Obesity Treatment Gastric Bypass Surgery: Long-Term Care By Colleen Doherty, MD Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis. Learn about our editorial process Colleen Doherty, MD Updated on November 17, 2020 Print Table of Contents View All Benefits of Surgery Possible Future Surgeries Lifestyle Adjustments Gastric bypass surgery, also known as Roux-en-Y gastric bypass (RYGB) surgery, is a type of bariatric (weight-loss) surgery that involves creating a small pouch out of a patient's existing stomach. The surgery has many potential benefits, including the improvement (even reversal) of health conditions like high blood pressure and diabetes. That said, gastric bypass surgery is not a "cure" or a magic solution to obesity. Patients must make a lifelong commitment to following a healthy diet and exercise regimen in order to maintain their weight loss. Drazen_/Getty Images Benefits of Surgery The primary benefit of gastric bypass surgery is significant weight loss with subsequent alleviation of obesity-related health problems. While not an exhaustive list, some diseases that may be cured, or at least improved, from surgery include: Type 2 diabetesHeart diseaseHigh blood pressureObstructive sleep apneaNon-alcoholic fatty liver diseaseOsteoarthritisInfertilityDepression Gastric bypass surgery has also been found to reduce the risk of death from diabetes, heart disease, and cancer. In addition, patients report improvements in energy levels, satisfaction with body image/appearance, and quality of life. Possible Future Surgeries While gastric bypass surgery is considered an overall safe surgery, future surgical procedures may be indicated if certain post-operative complications arise. Examples of such complications include: Marginal ulcer formation: A marginal ulcer is like a peptic ulcer. It may form near the site where the stomach pouch and small intestine are connected during the gastric bypass. Surgery may be indicated if the ulcer perforates (forms a hole in the gut), or if a patient has persistent pain or bleeding, despite medical therapy.Incisional hernia formation: An incisional hernia, which is an abnormal opening in the abdominal wall, may occur after gastric bypass. Surgery may be indicated emergently if a patient experiences severe pain or small bowel obstruction.Late-onset dumping syndrome: Dumping syndrome occurs when food moves rapidly from the stomach to the small intestines causing nausea and abdominal cramping. It symptoms do not get better with dietary changes and medication, revisional bariatric surgery may be required. Another indication for a possible future surgery (specifically, a revisional bariatric surgery) is if a patient fails to lose weight. This complication is rare and usually is due to poor eating habits that begin after surgery. Weight regain, which occurs in up to 20% of patients, is another indication for revisional bariatric surgery. Weight regain may occur as a result of the following: Nonadherence to eating and lifestyle changes after surgeryDevelopment of a gastrogastric fistula, which is when an abnormal tract forms between the new stomach pouch and the old stomach remnantProgressive stretching and enlargement of the new stomach pouchWidening of the connection between the stomach pouch and the small intestines (called the gastrojejunal anastomosis) Lastly, due to excess, sagging skin, patients may opt to undergo skin removal surgery after losing weight from gastric bypass surgery. Lifestyle Adjustments After laparoscopic gastric bypass surgery, approximately 80% of patients lose more than 70% of their excess body weight over two years. In order to maintain this weight loss after surgery, patients must adhere to several lifestyle practices. Eating and Drinking Right Patients will leave the hospital on a full liquid diet with protein shakes. They usually continue the full liquid diet for about two weeks or until their first post-operative follow-up appointment. After that, they will progress to a soft diet and eventually, a diet containing foods of a regular consistency. During this time, it's essential that patients stay hydrated, drinking around 60 ounces of water per day. When tolerating oral foods, some lifelong food or meal guidelines that a patient must follow include: Incorporating protein into every meal to meet daily requirements, which is around 60 grams. Consumption of a protein shake or a low-calorie protein food (e.g., a reduced-fat string cheese) in between meals may be needed to meet this requirement.Stopping eating when full.Not drinking for at least 30 minutes prior to and after meals.Drinking around 60 ounces of water a day to prevent dehydrationAvoiding all carbonated drinks (bubbles can stretch the stomach) and foods high in sugar or fat.Taking a daily multivitamin, along with calcium, vitamin D, iron, vitamin C, and vitamin B12) Exercising Regularly Exercising regularly (five to seven days a week) after surgery is essential for burning fat, preserving muscle strength, controlling appetite, and reducing stress. Many patients benefit from working with a fitness coach or physical therapist to help them find enjoyable, long-term physical activities, whether that be hiking, swimming, or dancing. Joining a Support Group To help patients cope with the aftermath of surgery, many bariatric surgery programs offer post-operative support groups. Joining a group (whether in person or online) can help patients remain committed to their new lifestyle habits (which may seem rigorous at first, but eventually become second nature). Support groups can also provide emotional support, as well as, extended contact and access to healthcare professionals if questions or concerns arise. Seeing Your Doctor Regularly Even after recovering from surgery, it's important for patients to follow-up with their bariatric surgeon and primary care physician as instructed (usually every three months, six months, and then annually). The purpose of these visits is to: Evaluate for possible long-term surgical complications related to the surgeryMonitor nutritional deficiencies through blood tests (taken at least every six months)Monitor chronic health conditions and adjust medications, as neededKeep track of a patient's weight loss progress (weight loss may continue for up to two years after surgery) Women in their childbearing years should also see their primary care physician or gynecologist in order to discuss birth control options. The American College of Obstetricians and Gynecologists (ACOG) recommends that people not become pregnant in the first 12 to 18 months after bariatric surgery. A Word From Verywell For many patients, gastric bypass surgery is a jumpstart into a life they dreamed of and deserved for years. Still, while surgery is a reliable means of achieving significant weight loss, it's only the first step. Patients must remain proactive and committed to their follow-up care and everyday habits. Was this page helpful? Thanks for your feedback! Get nutrition tips and advice to make healthy eating easier. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Wolfe B, Kvach E, Eckel R. Treatment of obesity: Weight loss and bariatric surgery. Circ Res. 2016;118(11):1844–1855. doi:10.1161/CIRCRESAHA.116.307591 Dawes A, Maggard-Gibbons M, Maher A et al. Mental health conditions among patients seeking and undergoing bariatric surgery. JAMA. 2016;315(2):150. doi:10.1001/jama.2015.18118 Adams T, Gress R, Smith S et al. Long-term mortality after gastric bypass surgery. 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Beyond weight loss: Establishing a postbariatric surgery patient support group—what do patients want? J Obes. 2018;2018:8419120. doi:10.1155/2018/8419120 Lim RB. Laparoscopic Roux-en-Y gastric bypass. Jones D, ed. UpToDate. Waltham, MA: UpToDate. Updated May 2019. John Hopkins Medicine. Roux-en-Y gastric bypass weight-loss surgery. American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 105: Bariatric surgery and pregnancy. Obstet Gynecol. 2009;113(6):1405–1413. doi:10.1097/AOG.0b013e3181ac0544 Additional Reading American Society for Metabolic and Bariatric Surgery. Benefits of weight loss surgery. Updated September 2020. Cleveland Clinic. 7 bariatric surgery benefits besides helping you lose weight. May 15th, 2015. Sarwer D, Wadden T, Moore R, Eisenberg M, Raper S, Williams N. Changes in quality of life and body image after gastric bypass surgery. Surgery for Obesity and Related Diseases. 2010;6(6):608-614. doi:10.1016/j.soard.2010.07.015 UCSF Health. Recovery from bariatric surgery.