Surgery Recovery Gastric Bypass Surgery Guide Gastric Bypass Surgery Guide Overview Purpose How to Prepare What to Expect Recovery Long-Term Care Purpose of Gastric Bypass Surgery By Colleen Doherty, MD Colleen Doherty, MD Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis. Learn about our editorial process Updated on December 01, 2022 Medically reviewed by Scott Sundick, MD Medically reviewed by Scott Sundick, MD LinkedIn Scott Sundick, MD, is board-certified in general surgery and vascular surgery. Since 2012, he has practiced with The Cardiovascular Care Group in New Jersey. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Related Diagnosis Criteria Tests and Labs Next in Gastric Bypass Surgery Guide Gastric Bypass Surgery: How to Prepare The purpose of gastric bypass surgery is to limit the amount of food you can eat and the number of calories your body can absorb. Not only can this help people with obesity lose weight, but it can also improve or cure obesity-related conditions, including diabetes, high blood pressure, and sleep apnea. This article looks closely at the purpose of gastric bypass surgery, the criteria you must meet to be eligible for it, and the tests and labs to expect. Verywell / Laura Porter Diagnoses Related to Gastric Bypass Surgery The primary goal of gastric bypass surgery is to lose weight in order to improve or reverse medical conditions associated with obesity. Examples of such obesity-related conditions include: Heart diseases, such as high blood pressure (hypertension) and coronary artery disease Lung diseases, such as obstructive sleep apnea, obesity hypoventilation syndrome, and asthma Venous conditions, such as deep vein thrombosis and pulmonary embolism Metabolic conditions like type 2 diabetes mellitus, non-alcoholic fatty liver disease, and high cholesterol Reproductive conditions, such as infertility and polycystic ovarian syndrome (PCOS) Urinary conditions, such as stress urinary incontinence Gastrointestinal conditions, such as gallstones, gastroesophageal reflux disease (GERD), and esophagitis Musculoskeletal conditions, such as hernias and osteoarthritis Nervous system conditions, such as idiopathic intracranial hypertension Criteria There are certain criteria a patient must meet in order to be considered a candidate for a weight loss surgery like gastric bypass. These criteria include a patient with: A body mass index (BMI) higher than or equal to 40 A BMI of over 35 with one or more obesity-related health conditions A BMI of over 30 with uncontrollable type 2 diabetes or metabolic syndrome BMI is a dated, flawed measure. It does not take into account factors such as body composition, ethnicity, sex, race, and age. Even though it is a biased measure, BMI is still widely used in the medical community because it’s an inexpensive and quick way to analyze a person’s potential health status and outcomes. Due to a higher prevalence of abdominal (truncal) obesity, weight loss surgery may also be considered for Asian patients who have uncontrolled type 2 diabetes and a BMI as low as 27.5. That said, meeting one of the above criteria is simply the first step in determining who is an appropriate candidate for surgery. Patients must be able to prove that they have been unsuccessful in maintaining a healthy weight through non-surgical means, such as lifestyle changes and drug treatments. Coverage for Weight Loss Surgery If you are considering gastric bypass surgery, be sure to check in with your insurance carrier to verify that you have met the requirements needed for the operation to be covered. Tests and Labs To confirm candidacy and to prepare for the outcome of the surgery, patients will need to undergo several evaluations with various healthcare professionals, usually beginning several weeks to months prior to the actual procedure date. These healthcare professionals include: A bariatric (weight loss) physicianA bariatric surgeonA nutritionist or dieticianA psychologist or psychiatrist The bariatric physician will review your medical history and order tests to either newly diagnose or monitor health conditions related to your obesity. Some of these conditions may need to be optimized prior to surgery in order to reduce the risk of surgical complications. Examples of such tests include: A comprehensive metabolic panel and liver function test to evaluate kidney and liver function A hemoglobin A1C to evaluate blood sugar control A series of blood tests to evaluate for malnutrition (e.g., vitamin D, albumin, ferritin) An overnight sleep study to evaluate for obstructive