Gastric bypass is a type of bariatric (weight-loss) surgery that treats obesity – a medical condition in which your body stores too much fat, causing serious health complications.
Gastric bypass treats a number of obesity-related conditions, including heart disease, diabetes and stroke. This is known as metabolic syndrome. Losing 5% or more of your weight can prevent or delay these health troubles.
At Temple Health, our compassionate multidisciplinary team guides you through your bariatric surgery. The surgery is part of a comprehensive weight-management plan.
Qualifications
Gastric bypass surgery may be an option if:
You have metabolic syndrome.
Your BMI is over 40.
You have a BMI of 35 to 39.9 and two or more obesity-associated health conditions, such as high blood pressure, sleep apnea, diabetes or heart disease.
Obesity affects daily living, relationships or your ability to move.
Diet and exercise changes haven’t worked long-term.
Preparing for surgery requires lifestyle changes physically, emotionally, mentally and financially. As you are preparing, take the following into consideration:
Check with Your Insurance Company
Most insurance plans cover Roux-en-Y gastric bypass if you meet the qualifications. Before your procedure, check with your insurance company to make sure you understand your coverage, including any co-pays or out-of-network considerations. Temple will help you with any pre-authorizations or required approvals.
Schedule Any Required Tests
Work with your bariatric team to complete any tests required prior to your procedure. Your bariatric surgeon will determine what tests you need based on insurance requirements and an evaluation of your overall health. These tests may include blood work and chest X-ray as well as an evaluation of your heart and gastrointestinal (GI) system.
Re-Think Your Relationship with Food
You’ll meet with a Temple dietitian in the months before your procedure to evaluate your nutrition and overall eating patterns. You'll work together to create healthier habits and prepare for long-term success after your surgery. Losing weight before your gastric bypass surgery will help you recover faster.
Your dietitian will also need to provide required paperwork to your insurance company to show that you’re committed to a successful procedure.
Move As Much As Possible
Successful long-term weight loss is a complex process that includes many different factors of your well-being. One of those factors is physical exercise. Even if you have not exercised in a long time, it’s important to move every single day before your procedure, and after you start your recovery process. Commit to moving just a little bit every day, even if it’s just a few steps.
If You Smoke, Now’s the Time to Quit
Smoking increases your risk of complications during and after gastric bypass surgery. If you smoke cigarettes or use any type of tobacco or nicotine product, talk to your doctor about strategies for quitting prior to your procedure.
Read Up and Ask Questions
During your initial consultation, you’ll receive a packet to take home and read. But don’t stop there. Conduct your own research about Roux-en-Y gastric bypass, talk to others who have been through the procedure, and ask your Temple weight-loss team as many questions as possible. You are the center of your own health care team, so make sure you are well-informed.
Gastric bypass surgically reduces your stomach size and reroutes the small intestines. It reduces how much you can eat and how many calories you absorb.
The small intestine is connected to a small pouch of the stomach.
Roux-en-Y gastric bypass is performed by creating a small pouch from your stomach. Doctors then connect the pouch to your small intestine. This sends food past a large part of your stomach, reducing the overall functional volume.
If you have a gastric bypass, you’ll feel full after eating less food. This combined with the recommended nutrition plan will help you achieve successful weight loss. You’ll lose weight since you’re taking in fewer calories.
Surgery Approaches
Doctors refer to bariatric surgeries as restrictive or malabsorptive. Procedures generally involve one or both of these approaches:
Restrictive – Restricts how much you eat by decreasing your stomach size
Malabsorptive – Changes how you absorb calories and nutrients by changing your digestive-tract structure
Traditional vs Minimally Invasive Surgery
Roux-en-Y gastric bypass surgery is a traditional bypass surgery that involves creating a stomach pouch and surgically redirecting or bypassing your intestines.
With minimally invasive (laparoscopic) bariatric surgery such as gastric sleeve, the potential benefits include fewer incisions so that you have less discomfort, less scarring and an easier recovery.
Your surgeon will recommend the best treatment method for you.
After the gastric bypass surgery, you’ll follow strict dietary guidelines that are essential to proper nutrition and healing. Avoid getting too full – especially while your newly created pouch heals. After that, keep portion sizes small to maintain weight loss. Your Temple Bariatric team will help you progress through these dietary phases based on your recovery process.
