By Scott Michaels
Surgery may be a weight-loss option for patients who are
severely obese and suffer from serious medical complications
due to weight. There are two accepted surgical procedures for
reducing body weight: gastroplasty and gastric bypass.
these two procedures use different surgical methods, they both
reduce the stomach to a pouch that is smaller than a chicken’s
egg, drastically limiting the amount of food that can be
consumed at one time. Surgery produces 25 to 35 percent
reductions in weight over the first year and most of this
weight loss is maintained five years after surgery. More
importantly, the serious medical conditions that accompany
extreme obesity improve significantly. Surgery is not without
risk and should be performed by skilled surgeons who also
provide patients with a comprehensive program for long-term
Limited gastric capacity and a narrow anastomotic
gastrointestinal stoma necessitate certain dietary
modifications particularly in the early post-operative period.
Diet progression varies amongst health care professionals. A
standardized GBP diet does not exist. Generally, most patients
begin with a liquid diet due to the small, edematous gastric
outlet. This phase of the diet may range from one day up to 6
weeks. Afterwards, pureed textures are introduced and the diet
is slowly advanced to soft-textured foods by about 12 weeks.
Small, frequent meals rich in protein are emphasized. Liquids
are usually consumed between meals to allow greater intake of
calories and protein with solid foods. Carbonated drinks may
cause distension and discomfort from the carbon dioxide. Red
meats, tough meats, breads and milk products may be difficult
for some patients to tolerate. Until solid food intake is
adequate, high protein liquid supplements such as sugar free
Carnation Instant Breakfast (mixed with low lactose milk if
necessary) are often recommended.
During the first six to 12 months after surgery, patients
generally consume 900 to 1000 calories. Calorie consumption
slowly increases due to a change in the pouch size and stoma
size, gastric emptying rate and intake of solid food. Sugar
concentrated sweets are discouraged in order to prevent
syndrome. Because the pyloric sphincter is bypassed, simple
sugar is dumped into the small intestine causing an increase
the osmotic load, thereby drawing fluid into the intestine
leading to diarrhea, nausea, diaphoresis and abdominal cramps.
The shunting of blood to the intestines and the perceived
decrease in blood volume 30 minutes to one hour after a meal
prompts many patients to lie down in an effort to improve
Gastric bypass patients generally lose 50%–75% of excess body
weight and are usually successful with weight maintenance.
The obese population, especially the morbidly obese, is
increasing at an alarming rate in the United States. Weight
loss programs have been found ineffective in this group. In an
effort to improve the quality of life and decrease
comorbidities associated with this patient population, gastric
bypass surgery may be an option.
About The Author: Gastric bypass surgery makes the stomach
smaller and allows food to bypass part of the small intestine.