Gastric Bypass Surgery: Two Patients' Stories
Severely obese people-those whose body mass index is higher than 40-who
have been unable to lose weight through diet and exercise
are sometimes candidates for a procedure called gastric bypass
surgery. Generally, severely obese men are at least 100 pounds
overweight, and women at least 80 pounds overweight.
works by restricting food intake and/or interrupting the digestive
process. We talked with two people who've had the surgery,
KJ and her co-worker, Mike. There are several types of gastric
bypass surgery, and KJ and Mike had what's called the roux-en-Y
procedure, which is the most common and the most invasive.
For this operation,
pouch is created by stapling or surgical banding. This small
pouch restricts the amount of food that can be eaten.
a Y-shaped section of the small intestine is attached to the
pouch. This allows food to bypass segments of the small intestine.
these segments of the small intestine absorb a great deal
of calories and nutrients. Bypassing them severely reduces
having the surgery, people typically can consume only ½ to
1 cup of food at time for the rest of their lives.
a quick fix
bypass surgery isn't a miracle procedure. Long-term success
depends on patient's motivation and behavior. And as with
any surgery, there are possible side effects such as nutritional
deficiencies, stretching of the pouch, breakdown of the staple
lines and "dumping syndrome," which occurs when food moves
too quickly through the small intestines. Dumping syndrome
can cause nausea, weakness, faintness, sweating and occasionally
Mike talked with us about what led them to have the procedure
and what life is like afterwards.
and Mike: A "food addict," a snacker
he had an addiction to food. "I would eat a whole box of cookies
while I was watching TV," he says. "Sometimes I'd eat out
of pure boredom. I'd eat without realizing how much I was
try dieting to some extent, but it never lasted."
co-worker, says, "I wasn't a binger, but I definitely liked
to snack. I feel like, for me, being obese was like a disease.
My mother and siblings struggle with weight. In a way, it
seems like there are two parts to eating-there's the food,
and then there's what your body does with the food. I think
my body puts on weight with the same food that might not cause
another person to gain weight."
tired of spending her life unhappy with her weight. "Basically,
I tried to lose weight for 40 years," she says. "I didn't
have a lot of physical problems, but I was tired all the time.
I could get tired just walking down the hall."
diet after diet and was never able to keep the weight off
successfully. She had reached 326 pounds when, after a lot
of research and discussions with her doctor, she had gastric
bypass surgery on October 11, 2000. She had the surgery, she
says, "as a last resort."
losing weight immediately. "The first year is the biggest
window of opportunity as far as losing weight," KJ explains.
"Then it slows down after that."
KJ's co-worker, Mike, was up to 440 pounds. He took medications
for type 2 diabetes and for high cholesterol. Just walking
was difficult for Mike. "I had a handicapped sticker on my
car," Mike says. "When I went to sporting events, once I sat
down I wouldn't stand up until the end of the game because
it was so difficult to get out of the seat.
KJ's success with the surgery. She had done all the research
and told me all about it, and I guess I was a typical male.
It was like, 'Sounds great. I want to go for it.' "
the surgery on April 25, 2001.
and mother were supportive of her decision. Her friends were
a little afraid for her though. "I'd tell them I was going
to have the operation and they'd say, 'Are you sure you want
to do that? Why don't you come on Weight Watchers® with me
wife was supportive as well. "She met me when I was a football
player. I weighed about 260 pounds. I've always been a big
guy, and she's always loved me for who I am. But she supported
my decision. In fact, after the surgery, she told me she always
feared for my longevity. We'd talk about our retirement, but
she didn't believe I'd live to old age."
scared to have the surgery? Mike says he felt a little bit
of fear but he was ready.
"I was scared. I cried all the way."
recommendation of their doctor, before the surgery they had
each lost about 10 percent of the weight they wanted to lose.
Their doctor explained that this helps to prepare your body
get into weight loss mode, and it helps you recover more quickly
from the surgery.
first three weeks after the surgery, patients are on a liquid
diet. Pureed foods are allowed after the first week.
in a lot of pain afterwards?
that bad," says KJ. "The incision was painful, but they give
you lot of pain medication. And they have you up and walking
around a couple hours after the procedure."
says, "I woke up hungry. I also wanted a cigarette." Mike
says he's planning on quitting smoking now that the surgery's
over with. "One vice at a time," he says.
the surgery, both KJ and Mike needed three weeks to recover
before they went back to work. They both have desk jobs, which
probably accounts for their getting back so quickly. Mike
says, "I knew that KJ took three weeks off before coming back.
