These questions and answers were derived from the Mercy and Unity Hospitals, web site. They are located in the Twin-Cities Minnesota area.

Why would a person choose the surgery over traditional weight loss methods?
Many morbidly obese people may be in a life-threatening situation. They have tried a variety of diets, with little or no success. Even when they experience weight loss, the weight is often regained. Gastric restrictive surgery is considered a permanent procedure, and therefore, has good long-range results when patients comply with the nutrional and exercise guidelines.

Will I ever be able to eat like a normal person again?
For your gastric restrictive surgery to be successful over the long term, you will need to continue to go along with the restrictions imposed by your gastric bypass procedure. You will always need to be food conscious. In other words, dieting in some aspect will be necessary for the rest of your life.

I heard that gastric banding is as good an operation as gastric bypass - is this true?
Gastric banding in some respects is a simpler operation and can have different side effects. For some individuals, banded gastroplasty (gastric banding) may work as well as gastric bypass depending on the person's eating patterns and food selection. A careful review of your dieting history will be very important in the decision-making process.

What is staple line breakdown - and is it true that gastric restrictive surgery does not work then?
Staple line breakdown tended to be a problem in operations that were carried out prior to 1987. Breakdown occurred where the new small gastric pouch was not physically separated from the lower bypassed portion of the stomach. Staple line disruption in this situtation re-established the continuity between the two parts of the stomach resulting in weight gain. The Roux-en Y Gastric Bypass involves complete separation of the new small gastric pouch and the distal stomach, tending to make it unlikely for spontaneous re-connection.

What happens to the part of the stomach that is bypassed?
The distal stomach tends to shrink slightly but continues to function as a normal stomach, producing acid and digestive juices. The only difference is that it does not receive food. The surgery is reversible.

How long does surgery take?
Surgery usually takes less than two hours.

Will I have a lot of tubes?
An oral-gastric tube is inserted during surgery to check for leakage. It is removed in the postoperative recovery room. Intravenous feeding tubes (IV) are left in for one to two days. Bladder catheters are generally not required.

Will my skin shrink? Will exercise help?
The skin tends to shrink after continuous and sustained weight loss. This occurs more readily in younger individuals and individuals who do not smoke. Exercise does help to some degree, but time is the most important factor. Plastic surgery is seldom requested and should not be considered for at least two years after surgery.

Will I lose my hair?
Some individuals will experience hair thinning that is associated with sustained weight reduction, and it is a result of the body going through a starvation phase. Other side effects during the time are dryness of the skin, lightheadedness when changing positions and brittleness of the nails. In the vast majority of the cases, these side effects are reversed after one year's time or after the weight loss has plateaued for a period of time.

My friend had surgery in 1974 and regained all of her weight - why?
Intestinal bypass operations and gastric weight reduction surgeries done in the 60's and 70's were still in the formative stages. These procedures tended not to be as successful over the long term as procedures currently being used. Other factors associated with weight gain may also be: breakdown of the staples, stomach stretching, resuming old eating patterns (such as multiple small meals, snacking, poor food selections) drinking liquids when eating and lack of exercise. These factors will defeat the weight reduction qualities of restrictive operations. Careful reevaluation and medical work-ups can usually detect the reasons behind the weight gain.

I know someone whose stomach stretched several years after surgery, they regained all their weight - why?
Older operations for gastric restriction tended to leave too large of a pouch which did in fact stretch to near normal size. Modern surgical techniques reduce this possibility.