sleep apnea An esophagogastroduodenoscopy (EGD) to evaluate for GERD An electrocardiogram (ECG) and echocardiogram to evaluate for heart problems Other imaging studies (e.g., chest X-ray or abdominal ultrasound) Your bariatric physician will also probably start you on a medical weight loss program, as losing some weight before surgery is typically recommended. Your bariatric surgeon will review the pros and cons of the surgery with you and enroll you in a bariatric pre-operative education program. The purpose of this program is to learn about the nuances of the surgery, including what to expect in terms of the short and long-term recovery processes, as well as, the potential risks involved. A nutritionist will prepare you for what your diet will look like after surgery. They will also help you adhere to a low-calorie liquid diet, which is often required beginning two to four weeks before surgery. A psychologist or psychiatrist will discuss the mental and emotional stresses associated with the surgery and its aftermath. Since mental health conditions, especially depression and eating disorders, are associated with obesity, your mental health professional may also provide therapy or recommend/prescribe medication. Bariatric Surgery: Everything You Need to Know Finally, consultations with different specialists may also be needed before surgery. For example, women in their childbearing years undergoing gastric bypass may need to see an obstetrician to discuss birth control options after surgery. This is because professional societies, like the American College of Obstetricians and Gynecologists (ACOG), recommend that women not become pregnant in the first 12 to 18 months after bariatric surgery. A Word From Verywell The possible benefits of undergoing gastric bypass surgery are vast. Besides improving (if not reversing) serious health problems, patients feel better about their appearance and often report having improved self-esteem and quality of life. Still, undergoing this type of surgery is an incredibly big decision, one that requires deep consideration and thought. As you continue to educate yourself about gastric bypass or other weight-loss surgeries, do not hesitate to reach out to loved ones for support. Also, remember to be kind to yourself during this long and arduous journey. A good piece of advice is to simply take one day at a day and remain focused on your ultimate goal of achieving a healthier life—something you truly deserve. How Bariatric Surgery May Change Your Life 11 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. Arterburn DE, Telem DA, Kushner RF, Courcoulas AP. Benefits and risks of bariatric surgery in adults: a review. JAMA. 2020;324(9):879-887. doi:10.1001/jama.2020.12567 Wolfe BM, Kvach E, Eckel RH. Treatment of obesity: Weight loss and bariatric surgery. Circ Res. 2016;118(11):1844–1855. doi:10.1161/CIRCRESAHA.116.307591 Telem DA, Jones DB, Schauer PR, Brethauer SA, Rosenthal RJ, Provost D, Jones SB. Updated Panel Report: Best practices for the surgical treatment of obesity. Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Rubino F et al. Metabolic surgery in the treatment algorithm for type 2 diabetes: A joint statement by international diabetes organizations. Diabetes Care. 2016;39(6):861-77. doi:10.2337/dc16-0236 National Institute of Diabetes and Digestive and Kidney Diseases. Potential candidates for bariatric surgery. Lim RB. Patient education: Weight loss surgery and procedures (Beyond the Basics). Lim RB. Bariatric operations for management of obesity: Indications and preoperative preparation. University of Pittsburgh. Preparing for bariatric surgery. Edholm D, Kullberg J, Karlsson FA, Haenni A, Ahlström H, Sundbom M. Changes in liver volume and body composition during 4 weeks of low calorie diet before laparoscopic gastric bypass. Surg Obes Relat Dis. 2015;11(3):602-6. doi:10.1016/j.soard.2014.07.018 Luppino FS et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010;67(3):220-9. doi:10.1001/archgenpsychiatry.2010.2 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 Hsu WC, Araneta MRG, Kanaya AM, Chiang JL, Fujimoto W. BMI cut points to identify at-risk Asian Americans for type 2 diabetes screening. Diabetes Care. 201;38(1):150–158. doi:10.2337/dc14-2391 Monpellier VM, Antoniou EE, Aarts EO, Janssen IMC, Jansen ATM. Improvement of health-related auality of life after Roux-en-Y gastric bypass related to weight loss. Obes Surg. 2017;27(5): 1168–1173. doi:10.1007/s11695-016-2468-6 By Colleen Doherty, MD Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit