Frequently asked questions
What happens to all of my excess skin?
Because most of your fat is stored in the tissue directly beneath the skin, when the fat is gone, the skin will eventually sag.
The skin will shrink to a certain extent but not as rapidly as the fat is lost. Six to twelve months after surgery you will see the worst of the sagging skin. Younger patients may have more elastic skin and may not sag as much as older patients.
Some patients may wish to have excessive skin surgically removed but this should be done 18 – 24 months following their surgery when their weight loss has stabilized.
Would eating more food in the postoperative time decrease sagging skin?
Absolutely not! Sagging skin is a function of weight loss. It is important that the rapid weight loss be optimized while the gastric pouch is small.
The situation with your skin should be seen as a cosmetic issue that will ultimately improve and can be treated with plastic surgery if necessary.
What happens to the rest of my stomach?
The remainder of the stomach remains in place and loses none of its function.
Could I reverse this operation?
This would be highly discouraged. Gastric bypass surgery is considered a permanent surgery. However, if this operation were reversed, it would result in the patient regaining most or all of the weight that had been lost.
What is dumping syndrome?
Dumping syndrome is experienced to a certain degree by all patients who have a very small gastric reservoir. Dumping is associated mostly with eating sweets and carbohydrates.
These foods are characteristically “hyperosmolar.” What this means is that these foods have a high concentration of sugar relative to other foods. As such, they stimulate the gastric reservoir to empty more quickly.
This causes these highly concentrated foods to be “dumped” into the small intestine. When this type of food enters the small intestine, it causes the small intestine to move the food very rapidly along this section of the bowel.
It also causes the release of hormones that give the patient a sense of dizziness, nausea, fatigue and sweating.
Patients usually describe this as an unpleasant feeling. While generally harmless, the unpleasant experience of dumping may decrease your choice to consume hyperosmolar foods.
Due to the unpleasant feelings associated with dumping syndrome, the brain soon learns to avoid these types of foods. This “aversion” to sweets also has additional benefits and helps in increasing the rate of weight loss.
Will I have diarrhea or increased gas?
Some patients are air swallowers. Air is 80% nitrogen and is not absorbed by the GI tract.
Because there is not a gastric reservoir and associated belching to relieve this swallowed air, it must pass all the way through the digestive system. Once passed through the digestive system, this swallowed air is expelled as flatus.
This can make the symptoms of irritable syndrome worse as well. This can be “un-learned” by the GI tract to some extent over time.
Will I regain weight in the future?
Maximum weight loss occurs at approximately 12-18 months after surgery. Some weight loss can occur for as long as two years.
At this point, weight loss levels off. There is a usual slight regain of around 5-10% of your weight loss at the five-year time.
However, this is typically the maximum weight re-gain long-term. However, when slow weight gain does occur, it is necessary to address this early on.
If you eventually are able to increase your food intake and you return to pre-surgical eating habits, it would be possible to overcome your bypass operation and experience significant weight gain in the future.
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