A large portion of the American population either is overweight, or in some cases, may be obese. There are many ways in which a person can fight obesity, but there are only a few successful treatments that help someone achieve a healthy weight in a relatively short time. These treatments are bariatric surgeries, and they are specific procedures that treat obese individuals. One such procedure is called Gastric Bypass. The goal of this surgery is to produce weight loss by limiting the amount of food a person is capable of consuming. There are many negative aspects of Gastric Bypass, which include the cost, bad side effects, and postoperative hospitalizations; however, tremendous weight loss, the impact on other diseases, and a higher self-esteem are all positive results that Gastric Bypass can have.
In the Gastric Bypass procedure, a small pouch of the stomach is created by separating it from the rest of the stomach. This is done by using staples. After surgery when the patient eats, the small pouch acts as the patient’s whole stomach (Steinbrook 1075). Since the pouch is small, the amount of food the patient is able to eat is small. The patient will then be eating less food after the surgery which helps to produce weight loss.
One of the downsides to this operation is the cost. Typically, gastric bypass surgeries range from about $20,000 to $50,000, depending on the type of health care company that the patient has (Steinbrook 1075). A major factor that depends on if a health insurance company will cover the surgery is the patient’s medical condition. If the patient has many other health risks and problems besides obesity, than the patient’s chance of getting approved for the operation is low. Frequently, obese patients do have more than one type of health problem, so this limits the accessibility of gastric bypass to certain patients.
Another downside to this operation is linked to the experience of the surgeon. Within the past decade, Gastric Bypass procedures have seen an annual increase from 16,000 to more than 100,000 performed in the United States (Steinbrook 1075). Certainly, the risks and complications that occur after the surgery are associated with the experience of the surgeon performing it. If the doctor has performed many Gastric Bypass surgeries, then the risk of problems during or after the surgery is performed is low. However, the opposite is true; if the surgeon is quite new to the operation and has done very little training in performing the surgery, then the risks increase (Steinbrook 1076).
One negative aspect that follows the surgery is the restrictive diet. For twenty-four hours immediately following the operation, Louis Martin reports, a meal plan composed of “a clear liquid diet not to exceed 60mL per hour” is imposed. If that is successful, the person can then move to a diet that is still restrictive and involves sugarless, high protein, pureed food and drinks. Because this diet is so restrictive, the intake of vitamin and protein tablets is required. Complications can occur if the patient fails to continue to take the vitamins for various reasons, thus leading to nutritional deficiencies (Martin 265). Complications can also occur if the patient fails to adhere to the diet altogether.
Other risks that one has following the operation are gastrointestinal leaks and internal hemorrhaging. Gastrointestinal leaks are contents and liquids that escape from the small pouch. According to Benjamin Schneider et al, this usually occurs along the stomach line where the staples have been placed (248). The leaks may occur because of staple failure, and also from the lack of experience that the surgeon may have. Following the surgeon’s performance of the first hundred gastric bypass surgeries, the risk of gastrointestinal leaks is reduced by about 1.6% (250). Also, as mentioned before, internal hemorrhaging can also occur. In fact, much of the mortality rate involving the gastric bypass procedure can be linked to either internal hemorrhaging or leaks from the staple line (247).
Post-operative hospitalizations are also common in patients undergoing gastric bypass surgery. In their study of patients, Zingmond, McGory, and Ko report that “20.2% were readmitted in the year after RYGB [Gastric Bypass],18.4% in the second year after RYGB, and 14.9% in the thirdyear after RYGB” (1918). Readmittance to the hospitals can, and probably does occur following that three year period. Most of the occurrences happen because of surgical complications like infections or gastrointestinal leaks (1918). However, the chances of hospitalizations following the surgery decrease with each passing year.
Another common side effect of gastric bypass surgery is a sickness called the dumping syndrome. The dumping syndrome is essentially a severe case of influenza, and is caused by the patient’s intake of sugar. The syndrome is often associated with profuse sweating, nausea, tremors, diarrhea, and a high fever. This negative side effect, however, can possibly be viewed as a positive one, because it reinforces the sugarless diet that the patient is supposed to adhere to (Martin 264).
Just as there are many negative outcomes of gastric bypass surgery, it is also important to focus on the positive outcomes of this surgery. An overall significant lifestyle change for the better and an improvement of the patient’s health is possible for those who undergo this operation. In Flancobaum and Choban’s research, the patients that they studied reported that the amount of their physical activity increased after the surgery. Other conditions, such as diabetes, hypertension, and sleep apnea improved remarkably in these patients (229).
