In the United States nearly 500,000 people this year will undergo surgical intervention for the treatment and prevention of their life threatening medically diagnosed morbid obesity. According to the American Society for Metabolic and Bariatric Surgery about 15 million people in the United States suffer from morbid obesity; yet only 1% of the clinically eligible population is being treated for morbid obesity through bariatric surgery. Surgical intervention has been shown to achieve long-term weight control for severely obese individuals.
Morbidly obese people considering bariatric surgery typically have three surgical procedures to consider when discussing weight loss surgery with their doctor: gastric bypass, gastric banding and gastric sleeve. Gastric Bypass Surgery is the most commonly performed weight loss surgery in this country and is considered a malabsorptive procedure.
Generally speaking malabsorptive procedures reduce the size of the stomach with staples creating a pouch in which a small amount of food is held following eating. Part of the stomach is removed or detached and therefore bypassed which results in fewer calories from food being absorbed and stored by the body as fat. Patients can expect to lose an average of 77% of excess body weight and most report an improvement in health conditions such as back pain, sleep apnea, high blood pressure, diabetes and depression as a result of weight loss.
Certain risks are associated with bariatric malabsorptive procedures including dumping syndrome. Gastric Dumping Syndrome, or rapid gastric emptying, is a condition where ingested foods bypass the stomach too rapidly and enter the small intestine largely undigested. To manage this food the pancreas' releases excessive amounts of insulin into the bloodstream and the body experiences the symptoms of hypoglycemia. The syndrome is most often associated with malabsorptive gastric surgery, specifically gastric bypass surgery. Symptoms of dumping syndrome may manifest immediately after eating or within three hours of eating. Symptoms may include nausea, vomiting, bloating, cramping, diarrhea, dizziness and fatigue. Symptoms do subside as insulin levels return to normal. Many patients experiencing dumping find comfort in lying down or sipping on fortified water or energy drinks served at room temperature.
Not only is dumping syndrome physically uncomfortable it can be unpredictable and embarrassing. Patients report suffering dumping episodes on things that they had eaten previously and tolerated well. One patient reportedly said, "It is like an entity all its own: one day I eat all of my regular food and I'm fine but the next day same food and I'm sick with dumping. I just don't get it." Many patients experience profuse sweating which can be embarrassing and difficult to explain to those unaware of the condition. At other times a patient may suffer from confusion and become disoriented which may appear as intoxication to someone unaware of the condition.
Gastric bypass patients may successfully avoid dumping syndrome by eating a diet of carefully chosen lean protein combined with low glycemic fresh fruits and vegetables. Patients are instructed to avoid simple sugars, simple carbohydrates and high-fat carbohydrates and to avoid drinking liquids with meals. At the onset weight loss surgery patients, regardless of the procedure, are instructed to eat a high protein diet following surgery.
Bariatric patients who undergo gastric banding, also called lap-band surgery, and gastric sleeve (vertical gastrectomy) are not affected by dumping syndrome. Banding and sleeve procedures are not considered malabsorptive procedures. However all bariatric patients are advised to develop prudent dietary strategies in an ongoing effort for weight loss, weight maintenance and overall good health.