Roux-en-Y gastric bypass (RYGB) weight loss surgery is designed to help individuals with severe obesity achieve significant and lasting weight loss. It is guaranteed for you to lose weight after a gastric bypass surgery. Knowing how much weight you will lose is essential in keeping your expectations and goals realistic. This article provides a comprehensive overview of the expected weight loss after gastric bypass surgery, factors influencing weight loss, long-term effects, and considerations for choosing the best surgeon.
Total Gastric Bypass Weight Loss
The amount of weight you will lose depends on several factors including the success of your surgery, nutrition, and exercise plan. A study conducted by Mayo Clinic shows that a patient who is compliant and motivated can lose half of his or her excess weight or more in a span of two years after the gastric bypass surgery. Most patients rapidly lose weight within the first six months after the surgery. After a year or two, the patient will settle with his final weight. Around that time the patient will lose 65 to 70 percent of his weight. It is important for you to understand that there is a difference between your starting weight and excess weight. You will not lose 70 percent of your total starting weight. To know your expected weight loss, you need to calculate your current Body Mass Index (BMI) then subtract it with your ideal healthy weight.
Here are some examples for you to fully comprehend the process:
- If you weigh 250 lbs and your excess weight is 105 lbs, then 65 percent of your total weight loss will be 68 lbs.
- If you weigh 400 lbs and your excess weight is 205 lbs, then 65 percent of your total weight loss will be 133 lbs.
As you can see, the numbers vary depending on your starting and goal weights, but the percentage of the weight loss is still the same. Now that you know how much weight you can potentially lose, you can begin to set healthy and realistic goals by pursuing a healthy, and fitness-filled lifestyle.
Long-Term Effects of Gastric Bypass Surgery
There are so many long-term benefits of gastric bypass surgery on patients. A lot of patients claim a dramatic change in their lives by gaining more confidence and avoiding the risk of health problems related to obesity.
Read also: Average Weight Loss with Ozempic
Based on the study conducted by the University of Michigan, the average weekly weight loss of gastric bypass patients is around 5 to 15 lbs for the first two to three months. It starts to taper off to 1 to 2 lbs a week after six months. You should know that the rate of weight loss depends on the individual’s age, health, and starting weight.
In addition, weight plateaus occur during the weight loss. However, if it lasts more than 6 weeks, then adjustments should be made. It is best for you to work with a dietician during this period.
Long-Term Weight Loss: VA Study
A retrospective cohort study was performed of Veterans Affairs (VA) bariatric surgery patients and a matched cohort of severely obese veterans who had not undergone bariatric surgery. Veterans who underwent any bariatric surgical procedure in VA bariatric centers or community hospitals reimbursed by the VA from January 1, 2000, through September 30, 2011, were studied. Data analysis was performed from September 9, 2014, to February 12, 2016. Potential matches for patients undergoing RYGB were identified from VA electronic health records using sequential stratification matching.
The 1787 patients undergoing RYGB had a mean (SD) age of 52.1 (8.5) years and 5305 nonsurgical matches had a mean (SD) age of 52.2 (8.4) years. Patients undergoing RYGB and nonsurgical matches had a mean body mass index of 47.7 and 47.1, respectively, and were predominantly male (1306 [73.1%] and 3911 [73.7%], respectively). Patients undergoing RYGB lost 21% (95% CI, 11%-31%) more of their baseline weight at 10 years than nonsurgical matches. A total of 405 of 564 patients undergoing RYGB (71.8%) had more than 20% estimated weight loss, and 224 of 564 (39.7%) had more than 30% estimated weight loss at 10 years compared with 134 of 1247 (10.8%) and 48 of 1247 (3.9%), respectively, of nonsurgical matches. Only 19 of 564 patients undergoing RYGB (3.4%) regained weight back to within an estimated 5% of their baseline weight by 10 years.
At 4 years, patients undergoing RYGB lost 27.5% (95% CI, 23.8%-31.2%) of their baseline weight, patients undergoing AGB lost 10.6% (95% CI, 0.6%-20.6%), and patients undergoing SG lost 17.8% (95% CI, 9.7%-25.9%). Patients in the Veterans Administration health care system lost substantially more weight than nonsurgical matches and sustained most of this weight loss in the long term. Roux-en-Y gastric bypass induced significantly greater weight loss among veterans than SG or AGB at 4 years.
Read also: Liposuction and Tummy Tuck Results
Comparison with Other Bariatric Procedures
Differences in weight change up to 4 years were compared among veterans undergoing RYGB (n = 1785), SG (n = 379), and AGB (n = 246). At 1 year, patients undergoing RYGB lost 30.9% of their baseline weight (95% CI, 30.2%-31.6%), patients undergoing AGB lost 13.0% (95% CI, 11.1%-14.9%), and patients undergoing SG lost 23.4% (95% CI, 21.8%-24.7%). Patients undergoing RYGB lost 17.9% (95% CI, 15.9%-19.9%) more of their baseline weight at 1 year than patients undergoing AGB and 7.6% (95% CI, 5.9%-9.2%) more than patients undergoing SG. At 4 years, patients undergoing RYGB lost 27.5% of their baseline weight (95% CI, 23.8%-31.2%), patients undergoing AGB lost 10.6% (95% CI, 0.6%-20.6%), and patients undergoing SG lost 17.8% (95% CI, 9.7%-25.9%).
