I admit it. As geeky as it sounds, I am a metabolism groupie. I even attend seminars that have little to do with my research if the word metabolism is mentioned anywhere in the title. So when I saw a poster for a seminar titled Gastrointestinal Regulation of Metabolic Function at a weekly diabetes seminar held at my university, I had to check it out.

The guest speaker was Dr. Lee Kaplan of Massachusetts General Hospital and Harvard Medical School. Kaplan spoke on the controversial weight loss technique, bariatric surgery. Specifically, he discussed the most widely practiced type of bariatric surgery, the Roux-en-Y gastric bypass (RYGB). RYGB involves creating a pouch (i.e. the new stomach) about the size of a golf ball by dividing it from the original stomach with staples. The small intestine is then cut at the jejunum (the middle portion of the small intestine) and distal portion of the jejunum is connected to the new stomach pouch. Thus, the duodenum, the first portion of the small intestine where most digestion occurs, is bypassed.

Roux-en Y gastric bypass (site and link to original image available here)

In short, he discussed the physiological changes that the body undergoes after Roux-en-Y gastric bypass. Patients experience dramatic weight loss, decrease their food intake, and increase their energy expenditure. Moreover, fasting glucose levels, glucose tolerance, and peripheral insulin levels all improve, such that remission of type 2 diabetes is almost immediate.

The effects are quite dramatic, but we’ve all heard the stories like these… My friend’s boyfriend’s cousin went in to get gastric bypass surgery and died of complications. So the question remains, is this procedure safe?

A recently published review article on the risks and rewards of bariatric surgery suggest that it is. In fact, the 90-day mortality rate of patients who have undergone bariatric surgery is only 0.35%. To put this number into perspective, the 30-day mortality rates of other major surgical procedures like coronary artery bypass graft (3.5%), pancreatectomy (8.3%), and aortic aneurysm (3.9%) are much greater than RYGB (0.5%). Not to mention, the weight loss after RYGB greatly reduces the risk of comorbidities associated with obesity.

Now don’t get me wrong. I am not saying any Joe Shmoe wanting to drop a few pounds should jump onto the operating table. But for morbidly obese people who are unable to loose weight with combination therapy (diet, exercise, and drugs), RYGB is a safe and effective option for weight loss.