Roux en Y (RNY) Gastric Bypass

The RNY gastric bypass is an excellent surgery for those who need to lose 5 stone or more, and need results quickly. It was my choice of surgery because it is more effective for my needs than the band, and yet not as drastic as the DS procedure.

The operation consists of a division of the stomach to form a new pouch, and then a bypass of 1 1/2 - 2 metres of bowel to prevent the natural absorption of food. The small intestine is carefully measured and cut. One end is connected to the small stomach pouch. The other end is reconnected to the small intestine, forming a "Y".
 The stomach is left in place and gastric juices still flow through the duodenum as before, however the passage of food is re-routed post op.

Many obesity experts consider the surgery to be the "Gold Standard" of modern obesity surgery, the benchmark to which other bariatric operations are compared.

The new pouch is about the size of an egg and as such severely restricts the intake of food volume. The hunger receptor nerves are bypassed so you just don't get hungry anymore, but more of a sensation that you need to eat something. The 'fullness' sensation is experienced very quickly because these receptors are around the top of the pouch. It's incredible how soon you feel the need to stop eating, and you cannot believe that after so little, you feel so full.

The Roux-en-y Gastric Bypass is an excellent tool for achieving long-term control of morbid obesity.
Weight loss of 9-11 stone is the achievable weight loss in the first year. When your BMI reaches a healthy 20-27, the pouch stretches to allow a bigger volume of food to be consumed. This allows weight to be maintained at a healthy level without overshooting the weight loss. It is rare for this not to happen, but occasionally it can. A stretched pouch can happen before all the excess weight is lost and this can make losing the last few pounds more tricky. You can control what happens to your pouch though, and preventing stretching of the pouch by not overeating when your body tells you to stop is the best way.

Pouch Rules

1. Avoid fizzy drinks which stretch the pouch with it's gases.

2.  Avoid bulky foods which also push the stomach walls out.

3. Listen to what your body is telling you it needs. Head hunger is a major contributor to a delay in weight loss - where your body is telling you to stop but your head is pushing you to carry on eating. You are unlikely to experience 'hunger' as you did before because the enzyme in the main (and now bypassed) part of the stomach which causes the growling hunger pangs is now no longer being stimulated. You can experience a sensation of discomfort though which is about as close to 'hunger pangs' as you will get post op. This sensation though can also mean that you are thirsty and a drink will stop this sensation quickly enough.

4. Avoid eating and drinking at the same time because the fluids will a) fill you up faster than the food b) will pass the food from your stomach to the lower part of the intestine too quickly for you to absorb any nutrients.

5. Drink 2 litres of fluid a day. Try to make the majority of this intake water. Tea and Coffee, juice etc also count as part of the intake count but water is the best because it does not carry any caffine.

The links below give more detail about the RNY and things you need to know if you are going to opt for this surgery.

This page as a PDF

1. How and why you lose weight with the RNY

2. Nutritional Information

3. Dumping Syndrome

4. Pro's and Con's

5. The Gastric bypass eating plan