I wanted to be a macho guy and come back a lot quicker, but
there was no way. I really needed all that time."
it's been more than a year since the surgery. She wondered
how she would handle the holidays last year, her first since
the operation. "I was fine," she says. "It didn't bother me
at all. Everyone around me was eating, and I couldn't, but
it didn't bother me. It was still new, and I was happy I was
losing weight. Believe it or not, I even watched the Food
Network on TV."
the surgery, KJ had asthma and allergies, and she took preventative
medication for her asthma. She no longer has to take the asthma
drugs. While she doesn't exercise regularly, she does feel
a tremendous difference in her energy level and her ability
to get around.
longer takes diabetes medications because he's able to control
his condition with diet. He's off the cholesterol medication
says Mike. "Mentally, psychologically, physically, I feel
great. I can go to a sporting event and sit in the chairs
comfortably. I'm not a regular exerciser, but I get more exercise
than ever before. I just put a floor down in my house. I built
a deck. I could never have done that before."
about food now?
is different now for KJ and Mike. They're limited to about
½ cup to ¾ cup of food at a time. And they have to chew their
food slowly and carefully before swallowing. When they go
out to lunch together, they share the entrée and still have
food left over.
who've had gastric bypass surgery experience what's called
"dumping syndrome" when they eat more food than their stomachs
can handle. Mike describes dumping syndrome as hot sweats
and feeling "yucky." He has particular difficulty with sweets.
More than one tiny candy bar can make him feel sick.
Mike, not being able to eat a lot at once is a small price
to pay for feeling so much better.
she went through a "bit of mourning" after her surgery. I
felt like, "I love food, and now it's gone. It'll never be
the same." She's put that behind her now. "Food is good again,"
she says. "I just can't have that much."
about their weight?
like that question," says KJ.
try not to focus on the numbers too much," says Mike. "Our
doctor recommends that. The main thing is that we feel good,
we're healthy, we're active. We try not to get sucked into
the idea that we have to be at a certain number to be happy."
will reveal how much they've lost, even though they don't
like to talk about it much. Mike has lost 160 pounds since
the surgery, KJ 146. That's after the 10 percent they lost
before the surgeries.
she's still not exactly where she wants to be in terms of
weight, but Mike is pleased. "I have people at work coming
up to me asking me when I'm going to stop losing weight."
is a tool, not a cure
KJ both stress that gastric bypass surgery isn't a cure for
obesity. KJ says, "This isn't a cure, it doesn't fix your
head. I'm at the point now where the weight loss has slowed
down, and I could actually gain weight again. I might not
be able to eat a whole pizza all at once, but I could nibble
on it all day long. I'm always telling myself, 'Okay, you've
gone through so much, don't wreck it now. Keep your act together.'
He could nibble all day too. The good thing for Mike and KJ
is they see each other at work all day. When Mike wants to
eat one of those tiny candy bars, he often goes to KJ's office
and she talks him out of it.
belong to a support group for people who have had the surgery
and those who are considering it. Both feel that the support
group is invaluable, although Mike acknowledges that he'd
like it if there were a few more men there. Far more women
undergo the gastric bypass procedure, which accounts for the
imbalance at the support group.
of the decreased nutrient absorption after the surgery, Mike
and KJ take quite a few nutritional supplements every day,
including a multi-vitamin, B12 and calcium. They also have
to drink a lot of water.
one of them has had any major side effects, although KJ admits
to having "a lot of skin hanging."
would Mike and KJ say to people thinking of having the surgery?
who's still losing weight and hasn't reached a plateau the
way KJ has, says that he would tell anyone to "go for it."
is a little more cautious. "Don't look at it as a miracle.
It's a tool," says KJ. You still need to watch what you eat.
And if you can lose weight any other way, you should try that
about gastric bypass surgery, including risks, benefits, descriptions
of who is and who is not a candidate, etc., visit the National
Institute of Diabetes and Digestive and Kidney Disorders (http://www.niddk.nih.gov/health/nutrit/pubs/gastsurg.htm
National Institute of Diabetes and Digestive and Kidney Disorders, December 2001