Gastric bypass improves obesity-related conditions. One study, for example, shows that the blood-sugar levels of most obese patients with diabetes returned to normal after gastric bypass surgery.

As with any surgery, there are risks. An estimated 5 to 10 percent require follow-up surgeries to correct complications. More than one-third will develop gallstones, though these can be almost completely prevented by taking bile salts during the first six months following surgery. There also is a risk of nutritional deficiencies such as anemia and osteoporosis, but we typically prescribe vitamin and mineral supplements to prevent these problems.

While gastric bypass surgery is no magic bullet, with a willing, motivated patient, it is a powerful tool for restoring health. It requires a patient to participate in support groups, eat healthy foods and commit to a regular exercise program. If that happens, it changes lives.

James Swain, M.D., Surgical Director, Obesity Treatment Program;
Mayo Clinic, Scottsdale, Ariz.

Additional Resources:
Treatment with Gastric Bypass Surgery
Appointment Information
More Information on Gastric Bypass Surgery
- - -

Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.