Thanks to medical advances and a meticulous and caring group of providers, Longstreet Clinic’s Center for Weight Management offers patients in need with an effective medical weight loss procedure: Gastric bypass.
Also called the Roux-en-Y (RNY) procedure, the gastric bypass is a minimally invasive surgery that produces astounding results for patients in need of immediate and substantial weight loss.
However, no matter how talented the surgeon or routine the procedure, true success for a gastric bypass also requires a post-surgery commitment from the patient. This obligates the patient to a very specific diet designed to ensure optimal health.
It is not an easy commitment but is one that supports life-changing weight loss for patients facing severe obesity and the comorbidities that condition produces. It also puts the patient on the path toward a health standard many would have previously thought unattainable.
In fact, nationwide statistics show that 80 percent of gastric bypass patients lose at least half of their excess body weight and maintain that loss for more than five years. The average weight loss equaled 80 percent of excess body weight. And at Longstreet Clinic’s Center for Weight Management – where our experienced surgeons have conducted more than 1,000 such procedures – our RNY patients average 80 percent of excess body weight loss at 24 months post-surgery.
But, as Longstreet Clinic Center for Weight Management bariatric surgeon Dr. Eric J. Velazquez notes, that kind of success also goes hand-in-hand with a determined effort from the patient.
“After a gastric bypass, the diet is very particular. We have a very specific protocol of how you’re going to start your diet after having a bypass,” Dr. Velazquez said.
Why the need for a new diet?
The reasons for this are twofold.
First, the procedure itself necessitates this diet due to the physical change that your digestive tract undergoes.
In the Roux-en-Y Gastric Bypass (RNY), a golf ball-sized part of the patient’s stomach is surgically divided from the rest of the stomach, completely separating the two pieces in most cases. The now much smaller stomach severely restricts the amount of food a patient can take in. The result is that you feel full much sooner than with your previous, regular-sized stomach. The procedure also changes your gut hormones, which will help you feel full longer. This appetite suppression is a key component of the weight loss that ensues post-operation.
The larger lower portion of the stomach never holds food again but does help with digestion.
During surgery, a branch of a Y-shaped segment of your small bowel is attached to the new, small stomach. The other branch of the bowel remains attached to the “original” stomach. This delays the mixing of food with digestive juices resulting in poorer absorption of calories and nutrients.
As a result, if you eat carbohydrates, including sugar, after gastric bypass surgery, the passage of “carbs” into your small intestine causes an immediate outpouring of fluid into the bowel and a release of insulin into the blood stream. This causes nausea, cramping and diarrhea for about 20 to 30 minutes. Called “dumping syndrome,” this unpleasant side effect can help deter you from consuming the wrong foods for the rest of your life.
The second reason for the dietary change is psychological.
Even with this approach to weight loss, a patient who refuses to make long term changes to their diet could eventually regain their weight. In other words, even this surgical approach can be overridden over time should a patient relapse into prior dietary habits.
The good news is that the dietary changes – which patients must agree to in order to be eligible for the procedure – combine with the physical changes that patients undergo to make things relatively straightforward for the patient.
That said, the initial diet post-surgery will likely be drastic compared to what the patient experienced prior.
“The first three days you’re only going to be in what we call a bariatric stage 1 diet. These are clear liquids and very small amounts. And we will even coach you on how many times a day you have to take those liquids,” Dr. Velazquez said. “After day three, we will proceed to a bariatric stage 2 diet that now is full liquids. And we’ll keep you there for probably about a week. When you advance into stage 3 diet, the diet will consist of some pureed and blender-ized options; and we’ll start adding your protein and other nutrients in.”
A meaningful – and lifelong – change
Undergoing a gastric bypass is not something to be taken lightly. Indeed, it is a lifetime commitment – but one that can help a patient counter obesity and a host of health concerns that may be borne from weight issues, including:
- Pulmonary Disease (includes abnormal function, sleep apnea, hypoventilation syndrome)
- Non-alcoholic Fatty Liver Disease (includes steatosis, steatohepatitis, cirrhosis)
- Gall Bladder Disease
- Gynecological abnormalities (includes abnormal menses, infertility, polycystic ovarian syndrome)
- Cancer (includes breast, uterus, cervix, colon, esophagus, pancreas, kidney, prostate)
- Coronary Heart Disease (includes dyslipidemia, hypertension)
- Type 2 diabetes
- Idiopathic Intracranial Hypertension
At the Center for Weight Management, we understand just how important these changes can be for your life – which is why we do everything possible to support you and help you to achieve lifelong success. That includes providing access to dieticians, support groups, and counseling – all of it designed to smooth the process at each step of the way. And while the initial diet sounds drastic, it also gives way to normalized foods in relatively quick fashion.
“Through the weeks we’ll be advancing with you and sometimes substituting one of the pureed or blender-ized diet for a regular diet. Asking you to chew your food really well. And at the end of the six weeks, we’ll have you in all of your meals eating a regular diet,” Dr. Velazquez said. “After that, it’s always important to continue with the concepts of eating a high protein, low carbohydrate, and low-fat diet. We’ll also ask you to take your vitamins and to follow the recommendations of the dietician.”
Only those patients who measure at a Body Mass Index (BMI) of 40 or above qualify for bariatric surgery. A BMI of 30 or above is considered obese by the National Institute of Health. Some patients with a BMI of 35-39 may also qualify for the procedure if they are also suffering from complications resulting from obesity.
The Gastric Bypass features low complication rates, and our physicians always put your health and success first. That said, it should still be considered a major surgery, even if it is accomplished through several small incisions.