Gastric Bypass
Gastric bypass can set someone on a path way that diets and exercise cannot do, obese people
have issues losing weight without the proper tool. With the tool they are given by having the
Gastric bypass done they are able to lose weight to improve their overall health and wellness.
Helping obese people lose weight with a strict diet for a total of 2 weeks before surgery they are
on a clear liquid diet, to help reduce the amount of fat that is around the liver. So it is easier for
the doctor to do the surgery plus while on the 2 week fasting diet the patient is losing some
weight. When an obese person is unable to get around exercising they are taught how to do every
day exercises sitting or lying down. Compared to someone who is able to get up and move
around, someone who is morbid obese has more issues and there are times were the Gastric
Bypass is required to help save the life of someone that is morbid obese.
The types of surgery??™s that can be done are the laparoscopic and the incision style. When
having the laparoscopic done there are 7 small incisions done on the stomach for the tools to be
placed, as well as a camera for the doctor to see what he is doing which leads to a faster healing
time. If having an incision style surgery done the patient is opened from breast bone on down to
their belly button. When having that style done there is more of a risk of infection and longer
healing time as well. Once the doctor and patient have talked over which style the doctor is going
to do then they talk about the type of gastric bypass that will work better for them. The doctor
and patient will talk about the Laparoscopic gastric plication, Roux-en-Y, Sleeve Gastrectomy,
lap band.
The Laparoscopic Gastric Plication is a restrictive procedure that reduces the size of the
stomach and limits food intake. This procedure is also referred to as Laparoscopic Greater
Curvature Plication (LGCP).Gastric Plication is a restrictive procedure. It greatly reduces the
amount of food that can be eaten at one time. It does not cause decreased absorption of nutrients
or bypass your intestines. After eating a small amount of food, you will feel full very quickly and
continue to feel full for several hours. Gastric Plication may also cause a decrease in appetite.
Laparoscopic Gastric Plication, involves sewing one or more large folds in your stomach.
During the Laparoscopic Gastric Plication the stomach volume is reduced about 70% which
makes the stomach able to hold less and may help you eat less. There is no cutting, stapling, or
removal of the stomach or intestines during the Gastric Plication. The Gastric Plication may
potentially be reversed or converted to another procedure if needed.
With Roux-en-Y Gastric Bypass (RYGB), the bariatric surgeon creates a very small pouch
(approximately 15-30cc or about the size of a golf ball) with the upper part of the stomach. The
rest of the stomach is permanently separated from the new pouch. The small intestine is then cut
below the stomach and is rearranged to provide an outlet from the new stomach. Further down, a
connection is made so that the flow of digestive juices from the lower stomach are maintained.
The bypassed intestine no longer absorbs food/calories, providing the malabsorption aspect of
the procedure. Roux-en-Y Gastric Bypass provides a “tool” with which clients can potentially
lose a large amount of excess weight, as long as they make necessary lifestyle changes and
follow program instructions/requirements before and after having surgery.
With Sleeve Gastrectomy (Vertical Gastrectomy (VG) or Longitudinal Gastrectomy (LG))
Procedures, the bariatric surgeon creates a “sleeve” or narrow stomach. The remaining stomach
is completely removed. VG achieves its effects by helping a patient to eat less food (restriction)
and reduce the feeling of hunger. The result is an early sense of fullness and satisfaction from a
smaller portion of food. There is also a decreased Grehlin (appetite stimulating hormone) level
following sleeve Gastrectomy which further reduces hunger. This procedure does NOT include
bypassing any portion of the small intestine. This means there is no malabsorption of food
digested. Sleeve Gastrectomy provides a “tool” with which clients can potentially lose a large
amount of excess weight as long as they make necessary lifestyle changes, and follow program
instructions/requirements before and after having surgery.
The most important reason helping obese people lose weight is because learning proper eating
habits as well as exercise will increase their overall wellness, and health. They will have to
follow a clear liquid diet 2 weeks before and 3 weeks after surgery, then they will be able to
slowly add food to their diets. In phase 1 is clear liquid diet and sugar free liquids. Stage 2
happens 4 weeks after surgery the patient is able to add full liquids into their diet regimen were
they have to make sure they reach the amount of protein in their diets daily. Phase 3 starts 2
months after surgery were the patient is able to add soft foods to their diet but they have to
contain high protein. With phase 4 the patient is 4 months out from surgery the patient has a high
protein, low fat, low sugar, high fiber solid foods by this point. Each phase can only be
increased if it can be tolerated to move onto the next phase.
The nutrition value on all foods have to be precise by reading labels, and following what the
nutrition class teaches in each session just before you are ready to go to the next phase in the
diet. That will have to be followed for the rest of their lives. The doctor and the physical
therapist will help the patient pick the right exercise program that will work for the patient until
they are able to move around better. The doctor also has a support group that the patient is able
to attend that will not only give them great support. They will lead them on the right path with
encouragement, with everyone that has the gastric bypass will need during the first year.
In conclusion, although there are others that just need to diet and exercise more instead of
having surgery, but helping obese people lose weight for two main reasons, First, to help save
lives of the morbid obese. The most important, learn proper eating habits as well as exercise for
those who have had the gastric bypass, and for others who don??™t have the gastric bypass, but
still follow the diet as if they did have the surgery.
References:
Dr. Brian Gluck, D.O., P.C 2012 Life without Limits www.drbriangluck.com
Developed & Hosted by K-Data Systems
MyFitnessPal, LLC 2005-2012 www.myfitnesspal.com
Mayo clinic Aug. 10, 2012 www.mayoclinic.com
Kalarchian, M.A., Wilson, G.T., brolin, R.E., & Bradley, L. (1999). Effects of bariatric surgery on binge eating and related psychopathology. Eating and weight disorders, 4, 1-5