Gastric bypass surgery is being used more and more often as Americans continue to gain weight.
In 2002, 63,000 weight-loss operations were performed in the United States, according to The American Society for Bariatric Surgery.
The number of weight loss surgeries will continue to go up as more and more people become dangerously obese, and as more health insurance companies add gastric bypass surgery to their benefits.
Are you qualified for gastric bypass?
Gastric bypass surgery can have great benefits, but it also can have complications and risks. For that reason, the North American Association for the Study of Obesity advises that this weight loss surgery should only be considered if:
- Your body mass index (BMI) is 40 or higher (extreme obesity)
- Your BMI is 35 to 39.0 (obesity) and you have a serious obesity-related health problem such as diabetes or high blood pressure
Some insurance policies now cover gastric bypass surgery, but there will usually be strict pre-treatment requirements. Prospective patients may be required to attend nutritional and psychological counseling for six-months prior to approval of the operation, and they will be asked to lose up to 8% of their current body weight prior to the gastric bypass surgery.
These requirement help to assure the surgeons and the insurance companies that the procedure will be successful. Most insurance will only cover one weight loss surgery in a patient’s lifetime.
Gastric bypass surgery is not for everyone.
If you are considering this procedure for your weight problem, you should do very careful research before committing to it.
Most reputable doctors will ask you to live on a lowered calorie diet for at least six months before gastric bypass surgery, and your insurance company may require extensive nutritional and psychological counseling before your surgery, which they may not pay for.
Your surgeon will also discuss any possible medical or emotional issues that may get in the way of complete recovery. This surgery is known to have a fairly high rate or complications, and some of them are life threatening. Find out everything you can about this procedure before you decide.
The Roux-en-Y gastric bypass surgery
The Roux-en-Y procedure is the most common form of gastric bypass surgery, and it is often the only form of the procedure that is covered by insurance. The surgery helps you lose weight because the new small stomach pouch created in the surgery will hold less food, so you eat less at each meal.
You will also notice that your body can not easily tolerate foods that you previously ate, such as foods high in sugars and fats. Since these are the foods that help many of us gain our excess pounds, you’ll naturally lose weight when you find these foods physically uncomfortable to eat. This is called “the dumping syndrome,” and can be quite painful if these foods are eaten.
You will have a smaller stomach pouch, and part of your digestive system will be bypassed after the gastric bypass procedure,, which reduces the amount of calories your body can absorb. This also affects the absorption of other nutrients, so you will be encouraged to continue with nutritional counseling.
The reduced stomach pouch size, change in eating habits, and reduced absorption allow people to successfully lose weight and keep it off long-term.
Choosing a surgical center with a high success rate and plenty of experience is important. For this reason, most insurance companies will only cover this gastric bypass surgery if it is performed at one of the clinics designated as a “Center of Excellence.” You can find one of these clinics at www.surgicalreview.org/
LAP-BAND® Adjustable Gastric Banding System
The LAP-BAND® system is less expensive than the Roux-en-Y described above, and the recovery times are lower. The procedure is also less invasive and has fewer reported complications.
The official name of the procedure is “laparoscopic adjustable gastric banding procedure” but it is often called the LAP-BAND® system after the inflatable silicon band that divides the stomach. The adjustable band creates a very small stomach pouch at the top of the stomach, with an adjustable opening to the rest of the stomach below. The diameter of the band is usually about two inches, but the surgeon can adjust its diameter by pumping saline into it from a reservoir implanted under the patient’s skin.
The LAP-BAND® system does not reroute the upper intestine, so it does not interfere with the digestive process. Weight loss occurs solely because the size of the stomach is restricted. Patients do not experience the “dumping syndrome” that is common for Roux-en-Y patients.
Although weight loss is slower with the gastric banding procedure, after 3 to 5 years, both gastric banding and gastric bypass patients show comparable weight loss, according to recent studies. The slower initial weight loss may be the reason why many U.S. surgeons prefer to offer the Roux-en-Y operation for their obese patients. Surgeons in Europe and Australia appear to show a preference for the less invasive gastric banding surgery, because it is usually safer.
The gastric banding procedure is less invasive than gastric bypass, and there are fewer reported complications and deaths from this type of surgery. However, complications do occasionally occur, and a second operation is sometimes needed. A recent study that looked at the records of 300 gastric banding patients found a 5% complication rate, while other studies have found the rate of complications to be higher. Some patients will need a second operation due to band slippage or because the stomach pouch becomes dilated.
As with all patients who undergo rapid weight loss, gall stones are common, and long-term nutritional and behavioral counseling is needed for the best outcomes. The pros and cons of gastric bypass vs gastric banding are discussed here.
Mini Gastric Bypass
The mini gastric bypass procedure, also called the “Loop Gastric Bypass,” takes less time in the operating room than the more “traditional” Roux-en-Y procedure, and may have been designed to be used by less experienced surgeons.
Most insurance companies consider the mini gastric bypass to be “experimental” and won’t cover it because of its safety record and the higher number of complications that have been observed. For a full discussion of the mini gastric bypass system, and why it is somewhat controversial, click here.
As more research is done, more surgical and non-surgical options become available to cure obesity. If you’re considering this type of treatment, be sure to become as knowledgeable as you can be – many people who have had gastric bypass surgery say their experiences would have been much less traumatic if they had educated themselves more thoroughly ahead of time.