If you are at least two times your recommended weight and have tried to lose weight through other supervised programs, than you might be a good candidate for a procedure commonly known as "stomach stapling," according to the American Medical Association. This procedure is a major surgery that changes the way the body digests food and requires altering your eating habits for the rest of your life. It has its dangers, but if you are severely overweight, it may just save your life by helping you shed pounds that are contributing to other health risks.
Candidates
The Cleveland Clinic only recommends you undergo such a procedure if you have a body mass index (the ratio of your weight to your height) of more than 40. In addition, your obesity should be severe enough that it is causing physical challenges--perhaps you can't work anymore or you can't walk as you once did. Other health problems may threaten your lifestyle and life, including severe sleep apnea that causes you to wake up in the middle of the night because you can't breathe. You should have exhausted other fitness and nutritional regimens before looking to this surgical alternative.
Procedures
You may know the procedure as "stomach stapling," but doctors know it as two main types of surgeries: Roux-en-Y gastric bypass (RGB) or extensive gastric bypass. The Cleveland Clinic reports that RGB is the more common of the two, while the second option is the more complicated one. The primary difference is that with extensive gastric bypass a portion of your stomach is removed and the digestive system is altered in such a way that food bypasses both the first and second portions of the small intestine, while RGB allows food to bypass the first portion of the small intestine, as well as part of the jejunum--or the second portion of the small intestine. The extensive option promotes substantial, quick weight loss, but it's not used often because of nutritional deficits associated with the procedure.
Basics
Expect to be on the operating table for two to three hours. You should also be aware of the risks, which include death. According to the Mayo Clinic, for every 200 to 300 stomach stapling procedures performed, one person died. Risk factors include your age at the time of surgery, pre-existing medical conditions and blood clots. Your doctor will also prepare you for surgery by doing such things as weaning you off of cigarettes, since smoking is another major risk factor.
Steps
At its most basic, your doctor creates a pouch at the top of your stomach. He then creates a bypass around a segment of the stomach and small intestine. From there, the stomach is stapled across the top, in turn sealing this portion off from the rest of the organ. Once this is done, your stomach is reduced to the size of a walnut. That means you can't hold more than an ounce of food at a time. After that, the actual bypass is executed by cutting the small intestine and sewing it to the stomach pouch, in turn redirecting the food so it skips most of the stomach and a portion of the small intestine.
Significance
Gastric bypass works because it shrinks your stomach. If you eat too much or chew too fast, your new stomach won't be able to handle it, which can cause you to experience pain or throw up, according to the Mayo Clinic. The AMA also reports that gastric bypass works by slowing down the amount of time it takes for the stomach to empty, allowing you to feel full longer. It's considered to be one of the most effective weight-loss procedures for those who are significantly overweight and medically compromised. The Cleveland Clinic found that two-thirds of those who underwent gastric bypass lost excess weight in two years, and very few of those who went through surgery regained the weight.
Complications
There is a long post-surgery care process, which starts with not eating for two to three days post-op, and continues with a special liquid diet that progresses to pureed, then soft and finally regular food over the course of three months. During that time, according to the Mayo Clinic, you may feel like you've got the flu and experience aches and chills. As you lose weight, you hair may fall out and your skin may become dry. You may have severe ups and downs with your moods. Serious complications include leaking at the line where the stomach is stapled, hernia and a syndrome called "dumping," where the food goes through the small intestine too quickly and causes diarrhea, vomiting and vertigo.
Final Note
Gastric bypass is not for the faint of heart. But with what can be a deadly procedure comes a lot of benefits. The Cleveland Clinic reports that those who keep all the weight off are relieved of conditions associated with their obesity, including elevated blood sugar. Though it is harder to eat as much and as quickly as you did before the surgery, maintenance is still crucial--you still need to eat the right foods, get exercise and you may need to take nutritional supplements to offset nutritional deficiencies associated with food skipping a portion of the intestine where much of the iron and calcium is absorbed.
Tags: small intestine, your stomach, Cleveland Clinic, associated with, gastric bypass, Mayo Clinic, portion small