Weight loss, the main goal of the surgery, is a tremendous outcome for those people that follow the doctor’s orders. Martin says that during the first month following the gastric bypass surgery, the loss of five to fifteen percent of the total body weight can be expected (164). Additionally, Schneider et al reports that in their case studies of patients in the twelve months following gastric bypass, excess weight loss of sixty-eight percent occurred (251). The amount of weight and fat loss that follows the surgery is a fantastic result for those patients. In fact, over eighty percent of the cases that adhere to the restrictions, diet, and orders from the doctor are successful (Martin 352).
There are also several diseases that will be improved, or be cured, as a result of the surgery. They include type two diabetes, coronary artery disease, and gout. Type two diabetes is mainly caused by obesity; therefore, the surgery will more than likely reverse the disease. In fact, the findings of Schneider et al confirm this: type two diabetes in obese patients is completely reversed in eighty-two to ninety-eight percent of the cases studied (253). Because insulin levels fall rapidly after the surgery, and in most cases, stay at a normal level, patients are not required to have insulin injections (Martin 354). Coronary artery disease and gout also improve following the surgery. In his book Obesity Surgery, Louis Martin tells us that the American College of Cardiology’s findings are that significant weight loss reduces the risk of coronary artery disease (356). Therefore, the weight loss produced through gastric bypass will prevent those people from being at risk for this disease. The other infection, gout, involves the over-production of uric acid levels and is worsened by obesity in patients. Weight loss can control the amount of the effects that gout has, making the surgery a positive outcome for this disease also (356).
Another important effect that gastric bypass surgery has on patients is the effect on their self-esteem. Frequently, obese people are looked down upon and sometimes seen as inferior or incapable of being successful. This usually leads to low self-esteem, feelings of worthlessness, and sometimes severe depression as well. After the surgery and weight loss has been induced, “depression caused by obesity is cured by weight loss” (Martin 359). The patient should no longer have any reason to feel shame because he or she is obese. Indeed, if he or she loses body fat then that should give him or her more reason to feel proud and be confident.
Both the negative effects and the positive effects of gastric bypass surgery have been indicated. Clearly there is a substantial amount of evidence for both sides. The cost of the surgery, restrictive diet following it, and all of the complications that can come from the surgery certainly can discourage a person from pursuing this type of treatment. However, after reviewing the many positive side effects that can result from gastric bypass surgery, it is clear that pursuing the surgery would be not only beneficial but also vital to one’s well being. One has to consider the following: What are the possible positive outcomes for me in this type of operation, and are the positive results worth having the negative side effects?
Works Cited
Flancobaum, Louis, and Choban, Patricia. “Surgical Implications of Obesity.” AnnualReview of Medicine. 1998: 215 Academic Search Premier. EBSCO. Paul Laurence Dunbar Lib., Wright State U. 22 January 2006. (http://epnet.com/).
Martin, Louis F. Obesity Surgery. New York: McGraw-Hill: Medical Publishing Division, 2004.
Schneider, Benjamin, et al. “Laparoscopic Gastric Bypass Surgery: Outcomes.” JournalOf Laparoendoscopic and Advanced Surgical Techniques. Aug 2003: 247-255. Academic Search Premier. EBSCO. Paul Laurence Dunbar Lib., Wright State U. 22 January 2006. (http://epnet.com/).
Solomon, Caren, and Dluhy, Robert. “Bariatric Surgery- Quick Fix or Long Term Solution.” The New England Journal of Medicine. 23 December 2004. Academic Search Premier. EBSCO. Paul Laurence Dunbar Lib., Wright State U. 22 January 2006. (http://epnet.com/).
Steinbrook, Robert. “Surgery for Severe Obesity.” New EnglandJournal of Medicine. 11 March 2004: 1075-1079. Academic Search Premier. EBSCO. Paul Laurence Dunbar Lib., Wright State U. 22 January 2006. (http://epnet.com/).
Zingmond, David, Marcia McGory, and Clifford Ko. “Hospitalization Before and After Gastric Bypass Surgery.” The Journal of the American Medical Association. 19 Oct 2005. Academic Search Premier. EBSCO. Paul Laurence Dunbar Lib., Wright State U. 19 January 2006. (http://epnet.com/).