You progress through these diet phases:
Week 1: Clear Liquid Diet
Right after bariatric surgery, sip only clear liquids. These may include drinks such as:
Broth
Sugar-free gelatin and sugar-free popsicles
Sugar-free, non-carbonated beverages
During the period just after your procedure, your body needs time to heal and build up its stamina. While in the hospital after your procedure, you’ll sip 1-2 ounces of clear liquids every hour. After discharge, and for the first week following your gastric bypass, you’ll increase your fluid intake to 3-8 ounces per hour. During that time, you’ll need to slowly increase your fluid intake to 64 ounces per day.
Weeks 2-3: Full Liquid Diet
At your one-week office visit after surgery, you will be advised to add full liquids such as:
Strained, low-fat creamed soup
Protein shakes
Fat-free milk, 1% milk or unsweetened non-dairy
Light yogurt
Sugar-free pudding
Over the following 1-2 weeks, as your body starts to heal, you’ll add more nutrition with a full liquid diet. Be sure to listen to your body during this time.
Weeks 3-6: Pureed Diet
Puree your foods for about 2 weeks. Eat small meals focused on high-protein foods.
During weeks 3-4 after surgery, you should start experimenting with pureed foods. This allows your body to get used to textures and gives you the opportunity to enjoy some additional flavors. Start first by adding pureed high-protein foods.
Foods you may puree and try at 3 and 4 weeks include:
Chicken
Fish
Turkey
Beans
Eggs
Cottage cheese
At Week 5 after surgery, add some pureed soft fruit and vegetables. Be sure to include variety for nutritional support, but avoid fibrous vegetables such as broccoli.
Foods you can puree at week 5 include:
Natural applesauce
Peaches
Carrots
Spinach
Sweet potato
Weeks 6-8: Soft Diet
Soft foods that are easy to chew are introduced after several weeks of the puree diet.
Generally, you can begin a soft diet about 6-8 weeks after surgery. Soft foods are foods that can be mashed easily.
Work with your Temple dietitian to make sure you’re ready and to talk about the best foods to try, when. These might include:
Lean ground meats, including hamburger, turkey and chicken
Canned meats, such as salmon, chicken and tuna
Scrambled eggs
Beans
Tofu
Fruits, canned in water or natural juice
Week 9: Stabilization
Solid food is reintroduced slowly after about 1 month of the soft diet.
Once your body acclimates to a soft diet, you can begin introducing solid foods. Usually this happens around week 9 following surgery, but check with your dietitian to be sure.
Tips include:
Focus on protein first to help fill you up, then progress to vegetables, then fruit
Meals should measure about 4-8 ounces, or 1/2 to 1 cup
Drink your liquids between meals, not during
Avoid certain foods, such as breads, rice, pasta and high-sugar and high-fat foods
Avoid fibrous vegetables
Avoid sodas and other carbonated beverages
Practice mindful eating – quit eating when you’re almost full
Benefits and Risks
Before choosing to have gastric bypass surgery, be sure you understand both the benefits and risks of the procedure. When performed laparoscopically, gastric bypass results in less blood loss during surgery, decreased risk of infection and a faster recovery, with less pain.
Benefits
Risks
Significant long-term weight loss
Venous thrombosis/DVT
Reversal of Type 2 diabetes
Leaking incision or incisional hernia
Improvement in chronic conditions, such as:
High blood pressure
High cholesterol
Sleep apnea
Urinary incontinence
Infection
Relief from arthritis-related pain and inflammation
Intestinal or bowel blockage
Improved heart health
Dumping syndrome
Gallstones
Nutritional deficiencies
Before having Roux-en-Y gastric bypass, your Temple bariatric surgeon will discuss the risks of the procedure with you. You can decrease your risk by following your pre-operative surgical plan, including working with your Temple dietitian to lose weight and follow best practice nutritional guidelines.
Post-Op and Long-Term Risks
The following are some of the risks associated with gastric bypass surgery, both after the procedure and long-term:
Venous Thrombosis
A venous thrombosis is a blood clot that forms in a vein. When the clot forms in a deep vein, it is known as DVT, or deep vein thrombosis. DVT can either occur during gastric bypass surgery or while you are recovering. Moving and walking before and after surgery will help decrease your risk of developing venous thrombosis.
