Gastric Bypass Surgery


What is gastric bypass surgery?
Gastric bypass surgery (most commonly the 'Roux-en-Y' gastric bypass) is a procedure which aims to reduce the amount of calories absorbed from your food whilst also helping you to feel full after eating smaller meals.

This weight loss procedure works in two ways:

  • By restricting the capacity of your stomach, and by
  • Bypassing part of your digestive system

Why do people choose to have gastric bypass surgery?

Gastric bypass surgery can help people with obesity lose a substantial amount of weight, after other methods like diet and exercise have failed. Obesity is associated with multitude of health problems and losing weight can also help to reduce them.

Gastric bypass surgery may be appropriate for you if:

  • You are morbidly obese (have a BMI of over 40)
  • You have a BMI of over 35 and suffer from a condition that poses a serious health risk (e.g. diabetes, heart disease or high blood pressure)
  • All appropriate non-surgical measures have been tried but have failed to achieve or maintain adequate, clinically beneficial weight loss
  • You are generally fit for anaesthesia and surgery and commit to the need for long-term follow-up.

Benefits of gastric bypass
The main benefit of gastric bypass surgery is its ability to help patients lose a significant amount of weight. Each patient is unique; however there are a number of positive effects of losing weight which are commonly reported:

  • Reduction in the health risks associated with obesity
  • Improved health and mobility
  • Improved mental wellbeing
  • Boost to self-esteem and self-confidence

What happens during gastric bypass surgery?
Firstly, a small compartment is created at the top of your stomach using staples. A piece of your intestine is then joined to this compartment, which bypasses the rest of your stomach and the upper part of the intestine, where most nutrients and calories are usually absorbed.

The small top part of your stomach fills up quickly with food, giving you a sensation of fullness, and then passes directly to the middle part of your small intestine and through the rest of your digestive system. As the digestive system has effectively been made shorter you should absorb fewer calories.

Is gastric bypass surgery available on the NHS?
NHS funding for this procedure is limited and varies by area. For this reason, many people find that getting a private gastric bypass operation is the best option for them.

Gastric bypass surgery aftercare
You will normally need to stay in hospital for about three days after the procedure so we can look after you and make sure we are happy with everything before you go home. Our team of dietitians and specialist nurses will look after you throughout your stay and provide support and advice after surgery.

Gastric bypass surgery from Spire Weight Loss Surgery
With Spire Weight Loss Surgery you will be treated by an experienced bariatric (obesity) surgeon at a time that suits you. You will be treated in a premium private hospital, not a clinic, and you can be assured of our commitment to healthcare standards and infection control excellence. What’s more, you’ll be able to recuperate in your own private room with friends and family able to visit when you wish.

Frequently asked questions about gastric bypass

How much weight will I lose?
The national average weight loss following a gastric bypass is 65-70% of excess body weight over a 12-18 month period. Weight loss is generally quite fast initially but will settle into a regular pattern. A patient with a BMI of approximately 50 would expect to reduce weight by 10-14lb per month.

Will I lose weight quickly?
Weight loss commences when the liver reducing diet is started prior to surgery. Post-operative weight loss can be quite rapid in the first six to eight weeks but then will settle into a steady monthly reduction. The national average weight loss is 65-70% of excess weight lost over a 12 to 18 month period, but success is related directly to motivation, commitment and following the guidelines provided.

How long will I have to stay in hospital after surgery?
You are normally expected to stay one to two nights for this type of procedure, however, if it is clinically necessary for you to stay in longer then this will be explained to you by our clinical team.  You will not be charged anymore if you are expected to stay in longer due to clinical reasons.

How long will I have to take off work?
Most people are able to return to work after two to three weeks depending on the kind of work you do. If you work in heavy manual labour you may require a little longer.

Will I have to take any medication after surgery?
Yes. All gastric bypass patients will need to take nutritional supplements and a medication to protect the stomach. Calcium, multivitamins, iron, B12, folic acid and a protein pump inhibitor will be prescribed by your GP to commence two weeks after your operation. These medications will be discussed when you attend your clinic appointments prior to surgery.

Should I exercise after surgery?
You will be encouraged to exercise following surgery, gradually increasing your activity over two weeks. Exercise is an important part of your recovery – it will help relieve the symptoms of ‘trapped wind’, reduce the risk of blood clots in the legs (DVT), help increase weight loss by increasing metabolism, and help reduce blood pressure and cholesterol levels. Exercise will also help support your joints and will improve your final physique.

Exercise such as walking in the first two weeks can be increased gradually until you are exercising for 30 minutes three or four times a week. 

