Weight-loss surgery

If you're among those who have tried and can't lose the excess weight that's causing your health problems, weight-loss (bariatric) surgery may be an option. Weight-loss surgery may be considered if:
Your body mass index (BMI) is 40 or higher
Your BMI is 35 to 39.9, and you have a serious weight-related health problem such as diabetes or high blood pressure

Gastric bypass surgery, which changes the anatomy of your digestive system to limit the amount of food you can eat and digest, is the favored weight-loss surgery in the United States.

In gastric bypass (Roux-en-Y gastric bypass) the surgeon creates a small pouch at the top of the stomach. The small intestine is then cut a short distance below the main stomach and connected to the new pouch. Food and liquid flow directly from the pouch into this part of the intestine, bypassing most of the stomach. The stomach continues to make digestive juices to help break down food. So the portion of the intestines still attached to the stomach is reattached farther down. This allows the digestive juices to flow to the small intestine. Weight loss is achieved by restricting the amount of food that the stomach can hold and to a lesser extent by reducing the amount of calories that are absorbed.

When appropriate, weight-loss surgery can result in dramatic improvements in weight and health. Within the first two years, you can expect to lose 50 percent to 60 percent of your excess weight. Those people who follow dietary and exercise recommendations tend to keep most of that weight off long term.

Weight-loss surgery does have side effects, however. Complications such as pneumonia, blood clots and infection can occur with any type of surgery. Rapid weight loss can result in gallstones; a hernia or weakness, which may require surgery to correct, may develop at the site of your incision. Gastric bypass can also cause dumping syndrome, a condition in which stomach contents move too quickly through the small intestine, causing nausea, vomiting, diarrhea, dizziness and sweating.

Surgery for weight reduction isn't a miracle procedure. It doesn't guarantee that you'll lose all of your excess weight or that you'll keep it off long term. Weight-loss success after gastric bypass surgery depends on your commitment to making lifelong changes in your eating and exercise habits.