Among patients with a 4-year weight, mean weight loss from baseline was 41.0 kg for patients undergoing RYGB (n = 1431), 15.4 kg for patients undergoing AGB (n = 200), and 25.3 kg for patients undergoing SG (n = 178). The mean (SD) excess body weight loss at 4 years from baseline was 28.6% (30.5%) for patients undergoing AGB, 43.0% (28.1%) for patients undergoing SG, and 60.0% (26.1%) for patients undergoing RYGB. A greater proportion of patients undergoing RYGB lost an estimated 20% or more and 30% or more of their baseline weight in years 1 to 4 than patients undergoing SG or AGB.
Factors Influencing Weight Loss
Several factors can influence the amount of weight loss after gastric bypass surgery:
- Success of the surgery: The skill and experience of the surgeon play a crucial role in the success of the procedure.
- Nutrition: Following a strict post-operative diet plan is essential for maximizing weight loss and preventing complications.
- Exercise: Regular physical activity helps to burn calories and maintain weight loss.
- Lifestyle changes: Adopting a healthy lifestyle, including mindful eating and regular exercise, is crucial for long-term weight management.
- Individual factors: Age, health, starting weight, and adherence to post-operative guidelines can also affect weight loss outcomes.
Qualifying for Gastric Bypass Surgery
Gastric bypass surgery requirements are similar to those of other bariatric procedures. You must be recommended for surgery by a qualified healthcare provider. In general, you may be a candidate for gastric bypass surgery if you:
- Have been diagnosed with class III obesity. This is determined by your BMI (body mass index). Class III obesity means a BMI of at least 40 kg/m2
- Have a BMI of at least 35 with at least one obesity-related condition.
- Have obesity-related type 2 diabetes. Because of its positive effects on blood sugar regulation, you may qualify for gastric bypass surgery to help manage your type 2 diabetes, if it’s unmanaged and you have a BMI of 30 or higher.
If you’ve met these benchmarks, you may be recommended for surgery. But your surgeon will have additional requirements. Before scheduling your surgery, you’ll meet with a team of healthcare specialists for counseling and screening. They’ll want to know:
Read also: American Diet: Trends & Health
- That you're committed to lifelong lifestyle changes. Surgery is a powerful tool for weight loss, but it won’t work if you won’t work with it. You’ll have to change the way you eat forever. If you don’t, you could regain the weight you lose.
- That you’re physically and mentally fit for surgery. You’ll likely take some standard medical tests to make sure the procedure will be safe for you. You may also be screened for mental health and for alcohol or tobacco use.
- That you’ve tried to lose weight by other means. Health insurance companies may ask you to prove that weight loss surgery is medically necessary. They may require that you try a supervised diet and exercise program first.
How Gastric Bypass Surgery is Performed
Most Roux-en-Y surgery operations today are performed by laparoscopy, a minimally-invasive surgery technique. The laparoscopic gastric bypass was introduced almost 30 years ago and has since become the standard of care for most people.
Laparoscopic surgery involves three to five small incisions in your abdomen, each about a half an inch. Smaller cuts mean fewer complications, less bleeding, less pain and a faster recovery. Your surgeon will perform the operation through these openings, using long, narrow tools.
Sometimes laparoscopic operations such as Roux-en-Y are done with robotic assistance. Robotic surgery is still controlled by the surgeon. It just means that the surgeon attaches robotic arms to the laparoscopic tools. They control the arms with a computer.
While 90% of Roux-en-Y surgeries are performed laparoscopically, some people may need to have open surgery to manage their specific conditions. Rarely, some laparoscopic Roux-en-Y surgeries may need to convert to open surgeries to be completed safely.
What happens during the Roux-en-Y procedure?
All laparoscopic surgeries begin with a single “keyhole incision” in your abdomen. Your surgeon uses this first keyhole to inflate your abdominal cavity with carbon dioxide gas. This helps separate your abdominal wall from your organs and makes everything easier to see.
Then your surgeon will place a tiny lighted video camera called a laparoscope through the keyhole to visualize your organs. The laparoscope will project onto a computer screen. Your surgeon will use additional keyhole incisions to access your organs.
The first step in the Roux-en-Y procedure is to divide the top portion of your stomach from the remainder with a surgical stapler. The resulting pouch is about the size of an egg. The remainder of the stomach is still attached to your small intestine.
The next step is to divide your small intestine several feet down its length and bring the lower segment up to attach to your new stomach pouch. Your food will now pass from your stomach pouch into this segment of your lower small intestine.
The final step is to reattach the upper branch of your small intestine to the trunk further down. Now your small intestine has two branches attached to the trunk: one leading from your stomach pouch, and the other leading from the remainder of your stomach.
The right side of this “Y” is the new branch, the one that your food will pass through. The left side is the original upper part of your small intestine (your duodenum). This is the part where your liver, gallbladder and pancreas deliver their digestive juices.
The left branch will deliver these juices into the new trunk of your small intestine, where they will mix with your food. This will enable you to properly digest your food, even though your shortened intestinal pathway will absorb fewer nutrients from it.
Recovery and Pain Management
The procedure itself takes between two to four hours. Afterward, you’ll probably remain in the hospital for two days. You won’t be able to eat solid foods yet. You’ll feel moderate pain in the first few days, but you’ll have pain medication on demand through a catheter in your vein. You won’t be discharged from the hospital until you’ve weaned from your pain medication and are able to move around comfortably on your own.
At home, you’ll have prescription pain medications to take. Most people wean from these within a week.
How to Choose the Best Gastric Bypass Surgeon
The success of your weight loss depends on the success of your surgery. Choosing the right surgeon is key to receiving the best surgery. The best Gastric Bypass Surgeon should have considerable years of experience, a high success rate, and a certified member of the American Society for Metabolic and Bariatric Surgery.