How long before I can drive after surgery?
You should not drive for ten days post operatively (DVLA policy). You can drive after that time if you can safely carry out an emergency stop.  Ask your insurance company for advice if you have any doubts.

How will my diet change after surgery?
Initially there is a need to restrict the consistency and type of foods that can be consumed. This is due to the presence of swelling between the opening of the new stomach pouch and the intestine. It is vital that only liquids should be consumed for the first two weeks to reduce the risk to the healing stitches. The new stomach pouch is much smaller and subsequently has a smaller capacity to store anything that you eat. This means you won’t be able to eat large volumes of food. You will feel full very quickly (a few teaspoons full initially) and your appetite should decrease. As the body adjusts and swelling settles there will be some give allowing for more solid food to be consumed.

Due to dietary restrictions it is important to protect against nutritional deficiencies. Following surgery you should have a multivitamin, calcium and iron supplement which will protect against the risks of osteoporosis and anaemia. Occasionally a zinc deficiency may occur and you may be prescribed a further supplement. An anti-acid tablet will help reduce stomach acid and prevent the formation of ulcers. Immediately following surgery, the body is healing, so it is important that you still consume adequate calories and protein to help promote recovery.

Will my current medical problems/conditions affect my weight loss surgery?
Many people with pre-existing medical conditions undergo treatment/surgery. Some medical conditions associated with increased body weight, such as type 2 diabetes, obstructive sleep apnoea, hyperlipidaemia and high blood pressure, can improve following weight loss and therefore treatment/surgery can help. It is vital that you inform the specialist nurse and your doctors of any investigations or treatments you are receiving to ensure all tests and investigations are completed before proceeding as this will best ensure your safety and reduce the risks associated with surgery.

What is the mortality rate?
The national mortality related to gastric bypass is 0.5%

What if I am still very hungry after surgery?
Most patients experience a reduction in hunger following gastric bypass though some patients continue to feel hungry at times. It is important to make lifestyle changes and change eating habits to best manage those symptoms. ‘Head hunger’ and ‘stomach hunger’ can be different and it is important to learn to recognise the difference at the early stages. Habit and food dependence may need to be addressed to reduce those symptoms.

What can I eat after surgery?
You will liaise very closely with your dietitian who will give you a specific diet plan tailored to your individual needs after your surgery.

Will I have big scars?
You will have five very small scars equally spaced across your upper abdomen. The skin is closed with either soluble stitches or surgical glue. Wounds are generally covered for one week following which the dressings can be taken off. Wounds should be healed within two to three weeks.

Will I be able to drink alcohol after surgery?
We would suggest that alcohol is avoided for the first six to eight weeks of the ‘weaning’ period immediately following your surgery. Many people enjoy an alcoholic beverage and there is no reason why it should be completely avoided but alcohol must be consumed in moderation. The national guidelines are that women should have no more than 14 units of alcohol per week, and men to have no more than 21 units of alcohol per week. However, alcohol is high in calories and therefore reducing consumption can assist in weight loss. Following bariatric surgery you will find that alcohol is absorbed into your blood stream much more rapidly, you may feel intoxicated much quicker as there is less food to absorb the alcohol in your stomach. Fizzy drinks are also a significant problem following surgery as the gas can cause pain and distension of the stomach pouch. An occasional glass of wine may be easier to tolerate than beer or mixers.

How long has this procedure been available?
Bariatric procedures have been available for many years and have developed to provide better outcomes for weight loss and health improvement. The Roux-en-Y gastric bypass is currently deemed to be the ‘gold standard’ of bariatric procedures by British Obesity and Metabolic Surgery Society. We have been carrying out this procedure for more than six years and our consultants have significant expertise in this particular form of surgery.

What does laparoscopic mean?
Laparoscopic surgery, also known as minimally invasive surgery, is a technique that allows surgery to be performed without the long traditional incision (cut). By using multiple small incisions, each between 5- 15mm long, the surgeon inserts instruments including a tiny camera. The camera allows the surgeon to see the surgery.

Can the surgery be reversed?
It is vital that a lifetime commitment is made by the patient prior to proceeding to surgery. Technically gastric bypass procedures can be reversed but this would only ever be attempted if deemed clinically necessary; we have not undertaken any reversal procedures. It would be a much more complex procedure with significantly higher risks for the patient.

Is it safe to fly after surgery?
We would suggest that you do not fly long haul during the weaning period. There is a risk of blood clots related to surgery and you will be provided with medication, stockings and advice about how best to reduce your risks.

Holidays abroad are best avoided during this time as dietary requirements may be difficult to manage if away from home.