Gastric Bypass Surgery: Is it Really the Golden Standard in Weight Loss Surgery?

More and more morbidly obese individuals are opting for bariatric surgery as a long-term way to manage their weight problem. Although there are several different choices when it comes to weight loss surgery, a majority of bariatric patients ultimately decide on the Roux-En-Y, better known as simply the gastric bypass. This is probably due to the popularity of this surgery. Bariatric surgeons often prefer the gastric bypass to other weight loss surgeries because of the ease of performing it as well as the anticipated results. Bariatric surgeons estimate that morbidly obese patients undergoing the gastric bypass surgery will lose about 70% - 80% of their excess weight. Of course most patients dream of losing all of their excess weight, and with hard work and exercise, it is very possible. The gastric bypass surgery has often been referred to as the "golden standard" in weight loss surgeries because of a lower risk or complications as well as due to the fact that it's often tolerated well by most patients.

Recent reports on the gastric bypass surgery have suggested that this surgery isn't so "golden standard", as it has failed for many patients, many failing to lose any substantial weight, while others lost all of their excess weight only to regain it. Of course the patient has to take some responsibility in such a case, because the gastric bypass isn't magic and a post-surgical person still has to make healthy food choices and exercise regularly in order to be successful throughout the weight loss stage as well as during maintenance. However, there are some patients who follow all the rules yet the gastric bypass still fails them. Why?

Researchers in Montreal, Quebec may have the answer to this question. Several general surgeons decided to perform a 10-year follow-up on gastric bypass patients in order to find out how successful they were with their surgery. The four surgeons were prompted to perform the study after noticing a large increase in the number of failed gastric bypass surgeries. Post gastric bypass surgery patients were regaining their weight at alarming rates and the general surgeons wanted to find out if patients who had long limb gastric bypass surgeries were more likely not to regain weight. Most gastric bypasses are performed "short limb", meaning that only a short amount of the intestines are bypassed. On the other hand, those who underwent long limb gastric bypasses have greater malabsorption, which for some patients helps to both accelerate weight loss and enable them to better keep off the weight.

The study consisted of over 200 individuals who had undergone gastric bypass weight loss surgery. Surgeons followed these patients over a ten-year or more time span, periodically asking for their weights, eating habits, exercise patterns, etc. Surgeons suspected that patients who had short limb gastric bypasses would be those who were more likely to regain their weight, but the results of the study were shocking. Researchers discovered that of the people who had regained their weight, it didn't matter whether they had had the short or long limb gastric bypass surgery. This signified that the reason for the failed gastric bypass surgeries was not because of the surgery itself, but it was in fact due to the patients failing to permanently change their eating and exercise habits. Others who claimed to have followed all of the post surgical rules may have added in small amounts of sugar or other forbidden foods, which can stretch the pouch signficantly over time, resulting in weight gain.

Well, it seems as though the Roux-En-Y gastric bypass is referred to as the "golden standard" for a very good reason-because it is the golden standard. The surgery, which is merely a tool, helps to retrain morbidly obese people, assisting them in learning new, healthier eating habits and incorporating regular exercise into their lives. Of course, despite the restrictive and malabsorptive functions of the gastric bypass, many patients who believe that they will lose weight and keep it off no matter how they eat, will be proven wrong as they begin to regain the weight that was lost prior to surgery. The Roux-En-Y gastric bypass is very serious surgery, and anyone who makes the decision to undergo it in order to drastically change their life must also be willing to make drastic lifestyle changes as well. If a person is unwilling to make these changes then perhaps they shouldn't have bariatric surgery of any kind.

Annals of Surgery Medical Journal

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1856611/

Mayo Clinic - Gastric Bypass Surgery

http://www.mayoclinic.com/health/gastric-bypass/MY00825