Weigh the Pros and Cons of Gastric Bypass Surgery

By Gaurav Sharma, MD, Bariatric Surgeon, Virtua Bariatric Weight-Loss Surgery

There are 4 types of bariatric surgery procedures: laparoscopic sleeve gastrectomy (gastric sleeve), gastric bypass, gastric band and duodenal switch. Of all of these, gastric sleeve and gastric bypass are top choices by patients looking to lose weight through surgery.

Gastric sleeve surgery (sleeve gastrectomy) is now more popular than gastric bypass for weight loss. In fact, gastric sleeve surgery is now the most common bariatric surgery in the US. In this surgery, the stomach is reduced to about 15% of its original size—giving it a sleeve-like structure. Patients lose weight because they feel full from smaller food portions, eat less and have a significantly decreased feeling of hunger.

In contrast, gastric bypass is a more aggressive option than sleeve gastrectomy, but it typically provides greater weight loss. Gastric bypass can reduce excess body weight by an average of 75 percent in one year. In addition to helping you lose weight, gastric bypass can resolve Type 2 diabetes in nearly 90 percent of cases, as well as reduce cravings for unhealthy foods, decrease feelings of hunger and even alter food preferences.

During gastric bypass surgery, the surgeon reduces the size of the stomach by using staples to create a small section that holds the food you eat. The doctor then connects the small intestine to a hole in the section of your stomach that holds the food, essentially bypassing the larger section of your stomach. While gastric bypass typically provides greater weight loss, the popularity of it has decreased due, in part, to an increased risk of complications like small bowel obstruction, internal hernia and ulcers where the stomach connects with the small bowel.

Your surgeon can help you choose the best surgery for you, but if you’re considering gastric bypass, here’s some important information to know.

What are the weight loss benefits of gastric bypass surgery?

Gastric bypass promotes weight loss by restricting the amount of food your stomach can hold and changing the way your stomach and small intestine absorb calories and nutrients from food.

Studies have shown that gastric bypass surgery also affects hormone levels that regulate feelings of hunger and fullness and changes your brain’s response to eating. As a result, patients who undergo gastric bypass surgery feel full most of the time, experience less pleasure from eating and are less susceptible to emotional eating and external eating cues. 

As an added bonus, people who have had gastric bypass surgery often report changes to their food preferences, including:

• Fewer cravings for foods that are high in fat and sugar
• Decreased preference for sugary foods and carbohydrates
• Decreased tolerance for specific foods/beverages, such as meat, dairy, carbohydrates, water or sweets

Some gastric bypass patients find that foods they previously enjoyed now taste bitter, have an unappealing consistency or smell bad. Hormonal changes also cause some gastric bypass patients to experience rapid gastric emptying, or “dumping syndrome,” a condition that causes food to travel to the small bowel too quickly after eating meals that are high in carbohydrates and/or sugar. Dumping syndrome can cause a variety of uncomfortable symptoms, including:

• Abdominal cramps
• Confusion
• Diarrhea
• Mood changes
• Nausea
• Sweating
• Vomiting

Patients who experience dumping syndrome quickly learn what foods their bodies can and can’t tolerate. They also use the way they feel after eating to help them regulate what and how much they eat.

How can I prepare for my diet after gastric bypass surgery?

Most candidates for bariatric surgery begin working with a registered dietitian 3 to 4 months before surgery. A dietitian can help you change your portion sizes and the types of food you eat so you don’t become overwhelmed in the months following your bariatric surgery.

Although bariatric surgeons recommend following a high-protein, low-sugar, low-carbohydrate and low-fat diet after surgery, working with a dietitian can help you cope with changes to food preferences and achieve maximum weight-loss results.

After bariatric surgery, you should see a dietitian every 4 to 6 weeks for at least 6 months. Your dietitian will be sensitive to any food preference changes you may experience while providing recipes and food substitution options to help you get the nutrients you need. Your dietitian also will show you how to track your calorie and nutrient intake and work with you to establish weight-loss goals.

Is it possible to regain weight after bariatric surgery?

Some patients who undergo bariatric surgery regain weight in the years following the procedure because they return to unhealthy eating behaviors. Although many patients experience dumping syndrome soon after gastric bypass surgery, some patients discover that unhealthy foods cause less discomfort over time and eventually start eating these foods again.

To minimize the risk of regaining weight after bariatric surgery, Virtua offers a monthly support group so you can learn from others and share helpful advice. There’s also a supportive, private Facebook page where Virtua bariatric surgery patients share success stories, challenges and advice (patients can join by request). 

Call 1-888-VIRTUA-3 (1-888-847-8823) to schedule a consultation with a Virtua bariatric surgeon, or attend an information session to learn more. 

Updated January 14, 2022