Exercise and a healthy, nutritious diet should be on everyone's daily routine, which can serve as the first line of defense against several ailments. But many patients wake up to the perils of obesity fairly late when their excessive weight has led them to a series of complaints including diabetes and coronary disorders. They get easily dispirited, especially when faced with the rigors of the demanding exercise and diet regimens that won't give them the fast results they desire, and turn in for gastric bypass surgery.
But is gastric bypass surgery the magic bullet that can provide permanent freedom from the extra pounds?
The bypass surgery, or for that matter any bariatric surgery, is not a quick-fix. As the surgery carries its own risk, the surgery is not for all, but only for those morbidly obese persons whose BMI has crossed 40 and who cannot achieve significant weight through diet and exercise alone. It can be successful only for those who are disciplined and committed to the prescribed diet. People who suffer from depression, bipolar disease, or schizophrenia should consult and be under the care of a psychiatrist before gastric bypass, as weight loss can worsen these conditions.
How the gastric bypass surgery works is simple. The stomach is cut high up so that it is divided into two parts - a small upper part, a one 1 oz pouch, and a large lower part a 39 oz bypassed part. Three rows of staples secure the two pieces so that most of the time they don't leak. The pouch is then connected to the small intestines bypassing duodenum and part of the intestines (jejunum). The larger lower part of the stomach is just left lying idle. So you end up with a small stomach and a shorter intestines. This means that you will feel full more quickly and that you will absorb less of the food actually eaten (because of the shorter bowel). Food flows directly into the middle section of your small intestine, limiting absorption of calories.
You can begin regular activity within 4 to 6 weeks after your gastric bypass. You should be pain-free after 10 days or so. Fatigue is common, and can last from 3 to 4 weeks after your gastric bypass. The surgery alters your digestive system to make it impossible for you to eat much food at one sitting without suffering unpleasant side effects such as 'dumping syndrome' or rapid gastric emptying, which occurs when the undigested contents of your stomach are "dumped" into your small intestine too rapidly. Common symptoms include abdominal cramps and nausea .This digestive side effect acts as a brake on calorie intake, and can lead to significant loss of weight within 2 years after surgery.
Almost every gastric bypass patient suffers hair loss and hair thinning during the first six months. Once your weight stabilizes and you consume more protein, the hair will grow back. Hair treatments and permanents should be avoided.
Gastric bypass is a success when half of extra weight is lost and the loss is persistent for up to five years. The risk of mortality with a gastric bypass is about 1 in 100. Though the surgery is generally safe, it can lead to serious and potentially fatal complications. In a gastric bypass, the stitches and staples that help to bypass lower part of the stomach and reconnect to the intestines have the potential to tear in the first few weeks after surgery. This can lead to peritonitis and acid leak and bleeding. Intestinal blockage, due to scar tissue or intestinal twisting, is a possibility. The pouch may get stretched, with the result appetite may return and result in some patients' regaining 10 to 30 pounds of lost weight.
Since the operation causes food to bypass areas of the small intestine that are responsible for absorbing protein, calcium, and certain vitamins, nutritional deficiencies may occur. In addition, less iron is absorbed because of the small size of the new stomach pouch. So you will need to take daily vitamin and mineral supplements everyday for the rest of your life, including a multivitamin, calcium, vitamin B12, and iron. You will also need to increase the proportion of protein in your diet, since you'll be eating less food overall. Blood tests must be performed every three months for the first year to check your nutritional status.
Revision surgery is required in about 10 to 20 percent of patients, usually to correct abdominal hernias or pouch stretching and narrowing. Though technically reversing the surgery is possible, it is advised only under exceptional circumstances. The complications of gastric bypass surgery must be carefully weighed in consultation with the doctors before making the decision to undergo surgery.
Once the decision has been made, simultaneously build up the determination to follow the doctor's recommendation regarding diet and exercise. Yes, you can shed the extra pounds. And the low self image.
Uma Shankari is a Bangalore-based freelance journalist. She is passionate about writing. She writes regularly on development issues, health and fitness, yoga/meditation, life and relationships. Read some her articles on Here
