Understanding Gastric Bypass Surgery for Teens

Gastric bypass surgery (Roux-en-Y gastric bypass) is a type of weight-loss surgery. This procedure makes changes to the digestive system. These changes help with weight loss by limiting the amount of food the stomach can hold.

During gastric bypass surgery, part of the stomach is closed off to make a small pouch. This pouch is the new, smaller stomach. This surgery also reroutes food from the stomach pouch to the middle of the small intestine. This reduces the amount of nutrients and calories that are absorbed from food that is eaten.

If your teen has been struggling with being severely overweight or obese, this surgery may be an option for them. Talk with your child’s healthcare provider. It’s important to know that gastric bypass surgery is not a quick fix. Your teen will have to commit to making lifestyle changes. They will have to learn new ways to eat and drink after this surgery. And they will have to take nutritional supplements.

Why gastric bypass surgery is done

This surgery may be advised for teens and adults who are severely overweight or obese who have tried other methods to lose weight. Getting to a healthier weight is helpful because obesity is linked to long-term (chronic) health problems such as:

• Type 2 diabetes

• High blood pressure

• High cholesterol

• Sleep apnea

• Heart problems

• Joint problems

Is gastric bypass surgery right for your teen?

In general, weight-loss surgery may be advised for teens about age 13 and older who meet certain criteria and who have either:

• A body mass index (BMI) of 35 or higher (or 120%) and health problems linked to obesity, or

• A BMI of 40 or higher (or 140%) and no other health problems

To be a candidate for this surgery, a teen should also:

• Be mentally and emotionally mature

• Understand and be ready to commit to making diet and lifestyle changes after surgery

• Have support from their family

• Not have an untreated eating disorder or mental illness

• Not be pregnant or breastfeeding

• Not have a substance use problem

How gastric bypass surgery is done

In most cases, this surgery is done laparoscopically. This means it uses very small cuts (incisions). Tiny tools are put into these incisions. These include a small video camera (laparoscope). The video images are displayed on a screen to help guide the surgeon.

The surgery may take about 2 hours. In general, here is what you can expect during the procedure:

• An IV (intravenous) line is put into your teen’s arm or hand. They will be given medicine (general anesthesia) through the IV, and a breathing tube will be inserted. This makes them sleep during the surgery.

• The surgeon will make several small incisions in the belly. They put tiny tools into these incisions

• The surgeon separates the stomach into 2 parts. They create a small pouch at the top. This pouch becomes the new stomach. It can hold only about 1 ounce of food.

• The surgeon then links the middle part of the small intestine to the pouch. Food will then travel from the small stomach pouch directly into the middle of the small intestine. It will go around (bypass) a large part of the stomach and the first part of the small intestine.

• The small incisions are closed with stitches or surgical glue. They are covered with bandages.

Risks and possible complications of gastric bypass surgery

As with any surgery, there are some risks. The possible risks for this surgery include:

• Bleeding

• Infection at the incision sites

• Blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism)

• Lack of certain vitamins and minerals

• Food moves too quickly from the stomach to the small intestine, causing nausea, abdominal cramping, and diarrhea (called dumping syndrome). If food is eaten too quickly, vomiting may occur.

Adolescent females should avoid pregnancy for 12 to 18 months after the surgery. Talk to your healthcare provider about preventing pregnancy and effective contraception both before and after weight loss surgery.

The emotional aspect of this surgery is important as well. It may be helpful for your teen to find online or in-person support groups and connect with others who have had this surgery.