RNY Gastric Bypass surgery is a last resort for many obese people who have tried everything else.  It has given many people their lives back.  They can look forward to being able to breathe again, to sleep at night apnea free (finally off CPAP machines), get off diabetes medication, feel relief from arthritis pain, and generally lead otherwise normal, healthy lives.  For many, this is literally a life-saving operation!  But make no mistake -- it is not a cure for obesity, nor is it something to be taken lightly.  It is not cosmetic surgery and should not be construed as a solution to the obesity problem.  You're not going to be skinny after this or because of this -- it's still a lot of hard work to get there (and the objective is to get HEALTHY, not get a Barbie or Ken-type figure!).  This is a tool that can be used to assist those who have tried conventional weight loss methods and failed.

Gastric Bypass surgery for obesity, specifically, Roux-En-Y Gastric Bypass, is the most common gastric bypass procedure today.  RNY Gastric Bypass is an operation to create a small food "pouch" at the upper end of your stomach with a capacity of less than two ounces (<50 ml).  The pouch is connected to the middle small intestine (jejunum) by a small outlet of about 1.0 cm (1/2 inch) in diameter, thus bypassing the remaining portion of your stomach and some of your small intestine, the duodenum, and the first part of the jejunum.

This bypass surgery functions by limiting the amount of food or liquid which you can eat or drink at one time (by the size of the pouch, but also the size of the opening into the intestine).  It also limits the amount of calories and nutrients that can be absorbed, due to the partial intestinal bypass (malabsorption).  Because of this, eating habits must change dramatically, food must be portioned properly, diet must be supplemented with daily vitamins and calcium, and extra iron for pre-menopausal women (the part of the intestine bypassed is the major absorption site for calcium and iron).  Protein supplementation (powder) is required until enough can be consumed from the diet (usually a few months post-op).  In addition, you must get vitamin B12 shots each month for the rest of your life (or take daily sublingual B12 tablets), since B12 is not absorbed well naturally, because the small pouch doesn't have intrinsic factor to bind to it and carry it to the ileum, where B12 is absorbed.

It's a drastic lifestyle change.  You can't eat more than 2 ounces of food at a time -- really -- your stomach isn't used much anymore.  You have a 2-oz pouch instead (okay, over time it learns to stretch, but not by much, if you eat properly).  If you eat too much, or too fast, you may throw up.  If you eat too much sugar, you may get sick (it's called "dumping syndrome", and includes nausea, flushed sweating, dizziness, and/or crampy abdominal pain followed by diarrhea).  You have to sip water all day long (you can't gulp a lot).  You have to eat pureed foods for two months post-op (to allow proper healing), then chew everything very carefully and completely after that, or you could get sick (or worse yet, clogged).  Hernias are not uncommon following RNY Gastric Bypass Surgery, so you have to be careful about lifting for many months following surgery.

If you don't follow the rules, you may lose weight, but you won't feel good, your hair could fall out, and worse (I've heard of anemia, bone disease, regaining lost pounds, and others I don't even want to think about).  Patients who have the bypass surgery generally lose two-thirds of their excess weight within two years, and keep it off, but you have to be serious about it.  It's a whole lifestyle change.  And yes, you can ruin it and gain it back -- this is not a SOLUTION, but a TOOL!!  

There are no guarantees -- you will really have to work at long-term weight loss (with proper diet and exercise .. sound familiar?).  The surgery has different results with different people -- some people don't have permanent problems with dumping; while others can't tolerate even a couple of grams of sugar without getting ill.  Some people get to their "perfect" weight (in the one-hundred-something range), while others lose hundreds of pounds and stabilize at a (still obese) hundred or so pounds overweight.  Every person is different, so the choice to either go with this surgery or not is very personal.  Nobody can make it for you, and it isn't a decision that should be made lightly.  Read other people's stories and experiences, and try to determine what type of person you are and how you would react in situations described by others.  Ultimately, this is a decision that you will have to live with...permanently!     

Here are a few links for more reading and help -- the first is the Morbid Obesity web site, where I found my doctor, Osvaldo Anez (as well as where I first got advice on insurance, types of surgery, etc., from others who had been through it).  The second is my web site, which chronicles my surgery, post-op, and subsequent "normal" life...

Obesity Help Web site: http://www.obesityhelp.com/morbidobesity

Stories by obesity survivors, with lots of good info and links to other resources:

Female (my story):  http://www.roboborr.com/rwells/rny.shtml

Female (one phenomenal story):  http://www.MyGastricBypass.com

Male friend #1:  http://www.basilwhite.com/gastric  

Male friend #2:  http://www.steven.ngtnet.com/mystory.htm

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