Understanding Gastric Bypass

How dangerous is gastric bypass surgery?

In one sense, the danger of surgery is...The danger of any surgery, is there. This is big surgery so there is a big danger to this type of surgery. And a patient who is, although they seem healthy, have a lot of problems, just due to their overweight status. On the other hand, If the patients do not lose weight, their weight is going to kill them. So the surgery, the danger of the surgery, more than outweighs the danger of remaining overweight, in most instances. And we are very careful working up a patient to make sure that the danger we are putting them in is not so great that we should not actually do the surgery.

What are the risks of gastric bypass surgery?

The dangers and the risks are one from the surgery. There is a death rate. There is what we call a morbidity rate which is infections, bleeding. Patients can have a heart attack on the table, the older patients mostly. Most of the time obviously that doesn't occur. Those are the risks of the surgery. But then there are the psychological risks and the lifestyle risks. Most of my patients tell me, "Food is my best friend. What am I going to do without it?" And that's a big problem that they have to know to do with afterwards. If afterwards they are going to go into depression, not be able to deal with life, that's a risk of surgery and weight loss and it's something we try to deal with ahead of time to see if that's going to occur.

What's the success rate for gastric bypass surgery?

Gastric bypass surgery has a success rate, in the literature, of between 70 and 80 per cent over a five year period. So we measure success in the bariatric world as having lost between 50 and 80 percent of your excess weight and keeping it off for five years. So I'd expect about 80% of my patients to keep their weight off for 5 years and probably 70% over 10 years.

How is 'gastric bypass' surgery defined?

Gastric bypass surgery is a surgery actually invented by Dr. Mason around 1968 as a method of losing weight. What it accomplishes is to make the stomach very small with a very small outlet. So it's what we call a restrictive procedure; it prevents things from going through fast, and it also bypasses a portion of the stomach and intestine, the duodena portion of the intestine, in order for patients to be able to lose weight. In one they are forced to lose weight, they are forced to learn how to eat appropriately.

When is gastric bypass surgery necessary?

Gastric bypass surgery is necessary in the sense that all other treatments for patients who are more than 100 pounds overweight, in that category, fail 98 percent of the time. Some people say 95 percent... it's probably closer to 98 percent of the time. So this operation was invented in order to help people who failed those other methods. The reason it's important for it to be done is it cures a lot of problems that those patients have... diabetes, hypertension, sleep apnea, which aren't going to get cured unless they lose the weight.

Why have gastric bypass patients failed with other weight loss methods?

Most of the other methods, which are diet methods, diet pills, work while they are being used and as soon as you're off the diet and go off the pills, the patients regain their weight. With bariactric surgery it's permanent, we've implanted a device in the case of a lap band, or we've rerouted the stomach in the case of the gastric bypass, and that is not reversed. It can be reversed but it's surgical and it's another big procedure, so this is there permanently, always reminding the patient they need to stay on the diet, they need to maintain the discipline needed for the surgery to work.

What are the benefits of gastric bypass surgery?

The benefits? Obviously, the weight loss. What does the weight loss then gain for the patient? In terms of medicine, cures their co-morbid conditions diabetes, hypertension, sleep apnoea, back problems, joint problems, and risks of cancer- which are increased in men and women who are over weight. The biggest gain and benefit I feel is lifestyle. These patients get to do what they have not been able to do in the past. Several of my patients have gone to Disneyland, which they couldn't do before. Gone to the beach, which they were afraid to do just because of what they looked like. Life is for living. Life is not for sitting around and hiding. And for these patients, that's their major benefit.