Laparoscopic Gastric Bypass Surgery:

Through the surgical creation of a small pouch out of a portion of the stomach, the patient is given a ”tool” to help him or her gain control over the feeling of hunger. Long-term weight control is dependent upon using this pouch/tool correctly, along with adopting a healthy lifestyle that includes good nutrition and exercise.

Initial weight loss (1 to 6 months) occurs due to the fact that it does not take much food or liquid to fill the new small pouch. Therefore, satiety or “feeling full” is reached very quickly. Moderate to rapid weight loss occurs during this time but it is very important that the patient follow the recommended diet in order to stay healthy by taking in sufficient amounts of protein, vitamins, and minerals. It is also important during these months that the patient starts getting into the habit of living a healthy lifestyle.

Not only is the amount of food intake reduced but the types of food must be modified as well. Because the new pouch is small and some food can quickly pass through it into the newly attached small bowel (the Roux limb, pronounced “Rew“) care must be taken to avoid high calorie items and in particular high concentration carbohydrates or sugars. This means some starches and all sweets, candies and cakes. If these foods reach the Roux limb the body will react by secreting a large amount of fluid into the Roux limb to try to dilute those carbohydrates. The result is abdominal cramping, diarrhea, sweating, light-headedness and sometimes fainting. This is the dumping syndrome as is not truly a complication but rather a byproduct of the new anatomy. The actual length of the patient’s gastrointestinal tract has been shortened as a result of the surgery as well but most patients have the ability to compensate for this loss of surface area over time by increasing the efficiency of the remaining small bowel.

Over time, some patients note a moderate increase in their appetite (6-12 months). The patient continues to maintain control over hunger by filling the pouch/tool with just enough nutritious food at each mealtime. By doing so, the pouch/tool actually stretches very slightly which signals stretch nerves to tell the brain to cut off feelings of hunger and replace them with feelings of fullness. Learning how to use your pouch correctly and long-term follow-up with the medical and nutritional support team are necessary for successful weight loss and management.