Your bariatric surgery team will also provide you with compression stockings during the procedure and may give you medication to help prevent clots from occurring.
Leaking Incision
Leaking can occur in both your internal and external incision sites. This generally happens when your incisions have not yet healed. Be sure to work with your dietitian before and after your procedure to make sure you’re getting proper nutrition to support faster healing.
Infection
One of the most common complications following gastric bypass is wound infection. You will receive wound care instructions before discharge from the hospital. Be sure to contact your doctor if you notice any signs of infection, including redness, swelling or heat in the area.
Bowel Blockage
Intestinal or bowel blockage is when the contents of your intestine cannot move through to exit your body. You may experience abdominal pain, nausea and vomiting.
Dumping Syndrome
Once you begin to introduce more solid foods into your diet after surgery, you may experience dumping syndrome. You may experience stomach cramping, diarrhea and feel lightheaded very soon after eating. Certain foods may increase your chance of experiencing dumping syndrome, such as those with a lot of sugars or fats.
Gallstones
These small hard pieces of material form in your gallbladder or bile ducts. While your body may pass gallstones, they may also cause obstruction. Gallstones cause pain in your abdomen and right shoulder, and may result in nausea and vomiting.
Nutritional Deficiencies
You will have blood work periodically for the first year following Roux-en-Y gastric bypass, and then periodically as recommended by your weight-loss team. This ensures your body is absorbing the nutrients it needs to stay healthy. Your team will recommend vitamins and supplements to help support your good nutrition.
Benefits and Quality of Life After Surgery
Roux-en-Y gastric bypass requires the expertise of an experienced bariatric surgery team. If you and your bariatric surgeon decide gastric bypass is right for you, you may benefit in the following ways:
Significant Long-Term Weight Loss
You may expect to lose up to 60% of your excess weight within the first 2 years following gastric bypass surgery. Keep in mind that your surgery is just one part of the big picture. In order to lose the weight and keep it off you will need to follow diet, exercise and nutritional guidelines as recommended by your weight-loss team.
Resolution of Type 2 Diabetes
Calorie restriction and significant weight loss lead to improvement or resolution of Type 2 diabetes in some patients. Type 2 diabetes is linked to serious conditions, such as heart disease and nerve damage.
Improvement in Chronic Conditions
As you drop the weight following gastric bypass, you’ll notice improvement in metabolic disorders and conditions such as high blood pressure, high cholesterol, sleep apnea and urinary incontinence. Because you’re not putting as much pressure on your joints, arthritis symptoms such as pain and inflammation may also improve.
Improvement in Heart Health
Obesity is linked to atherosclerosis, a build-up of plaque in the vessels of your cardiovascular system. Bariatric surgery such as gastric bypass reduces body fat and decreases inflammation. This leads to improvements in heart-related symptoms such as high blood pressure.
With decades of experience in bariatric care and surgical procedures, we understand the complex problems of obesity. At the Temple Bariatric Program, you receive high-level care that includes:
Skilled Surgeons
Through Temple’s Bariatric Program, our skilled surgeons have a record of accomplishment of successful outcomes. For nearly a decade, our specialists have exclusively cared for patients receiving bariatric surgery.
After so many years of trying to do it myself, I had to get medical help.
LOIS
Lois — after weight-loss surgery.
Lois struggled for years with gaining and losing weight. She decided to take a different approach by exploring bariatric surgery. Before surgery she weighed 353 pounds, and she is now down to 165 pounds.
I met with the whole staff, everybody was so helpful and they still are.
JOAN
Joan — after weight-loss surgery.
Joan had many co-existing conditions (the occurrence of more than one disorder at the same time) that she struggled with throughout her life. She tried all the fad diets, but never felt successful. After research, she felt she made the right move to get bariatric surgery. The staff provided guidance and support throughout her surgery process.
Our team of bariatric surgeons, dietitians and psychologists see patients at both Temple University Hospital and Temple University Hospital – Jeanes Campus.
Temple University Hospital is one of the region's most respected academic medical centers.
Jeanes Campus provides sophisticated surgical services in a convenient, community-based setting.
