Gastric Bypass

How to Know if Roux-en-Y Gastric Bypass Surgery is Right For Me

For so many people, the weight-loss journey can be a frustrating rollercoaster of loss and gain. So many New Year’s resolutions, only to eventually find ourselves back to where we started — or worse. You may feel like you’ve tried everything: fad diets, appetite-suppressant pills, near starvation or other weight-loss quick fixes. It can be so discouraging, you may wonder if it’s worth another try.

We say it is. A healthier you is worth it.

The first thing to understand is that weight-loss surgery is not a quick fix. Surgery is simply a weight-loss tool, albeit an effective one, towards a healthier you. To get the best results, you need to arm yourself with knowledge, commitment and support for long-term success. While gastric bypass surgery can be effective, there are other non-surgical options available to you. Familiarize yourself with what we offer and set up a time to meet with a bariatric expert to discuss all of your options.

What is Roux-en-Y Gastric Bypass Surgery and How Does it Promote Weight-loss?

The Roux-en-Y gastric bypass is considered the gold standard for weight-loss surgery. During surgery, the stomach is divided into a small egg-sized pouch, limiting the amount of food you can eat after surgery. The bowel is rerouted and there are two new connections made: between the stomach and bowel and between two pieces of bowel. This creates two new channels. One of the channels allows food to travel downstream from your new stomach pouch without being absorbed. The other channel allows digestive juices and enzymes to travel downstream from the other portion of your stomach and liver. These two channels eventually meet up; this is when digestion and absorption begin.

The bypass promotes weight loss from three different mechanisms.

  1. Restriction – which means you are not allowed to eat as much as you once could. This limits the amount of calories consumed
  2. Malabsorption – because of the rerouting of the bowel, you do not absorb as much of the fat, calories and nutrients from food as you once did
  3. Hormonal Changes – because of the rerouting of the bowel, there are changes in hormones which help you typically not feel as hungry and help you feel full faster

How do I Know if I’m a Candidate?

According to the guidelines provided by the American Society for Metabolic and Bariatric Surgery, you may be a candidate if you:

  • Have a body mass index equal to or greater than 40. For example, an adult who is 5’11” and weighs 290 pounds would have a BMI over 40
  • Have a BMI that is equal to or greater than 35 and at least one obesity-related co-morbidity, such as: Type II diabetes (T2DM), hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders or heart disease 
  • Have been unable to maintain a healthy weight loss for a sustained period of time using other reliable methods

Calculate your BMI

What are the Benefits and Risks?

As with any surgery, there are benefits and risks that need to be discussed with your doctor. Most bariatric surgical patients see a drastic change in their overall health immediately after surgery. A comprehensive program should address conditions such as sleep apnea, diabetes, high cholesterol and hypertension, among other weight-related health issues.

  • 90 percent of Nebraska Medicine patients, diabetes becomes diet controlled
  • 66 percent are cured of high blood pressure
  • 95 percent are cured of reflux and heartburn
  • 90 percent are cured of sleep apnea
  • 90 percent are cured of stress incontinence
  • 90 percent control their high cholesterol/triglyceride

Benefits of Roux-en-Y Gastric Bypass

Studies show a weight loss of 60 to 80 percent excess body weight. For example, if you were 100 pounds overweight we would anticipate you losing 60 to 80 pounds after weight-loss surgery.

  • Weight loss of 60 to 80 percent of excess body weight, with average weight maintenance of >50 percent of weight lost
  • 80 percent remission of Type II diabetes
  • Changes in hormones typically make you feel less hungry and help you feel full faster
  • Many patients are able to stop taking a large percentage of the medications, such as diabetes or hypertension medications
  • Other potential benefits include improved psychological health and self-image, a reduction of some or all co-morbidities and even possible reduction in health care expenses to treat them

Risks of Roux-en-Y Gastric Bypass

  • Technically more complex, therefore has a higher risk for complications compared to sleeve gastrectomy
  • Lifelong vitamin and supplementation compliance is extremely important, as you do not absorb the nutrients from food like you once did
  • A hernia developing at your incision area
  • Wound healing problems
  • Staple line leak
  • Blood clots
  • Bowel obstruction
  • Pneumonia
  • Gastric outlet obstruction

What Can I Expect Before Surgery and During Recovery?

Before Surgery

In the pre-surgical classes, you’ll learn how your life is going to change after surgery and about new eating habits to make your surgery successful. You’ll get advice on exercise and other lifestyle changes you must make as well. It’s essential that you follow this advice to the letter.

After Surgery

After surgery, we provide follow-up and a support group to help you stay on track. Studies show this type of support directly affects a patient’s success. Those who are committed to the journey and stay excited about what they’re achieving will succeed! We want to help you over the long term, not just the initial surgery. The first year after surgery, we’ll want to see you frequently. Two years after surgery, we set an annual appointment. It’s not uncommon for patients to slip a little, which is why we continue to help over the long haul. We help our patients get energized again to doing the right things. If you’re struggling, you can visit with the dietitian or the exercise therapist. If feeling depressed, a psychologist can help. We also have an endocrinologist who can prescribe medication that boosts weight loss to help get back on track.

Does Insurance Cover the Cost?

We suggest contacting your insurance company directly to find out what coverage your insurance plan allows. You can find a list of insurance plans we accept here. If you need to self-pay, Nebraska Medicine can set up a payment plan that works for you. We believe in what we do and know we can help you improve your quality of life.

How do I Maintain a Healthy Weight After Surgery?

With on-going support and commitment, weight maintenance is achievable! Gastric bypass surgery may be a great option for you, but is only the beginning of a journey. “I can tell you from personal experience that bariatric surgery is a great tool for weight-loss,” says Corrigan McBride, MD, bariatric surgeon and former bariatric surgery patient. “But there’s nothing magic about these surgeries. Yes, problems can be corrected. But when it comes to weight loss, you still have to count calories, you still have to burn calories and you still have to exercise.”

Success depends on your effort after surgery, and we are here to help.

I Want to Take the Next Step. Now What?

Start with what you are doing now — your homework! It’s important to look at all the factors involved in your decision. Doing your research, thinking through questions and meeting with a specialist are great starting points in making an educated decision.

Take time to watch Nebraska Medicine bariatric surgeons and their team explain the procedures and how they can help. You’ll learn more about weight-loss surgery and the benefits of a medical weight-loss program.

Think about your goals for your health, for your family, for your long-term well-being. Think about your financial situation. Could you afford to pay for — or make payments on — the surgery if insurance doesn’t cover it?

Take notes as you research, jot down your questions and take them with you when you meet with a specialist.

Whatever your circumstances, we can help you sort through which type of weight-loss surgery is the best option for your life and goals. Is it time to schedule an appointment to discuss bariatric surgery? We look forward to meeting and helping you on your weight-loss journey.

To make an appointment, or for a consultation at the Bariatrics Center, please call 402.559.9500.