Gastric bypass is one of the oldest bariatric procedures That have stood the test of time. It is regarded as the gold standard amongst bariatric surgery because the long term (> 15 years) results of gastric bypass in terms of both weight loss and resolution of comorbidities have been better than any other procedure till date.
It is a combined bariatric surgery That offers both restriction to food intake as well as malabsorbtion of the ingested nutrients. It involves the creation of a very small capacity pouch (30-50 cc) from the existing stomach and bypass of around 150-200 cm length of the small intestine to limit the absorption of food. Because of the small pouch, the intake of food at any one time is markedly reduced. This leads to the overall restriction in the quantity of calories consumed throughout the day. Moreover, any calories that are consumed are also not completely absorbed Because of the reduced length of the intestines.
This creates a large Caloric deficit in the body which is fulfilled by breakdown of the body’s existing energy stores namely the body fat. Once the fat starts getting burned to provide the energy requirement, the patient starts losing weight. This weight loss is quite rapid in the initial (3-5 months) period following surgery but continues steadily for up to 12-18 months after the procedure. The weight loss is mainly due to loss of body fat But occasionally some muscle mass may also be lost if proper supplements are not being taken. The total amount of weight lost varies amongst different individualsM But usually ranges between 60-80% of the excess weight present initially before the surgery.
In addition to weight loss, Certain metabolic alterations occur in the body as well which help in resolution of diabetes, hypertension and other obesity associated diseases. Due to bypass of the initial part of the intestine, the contact of the distal intestine with undigested food leads to production of gut hormones known as incretins which stimulate insulin secretion from the pancreas.
Also, weight loss And loss of intra-abdominal fat increases the insulinsensitivity in the body which means that even lesser amounts of this hormone are able to bring the blood sugar under control.
Other benefits of gastric bypass Include lowering of blood cholesterol and lipid levels which leads to lowering of blood pressure, reversal of fatty liver, reduction of joint pains, Improvement in sleep apnea, etc. Weight loss is usually associated with an improved body image and heightened self-esteem which ameliorates depression often found amongst such people. The quality of life scores after gastric bypass show significant improvement Which contributes to the overall well-being of the individual after these procedures.