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Gastric Bypass Surgery (Roux-en-Y Gastric Bypass)

What it is: Gastric bypass is the most common type of weight loss surgery. It combines both restrictive and malabsorptive approaches.

In the operation, the surgeon divides the stomach into two parts, sealing off the upper section from the lower. The surgeon then connects the upper stomach directly to the lower section of the small intestine.

Essentially, the surgeon is creating a shortcut for the food, bypassing part of the stomach and the small intestine. Skipping these parts of the digestive tract means that the body absorbs fewer calories.

Pros: Weight loss tends to be swift and dramatic. About 50% of it happens in the first 6 months. It may continue for up to 2 years after the operation. Because of the rapid weight loss, conditions affected by obesity -- such as diabetes, high blood pressure, high cholesterol, arthritis, sleep apnea, and heartburn -- often get better quickly.

Gastric bypass also has good long-term results. Studies have found that many people keep most of the weight off for 10 years or longer.

Cons: You won't absorb food the way you used to, and that puts you at risk for not getting enough nutrients. The loss of calcium and iron could lead to osteoporosis and anemia. You'll have to be very careful with your diet, and take supplements, for the rest of your life.

Another risk of gastric bypass is dumping syndrome, in which food dumps from the stomach into the intestines too quickly, before it's been properly digested. About 85% of people who get a gastric bypass have some dumping. Symptoms include nausea, bloating, pain, sweating, weakness, and diarrhea. Dumping is often triggered by eating sugary or high-carbohydrate foods, and adjusting your diet helps.

Unlike adjustable gastric banding, gastric bypass is generally considered irreversible. It has been reversed in rare cases.

Risks: Because gastric bypass is more complicated, it's riskier. Infection and blood clots are risks, as they are with most surgeries. Gastric bypass also makes hernias more likely, which may need further surgery to fix. Also, you may get gallstones because of the rapid weight loss.

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