Obesity is a complex problem in which predisposition, morphology and nutrition are key factors. Obesity surgery can be necessary to give severely obese people the chance to restore their health. A gastric bypass is one of the most applied procedures.
What is a gastric bypass?
There are several ways to treat obesity. Each method responds to the energy balance differently, either by reducing the intake of nutrients or by hindering absorption and digestion. A gastric bypass is a combined restrictive / malabsorptive procedure, meaning that it reduces the sense of hunger and causes the body to digest less food.
A gastric bypass causes the food to be directed around the stomach. Food first enters a small stomach reservoir, after which it ends up in the small intestine via a new connection. The patient loses weight for two reasons:
- The small stomach reservoir causes the patient to feel satisfied faster, making them eat less.
- Nutrition goes straight from the reservoir to the small intestine, instead of via the duodenum. This causes digestion to come into effect later.
Who benefits from a gastric bypass?
A gastric bypass is recommended for motivated patients because the procedure only leads to the desired outcome if the patient is willing to change their nutritional habits. They need to learn how to eat slower and to avoid high-fat or high-calorie snacks. If the patient fails to do so, the reservoir may expand, causing the intake of energy to become too high after all.
Extremely obese (BMI of 40 or more) or severely overweight (BMI of 35 or more) patients who also suffer from associated conditions such as diabetes, hypertension, hypercholesterolemia, OSAS or arthralgia are eligible for a gastric bypass. The procedure is not recommended for underaged patients.
Gastric bypass surgery is performed under general anesthesia. Because it is a laparoscopy, no large incisions are made, making the recovery much faster.
The surgeon reduces the stomach. From the small stomach – a 15 ml reservoir – the doctor then connects to a lower part of the small intestine, that is being elevated. By creating a rather narrow connection, it creates a restrictive function, crucial for the success of the gastric bypass.
The remainder of the stomach is sealed at the top. The organ loses its function but remains vital. The duodenum continues to function as a connection between the old stomach and the small intestine, meanwhile not digesting any food.