Gastric Bypass:
Q&A
I’m trying to lose a lot of weight. Should I get my mouth wired shut or
have my stomach stapled?
Before such drastic measures are performed, there are a few qualifying
conditions to be considered eligible for either of these procedures. You must be
at least 100 pounds over your recommended weight and have exhausted all efforts
to lose weight by reducing food intake, changing your eating habits, planning
your meals, and exercising.
Keep in mind that there are no miracle weight loss cures. Any type of
weight loss or maintenance regimen requires a lifetime commitment to be
successful.
Before you seriously consider either of these procedures, you should
investigate the possible risks of the procedures, potential side-effects after
the procedures, and whether or not your insurance will cover the procedures.
The stomach stapling procedure you mentioned is called gastric-bypass
surgery. It is a permanent procedure and requires a lifetime commitment to
eating well and staying fit.
Gastric bypass is traditionally a laparoscopic or minimally invasive
procedure. During the operation, which requires general anesthesia (being
completely "put under"), a surgeon makes tiny incisions in the
abdominal area and, working with a miniature scope, divides the stomach into two
sections with two rows of stitch-like staples. Between the rows of staples, the
surgeon makes incisions so scar tissue will grow over the staples to secure them
in place.
The top section, called the pouch, holds the food (about a
tablespoonful, compared to the normal stomach, which holds about a quart). The
pouch will eventually expand enough to hold no more than one cup of chewed-up
food, so you will feel full quickly. Then, the intestines are detached from the
bottom of your stomach, and attached to the pouch. Since the intestines are
brought up and not shortened, the food can be fully absorbed, eliminating the
chance of vitamin and mineral deficiencies, a problem with previous surgeries of
this type. The unused part of the stomach still produces gastric juices, which
help the body absorb nutrients.
The surgery might or might not be covered by your insurance. (It generally costs
between $15,000 and $20,000.) Many insurance carriers are covering the procedure
because it has proved to improve some obesity-related health problems such as
diabetes and high blood pressure.
The risks of the surgery include bleeding, infections, and respiratory
problems. Generally, the procedure requires a three- to four-day hospital stay.
After you go home, you need to follow strict dietary instructions. For the first
few weeks after surgery, it might be difficult to eat anything without feeling
uncomfortably full, and your stomach will still be very tender. It will take six
to eight weeks before you are able to digest complex carbohydrates and protein
(such as chicken, pasta, and dairy products) without vomiting. It will be
difficult for you to digest large amounts of fat, alcohol, or sugar. Most
patients lose an average of 10 pounds per month, and reach a stable weight 18
months after surgery.
Points to remember about laparoscopic bypass surgery:
- Laparoscopic bypass surgery is not a miracle cure for quick weight loss.
It's a major one-and-a-half to two-hour surgery with possible complications
and side-effects.
- Laparoscopic bypass surgery is only available to those who are at least
100 pounds over their recommended weight, and have unsuccessfully tried other
diet and exercise programs.
- For more information, contact a bariatric doctor at your local hospital.
If you weigh 500 pounds or more, your doctor might recommend a low-protein diet
or the mouth-wiring procedure for a few months so that you can lose some weight
before a gastric bypass can be performed. While your mouth is wired shut, you
will lose weight quickly because your food intake, provided in liquid form, is
strictly regulated.
Weight loss before gastric bypass surgery might be necessary
because the endoscopy equipment is not long enough to accommodate the girth of a
patient weighing 500 or more pounds. In addition, most operating tables can hold
up to 400 pounds. Other risks, such as reaction to anesthesia, are also
increased in patients who weigh more than 500 pounds, so wiring your mouth shut
to promote weight loss might be suggested. However, wiring your mouth shut is only
a temporary solution, usually only suggested for a few months. Then, the gastric
bypass procedure and reducing and monitoring food intake are needed for
long-term success.
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Copyright 1995-2005 The Cleveland Clinic Foundation. All rights reserved
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