Gastric bypass is a surgical treatment approach to help obese patients reduce their weight. However, some patients still experience significant weight gain after this surgery. Surgery for gastric bypass revision may be an option in certain cases.
Weight Gain after Gastric Bypass Surgery
The most common type of bariatric surgery, known as the Roux-en-Y gastric bypass, takes a small section of the stomach and attaches it to the small intestine directly. By creating this bypass around the whole stomach and duodenum, calorie and fat absorption is drastically reduced, resulting in lost weight over time.
When a patient continues to gain weight after a gastric bypass surgery, several factors should be considered as the potential cause. While it is possible for patients to develop a gastro-gastric fistula — a fissure that unexpectedly connects the stomach and intestine outside of the surgical bypass — or experience other atypical, anatomical issues related to the surgery, weight gain is more likely to be caused by lifestyle factors.
Weight loss surgery like a gastric bypass requires a patient change a lot of their eating habits and become more aware of their food intake in both nutrient quality and calorie quantity. This can be a difficult transition for some patients, especially when their mental health needs are untreated or if their finances negatively impact their ability to shop for and prepare more nutritionally appropriate foods.
Before investigating the viability of a gastric bypass revision, doctors may consult with their patient about eating behaviors and other lifestyle factors to determine if these are the primary cause for weight gain after a gastric bypass. Further diagnostic tests may be necessary if physical complications after a gastric bypass are suspected.
Benefits and Risks Associated with Gastric Bypass Revision
As with any surgery, there is an increased risk of infection due to the invasive nature of the procedure. Post-surgical pain is also possible, though it can often be controlled by prescription or over-the-counter painkillers according to the patient or doctor’s preferences.
Gastric bypass revisions can be performed a few different ways, including accessing the surgical site through the mouth or an abdominal incision. The specific cause of weight regain after a gastric bypass surgery will typically determine the best approach for a revision. Other health factors may also play a role in which procedure a physician chooses.
Successful gastric bypass revision should help patients resume the weight control plan they had after their initial gastric bypass surgery. Other than normal restrictions to diet or exercise related to recovering post-operatively, no additional changes should need to be made to the types and amounts of foods they can eat after the first gastric bypass.
It is possible for a gastric bypass revision to fail if a patient continues to experience the same anatomical complications as before, or if they are unable to adhere to the changes their diet and lifestyle require in order to reduce and maintain their weight. A physician can help a patient understand their risks and reaffirm the most appropriate lifestyle choices for weight reduction going forward.
Medicare Coverage for Gastric Bypass Revision
Certain recipients who satisfy Medicare’s requirements for coverage of bariatric surgeries like the Roux-en-Y gastric bypass may also be covered for a revision with their Medicare benefits. To be eligible for coverage for the initial gastric bypass surgery, medical records must show that a patient has been classified as morbidly obese for five years or more. Additionally, documentation that conventional weight loss methods have failed is also required.
Your doctor must show that a gastric bypass is medically necessary and that you pass a psychological assessment that evaluates your likelihood of successful weight loss after the surgery. Diagnostic labs that establish no other treatable physiological factors play a role in a patient’s obesity are also required. Similarly, Medicare benefits for a gastric bypass revision also require proof of medical necessity and a patient may be asked to undergo additional psychological and physiological diagnostics to address any non-surgical approaches to treatment.