| Bypass Buddies Homepage On Gastric Bypass | |||||||||||||||||
| Our you over Weight? 80 to 100 Pounds? |
Obesity is a chronic medical condition without a "cure." For severely obese patients who have significant medical complications from their obesity, surgery is an option. Generally, the criterion for surgery is to be at least 100 lbs (45 kg.) over ideal body weight. The surgical methods have changed over the years but can be divided into gastric (stomach) restrictive procedures and gastrointestinal (intestinal) bypass procedures. Gastrointestinal Bypass Procedures The gastrointestinal bypass procedures include either surgically bypassing the stomach, duodenum, and portions of the small intestine or bypassing most of the small intestine, where absorption of nutrients takes place. The most famous of these procedures was the intestinal bypass surgery that was done in the 1970's. Basically, most of the small intestine was bypassed which resulted in malabsorption of vital nutrients leading to diarrhea, nutritional deficiencies and severe metabolic complications. These bypass procedures produced significant weight loss but with significant morbidity (complications) and mortality (death) with the large majority of the patients that underwent these procedures needing their surgeries revised or totally reversed. A current variation of the intestinal bypass and one that is becoming more popular is the Roux-en-Y Gastric Bypass. This procedure, which involves attaching a portion of the small intestine directly to the stomach (thus bypassing part of the small intestine), is much better tolerated than the traditional intestinal bypass but still produces significant complications such as vitamin and mineral deficiencies and may lead to osteoporosis long-term. Individuals that undergo this surgery will lose significant amounts of weight (mainly fat as opposed to lean body mass or muscle tissue) but will need lifelong medical follow-up. Gastric (stomach) Restrictive Procedures The gastric restrictive procedures are what are currently in vogue. Basically, the most widely used procedure is the vertical banded gastroplasty (VBG), sometimes with an additional reinforcement of a small silastic ring. In VBG, the stomach is "stapled" to reduce its capacity to approximately 15 ml (1/2 oz.) and the Silas tic ring helps prevent the stomach from "stretching" in size. What is formed is essentially a "small" stomach that receives the food from the esophagus and the much larger, unstapled stomach that receives small amounts of food from the small, proximal pouch. When one attempts to eat, one can consume only a small amount of food without the pouch (which is formed from the surgery) becoming distended. This generally leads to a feeling of satiety or fullness. If one continues to eat, one will develop nausea, vomiting or pain, which generally will result in termination of eating. Patients have to become aware of their new, restricted food intake to prevent these side-effects. Complications can result from the surgery. When gastroplasty is done by well trained physicians, the mortality (death rate) from the surgery is around 1 or 2 %. Complications include risk of infection, obstruction of the outlet necessitating surgical revision, development of blood clots in the legs or lungs, bleeding, metabolic or nutritional deficiencies (including protein calorie malnutrition) and recurrent vomiting. It is not uncommon to slowly develop vitamin (especially vitamin B-12) and mineral deficiencies resulting in anemia or osteoporosis (softening of the bones). After the surgery, the patient should be followed-up by physicians who are familiar with the long-term treatment that is required afterwards. The effectiveness of the surgery is generally good with average weight loss being between 50 and 100 lbs with over 50% maintaining the weight loss for 5 years. It is generally common, however, for the weight to slowly increase after the first or second year. The surgery does require the diet to be modified to prevent nausea and vomiting and to help prevent the long-term side effects. Additionally, one can (partially) bypass the "restriction" by eating calorie dense liquids such as ice cream or soda. Long-term medical follow-up is needed after the surgery and the person must understand that long-term changes in eating habits must take place to be successful. Vertical Banded Gastroplasty, however, is a viable treatment alternative for severely overweight individuals but again, it is not a cure. | ||||||||||||||||
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I see a picture on memory's wall, Of my grandma who never was all that tall, She was angel in my eyes, Even though she weighed Heavy in life, She was a goddess to me in my heart, and so humbly she did her part, Sometimes someone would wound her loving heart, With those laughs and rude remarks, How could someone be so dark, Always with open hands she welcome people from far and near, Her door stood open with goodly cheer, So she was 300 pounds all her years, Was there ever a better person around, They didn't no her christian spirit, Nor did they get to know the woman behind the heavy face, Who's heart was like fragile lace, I am so proud of you grandma and justly so, For your soul was spun of purest gold. I only hope I may find, By serving, loving,and giving. Somewhere along life's way, the art of of happy living. | Poem Of About My Grandmother | ||||||||||||||||
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