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Gastric Bypass Surgery: An Easy Solution? PDF Print E-mail
Written by Jeff Novick, M.S., R.D.   
Tuesday, 19 April 2005 19:00

Gastric Bypass Surgery: An Easy Solution?

Jeff Novick and Weight LossThis year, an estimated 140,000 Americans will undergo weight loss surgery — up from 75,000 last year. The operation, costing $26,000 and more, is typically reserved for extremely obese people who are at least 100 pounds heavier than their recommended weight. The most common procedure, called Roux-en-Y gastric bypass, reduces the size of the stomach from about the size of a football to the size of an egg, severely limiting the amount of food patients can digest.


Obesity surgery does have confirmed health benefits. In a recent, well-publicized analysis of 136 studies, researchers at the University of Minnesota found that patients who under-went various surgical procedures for obesity lost an average 61 percent of their excess weight, and the majority saw problems like high blood pressure, sleep apnea, diabetes, and high cholesterol improve significantly.1

No Free Ride

What many people considering the surgery do not know, however, is that life after surgery is no free ride. Far from it. To begin with, malnutrition is inevitable unless you take daily supplements of vitamins and minerals because the operation diminishes the digestive tract’s absorption of nutrients.

Nearly 20 percent of post-surgery patients, a recent Mayo Clinic study found, develop nerve damage called peripheral neuropathy, a symptom of malnutrition.2 Problems include tingling, numbness, and stabbing pain, like somebody is sticking you with a knife, reported lead author Dr. James Dyck. Some patients also experience severe hair loss.

Secondly, many patients suffer “dumping syndrome,” in which food travels too quickly through the small intestine, causing nausea, uncomfortable fullness, cramping, diarrhea, fast heart rate, sweating, and overall weakness.

Death Rates

The surgery itself is risky. The University of Minnesota review found that one in 200 died in the month after the operation. Another recently published review of 3,328 patients found that one in 50 died within 30 days.3

Forbidden Foods

food pyramidPost surgery, physicians routinely advise that patients make a complete change in lifestyle. Foods to be avoided, because they commonly provoke “dumping” symptoms, include sugary foods, red meat, high-fat foods, high-fiber foods, and milk. Too much fat also causes reflux, a back-up of stomach acid and food into the esophagus that causes heartburn.

Common offenders: fried foods and fatty meats

And because the new stomach can only hold about one-half cup of food at a time, patients are advised to sit down to three to six very small meals every day, eat very slowly, and chew thoroughly. Overeating may cause vomiting, expansion of the stomach pouch, weight gain, or even rupture of the stomach.

Last Resort

Gastric bypass surgery should be a “last resort” after all other options have been tried, and there are other options. In my seven years at Pritikin, I’ve seen hundreds of men and women lose 50 to 100 pounds and more just by exercising and following a healthy eating plan.

It all boils down to lifestyle change. You can undergo surgery — and all its risks and complications — and then make major lifestyle changes. Or you can avoid surgery altogether and make lifestyle changes via solid, science-based, diet-and-exercise approaches.

With a healthy lifestyle, the only side effect is better health — better blood pressure, better cholesterol, better diabetes control, freedom from angina pain and heart surgeries, and last but not least, healthy long-term weight control, as many published studies on lifestyle interventions have found. It’s all good news — and no horror stories.

Journal of the American Medical Association, 2004; 292: 1724.
2. Neurology, 2004; 63: 1462.
3. Journal of the American College of Surgeons, 2004; 199: 543.


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